Organ transplant and donation

Candidatecy for organ donation

GCS of 5 or less

OR loss of 2+ brain stem reflex

OR family discussion regarding end of life options

call within 1 hr regarding of age or diagnosis - refer all deaths within 1 hr

Legal consent for donor organ?

driver license or online registry

advance directive

living will

Pre-procedure kidney

• Blood from the live kidney donor is transfused into the client receiving the transplant.

• Client receives dialysis within 24 hours of surgery.

• Schedule pre-op labs

• Administer pre-op medications

• Psychosocial support to client

• Education about post-transplant lifestyle

Post-procedure

• Vital signs every 15 minutes, then every hour

• Assess intake and output and daily weights

• Monitor fluid and electrolyte imbalances

• Monitor for signs of infection

• Monitor for early manifestations of organ rejection and other post-op complications

• Assess surgical dressing

• Administer post-op medications

Medications

Immunosuppressants

• Tacrolimus

  • Nursing considerations: monitor for nephrotoxicity, hyperkalemia, neurotoxicity (tremors).  Assess for hypertension.

  • Monitor tacrolimus levels

• Cyclosporine

  • Monitor for nephrotoxicity, hirsutism, gingival hyperplasia.

  • Give medication with food to reduce gastrointestinal upset.

  • Administer medication at the same time each day and ensure consistent food intake. 

  • Monitor cyclosporine levels.

Draw blood levels for both! Don’t take med yet tho

Complications

Rejection: Hypertension, oliguria, fluid retention,

• call provider!