Open Live Donor Nephrectomy

WHAT YOU SHOULD KNOW:

• Open live donor nephrectomy (ne-FREK-to-me) is surgery to remove a kidney. The kidney is then placed in another person who has kidney disease or damage. A person who donates (gives) a kidney is called a donor. The person who receives the kidney is called a recipient. The kidneys are two bean-shaped organs found under the ribs on each side of the upper abdomen. The kidneys remove wastes and other unwanted chemicals from the body. These wastes are flushed out of the body in urine. When kidneys are badly damaged, these wastes build up in a person's body. The waste build-up causes symptoms such as dizziness, headaches, seizures, confusion, fainting, and may even lead to death.
  
  
• To be a kidney donor, you must be in good health, and between 18 and 70 years old. To be a donor, you must know and understand what can happen to you. You must also have thought carefully about giving your kidney to someone else. Your kidney can replace the damaged kidney, and help the recipients body to get rid of wastes as it should. Being a kidney donor may help the person who is the kidney recipient live longer.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Risks with surgery include infection, bleeding, blood clots and trouble breathing. Nerves, blood vessels, muscles, intestines, and other organs may be damaged. Your ureter (tube for urine) may be damaged and cause urine to leak out into your body. Call your caregiver if you are worried or have questions about your condition, treatment, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: Giving a kidney is a serious decision, and you must think about it very carefully. No one should force or pressure you to give your kidney. You must be giving it willingly. Your caregiver will tell you what will happen before, during, and after surgery in words that you know. You will be told what tests, treatments, or procedures may need to be done. Your caregiver will tell you the risks of having this surgery. He will also tell you how your kidney can help someone else. If you have consented (agreed) to giving your kidney, you have the right to change your mind. Before giving your consent, make sure all your questions have been answered and that you understand what may happen.
  
  
• Tests:
  
  
  • Computerized tomography scan: This is also called a CT scan. An x-ray machine uses a computer to take pictures of your abdomen. It may be used to look for changes and problems with your kidneys.
    
    
  • Magnetic resonance imaging: This is also called an MRI. During the MRI, pictures of your kidney and abdomen are taken. An MRI may be used to check around your kidneys for problems.
    
    
  • Renal arteriography: Renal arteriography is done to check for problems with blood vessels in your kidneys. Your caregiver uses a special dye to help blood vessels show up better on x-ray pictures. Tell your caregiver if you are allergic to iodine or shellfish (lobster, crab), as you may also be allergic to the dye used for this test.
  
  
• Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty your bowels.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
    
    
  • Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.

During your surgery: You are turned to your side after you are asleep. Your skin is cleaned and then covered with clean sheets. Your caregiver makes an incision (cut) on your side. The tip of your lowest rib may need to be cut to let your caregiver see and reach your kidney. Blood vessels and tissues are clamped, tied, or cut, and your kidney is removed. Your caregiver checks for problems before closing the incision with stitches and covering it with a bandage.

After your surgery: You will be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to help prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound.

• Activity: Caregivers may help you get out of bed to walk on the same day of surgery, or the day after. Ask caregivers if there are exercises that you may do while in bed. Exercise helps blood move through your body and may help prevent blood clots from forming. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy while standing up, sit or lie down right away and call your caregiver.
  
  
• Diet: You may be able to eat when bowel sounds are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be given ice chips at first, and then liquids such as water, broth, juice, or soda pop. If you do not have problems after drinking liquids, caregivers may then give you soft foods. Some examples of soft foods are ice cream, applesauce, or custard. Once you can eat soft food easily, you may begin eating your usual diet.
  
  
• Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
  
  
• Medicines: Your caregiver may give you the following kinds of medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
    
    
  • Medicines for pain, swelling, or fever: You may be given medicines to treat pain, swelling, or fever while you are in the hospital. These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease, a history of bleeding in your stomach, or any other medical problems. Also tell your caregiver about any allergies you have to medicines. Tell your caregiver about all other medicines, herbs, and supplements that you have taken lately.
    
    
  • Stool softeners: You may be given stool softeners to soften your bowel movements, making them easier to pass.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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