1. Renal Transplant Patient Education
Prepared by:Menah Sharaf
RN,CNC,RTNU,KFSH&RC

2. Overview
The roll of the renal transplant team in the care of renal patients
The collaboration between the multidisciplinary team in order to deliver holistic care for the renal transplant patient.

3. WHY TRANSPLANT IS NECESSARY
Damage to the kidney can seriously affect the following:
Removal of water and waste products from the body
Production of red blood cells
Regulation of blood pressure and balance of electrolytes such as potassium, calcium and phosphorus.
If the damage is severe enough, transplantation may be necessary. A transplant provides a patient with a kidney that can keep up with the demands of a full, active life.

4. Criteria for accepting patients for renal transplantation
Referral from another institution after determining that renal transplantation is the optimal treatment for the patient
Medical report from the referring institution
Referrals from other departments within our hospital

5. Renal Transplant Program
Surgeons
Operating
Room
Transplant
Nephrologists
I.C.U
B-2 ward
Surgical Nursing
Transplant
Coordinators
OBG/YN
DPC
Renal Transplant
Program
Transplant
Nurses
Immunology
ECHO lab
Cardiac cath
Radiology
Transplant
Social Workers
Dental
Admission
Clinical
Pharmacist
Transplant
Health Educators
Nutritionist
Other referrals

6. Pre-Renal Transplant Education
Pre-Transplant testing and information regarding the patient's overall health status help in identifying potential problems before they occur. They also help in determining whether transplantation is truly the best option for the patient. All of the above increase the likelihood of overall success.

8. Pre renal transplant workup: Recipient
Laboratory investigations including Tissue Typing, Hematology, Serology/Virology, Chemistry, Urinalysis
Chest X-Ray
Abdominal Ultra-Sound
Electrocardiogram (EKG)
Vaccinations (if needed)
PPD Skin Test
Liver Biopsy (as required)
Dental clearance
Mammogram
OB-GYN clearance (females only)
Pre-renal transplant evaluation
Other referrals as needed

9. Pre renal transplant workup: Donor
Laboratory investigations including Tissue Typing, Hematology, Serology/Virology, Chemistry
Chest X-Ray
CT Scan abdomen angiogram
Electrocardiogram (EKG)
Vaccinations (if needed)
PPD Skin Test
Mammogram
OB-GYN clearance (females only)
Pre-renal transplant evaluation

10. Renal transplant committee meeting
Recipients and potential donors will be presented at the Renal Transplant committee
Members of the Committee
Transplant Surgeons
Transplant Nephrologist
Clinical Pharmacist
HLA Immunologist
Transplant Nurses
Social worker
Transplant Coordinator
Health Educator

11. Final acceptance of both recipients and donors will be made during the committee meeting . Any pending issues will be resolved prior to renal transplant surgery

12. Day of Admission 1. Transplant pair admitted to the renal ward.
2. Transplant pair to be assessed by surgeon
3. Pre and post-operative education begins
4. Continuation of health education commenced during pre-renal work-up

13. The Role of the Health Educator in Pre-Operative Teaching
Identify the urinary system location & function.
Understanding renal transplant surgery.
Explains the need for pre-operative preparation.
Understanding the importance of Immunosuppressive therapy & antibiotics.
Understanding post operative expectations.

14. Post Operative Instructions
Understanding the life long commitment of immunosuppressive medication.
Correctly identifying medications {FK,Pred,…..}
Understanding the correct time to take medications

15. Cont Understanding most common side effects.
Proper storage of medications
Appropriate hand hygiene

16. Discharge Instructions
Reinforcing Post Operative Teaching.
Importance of bringing all medications to all clinic visits.
Dietary Instructions.
Exercise .
Hygiene Concerns.
Social Concerns.
Recreation/Work precautions.
Religious duties.
Sexual activity.

17. Health Care After You Leave The Hospital
Monitor urine output daily.
Avoid stopping or changing any medications without consulting a renal transplant physician .
Report any signs & symptoms of rejection or infection to renal transplant physician.
Increase fluid intake.

18. Post renal transplant follow up
Donors will follow–up in the transplant surgical clinic
Recipients will alternate follow–up in both the surgical and the post renal transplant clinic twice weekly with labs for the 1st three months
Months 4 – 6 post transplant, patients will follow–up in the post renal transplant clinic every other week

19. Long term follow up
After the 7th month post transplant, patients will be referred back to the original nephrologist and/or maintain follow-up in our renal transplant clinic as deemed necessary by our transplant physicians.

20. References
Gabriel M. Danovitch. (2005). Handbook of Kidney Transplantation (4th ed.). Lippincott Williams & Wilkins.
American Society of Transplantation: Screening of donor and recipient prior to solid organ transplantation, (2004) American Journal of Transplantation. 4(Suppl 10) (p ). Blackwell Munksgaard.
American Society of Transplantation: Guidelines for vaccination of solid organ transplant candidates and recipients, (2004), American Journal of Transplantation. 4(Suppl 10) (p ). Blackwell Munksgaard.

21. Thank You