Kidney transplantation involves transplanting a kidney from a living or deceased donor to a patient with end-stage renal disease. It has become the preferred treatment for most patients with kidney failure as it allows patients to avoid dialysis and improve their quality of life. The success rate is highest for transplants from living donors who are closely matched. The procedure involves removing the patient's native kidneys and surgically placing the donor kidney in the patient's body. Post-operative care focuses on monitoring for rejection and infection while the patient receives immunosuppressive drugs to prevent rejection of the new organ.

1. KIDNEY T
RANSPLANTATION
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.

2. INTRODUCTION
-Kidney transplantation has become the
treatment of choice for most patients with
ESRD.

7. REASONS OF KIDNEY TRANSPLANT
-the desire to avoid dialysis or
- to improve their sense of well-being and
- the wish to lead a more normal life.

8. -Additionally,
-the cost of maintaining a successful
transplantation is one-third the cost of
treating a dialysis patient.

9. definition of kidney transplantation
-Kidney transplantation
-transplanting a kidney from a living donor or
human cadaver
-to a recipient who has ESRD
(End stage renal disease/ CRF).

10. Compatible ABO and HLA
antigens
-Kidney transplants from well-matched living
donors who are related to the patient are
slightly more successful than those from
cadaver donors.
(those with compatible ABO and HLA
antigens)
ABO- Blood grouping
HLA- Human leukocyte antigen

11. PROCEDURE
-The success rate increases if kidney
transplantation from a living donor is
performed before dialysis is initiated.

12. Nephrectomy of the patient’s
-A nephrectomy of the patient’s own native
kidneys may be performed before
transplantation.

13. Placement of new kidney
The transplanted kidney is placed in the
patient’s iliac fossa anterior to the iliac
crest.

14. - The ureter of the newly transplanted kidney
is transplanted into the bladder or
anastomosed to the ureter of the recipient.

16. PREOPERATIVE MANAGEMENT
-Maintenance of patient’s normal metabolic
state
-patient is free of infection,
-preparing the patient for surgery.

17. MEDICAL MANAGEMENT
-performance of complete physical
examination.
-prior Identifying possible complications
after transplantation.

18. Conducting investigations
- Tissue typing,
- Blood typing,
- Antibody screening
- to determine compatibility of the tissues
and cells of the donor and recipient.

19. -Completion of other diagnostic tests.
-Assessment of lower urinary tract.
- psychosocial evaluation of the patient.

20. Nursing Management
-Pre-operative teaching of the patient.
-Explanation of outcomes of the surgery.
-Maintenance of post-operative care.

21. Immunosuppressive Therapy
-The survival of a transplanted kidney
depends on the ability to block the body’s
immune response to the transplanted
kidney.

22. Immunosuppressant agents
-immunosuppressant agents such as
• Azathioprine (imuran),
• Corticosteroids (prednisone),
• Cyclosporine, and OKT-3
• (a monoclonal antibody).
Note:Minimising the doses of
immunosuppressant agents.

23. POSTOPERATIVE NURSING MANAGEMENT
-ASSESSING THE PATIENT FOR TRANSPLANT
REJECTION
-oliguria,
-edema,
-fever,
-increasing blood pressure,
-weight gain,
-swelling or tenderness over the transplanted kidney or graft.

24. Monitoring of blood reports
-blood chemistry tests (BUN and
creatinine)
- leukocyte and platelet counts
Note: Immunosuppression depresses the
formation of leukocytes and platelets.

25. Clinical manifestations of
infection
-Clinical manifestations of infection include
• shaking chills,
• fever,
• rapid heartbeat and respirations
(tachycardia and tachypnea),
• and either an increase or a decrease in
WBCs (leukocytosis or leukopenia).

26. Nursing care
-Monitoring for infection.
-Following aseptic measures while caring
patient.
-Performance of Urine c/s frequently
-Observing wound drainage.
-providing catheter care.
-Minimize hospital/ patient visitors
- Monitoring urinary functioning

27. -Care of patient under haemodialysis.
-Monitoring patient fluid and electrolyte status.
-Assessment of urinary drainage.
-Monitoring intake and output of the patient.
-Checking vital signs.
-Administration of intravenous medications.
-Identifying psychological status of the patient.
-Monitoring and managing potential
complications.

28. -Educating regarding physical exercises.
-Education regarding home and continuous
care.
-Understanding anxiety level of the patient.

29. INSTRUMENTS USED FOR
KIDNEY TRANSPLANTATION

31. Top:
-Webster infusion cannula.
Bottom, left to right:
-2 iris scissors, straight, sharp, 4 inch;
-1 facelift scissors, curved, 7 3/4 inch;
-2 Metzenbaum scissors, curved,7 inch.

32. Webster infusion cannula

34. Left to right:
-2 Metzenbaum scissors, curved, 9 inch;
-1 Potts-Smith cardiovascular scissors;
-and 2 Ryder needle holders, 9 inch.

35. Tip of Ryder needle
holder.

37. Left to right:
A, 2 jeweler’s forceps, and tip;
B, 2 Adson tissue forceps with teeth (1 ×
2), and tip;
C, 2 Gerald-DeBakey tissue forceps, 7
inch, and tip;
D, 2 microdiamond dust ring forceps, 7
inch, and tip.

40. Left to right:
A, 2 Autraugrip tissue forceps, titanium,
and tips;
B, 1 Kay aortic clamp, and tip;
C, 2 Cushing vein retractors, and tips;
D, 1 nerve hook, dull, and tip;
E, 1 bulldog clamp applier, and tip;
F, 1 Lahey gall duct forceps, and tip.

44. Left center and clockwise:
-A, 1 Backhaus towel clip;
-B, 4 Hartmann mosquito forceps, curved,
and tip;
-C, 2 microdiamond dust needle holders, 6 1/4
inch, and tip;
-D, 2 Fell carbon inlay needle holders,
6 inch, and tip.

45. Thanking you