KIDNEY

TRANSPLANTATION
GROUP 9
SYAZWANIYATI
NURULASMIRA
NUR HAMIZA
SITI NURSUHADA
INTRODUCTION
◦ • Kidney transplant provides better long- term survival
and improved quality of life compared to dialysis.
◦ • Patient survival and transplant success has been
progressively improving over the years.
◦ • Kidney transplant is the treatment of choice for End
Stage Renal Disease (ESRD) in eligible patients.
INDICATION
◦ • ESRD GFR less than 15ml/L.
◦ • MALIGNANCY.
◦ • HYPERTENSION.
◦ • DIABETES MELLITUS.
◦ • GENETIC DISEASES- polycystic kidney diseases.
◦ • METABOLIC DISORDERS.
◦ • CHRONIC RENAL FAILURE (CRF).
CONTRAINDICATIONS
• CARDIAC , HEPATIC AND
PULMONARY
Insufficiency(severe Extrarenal
Disease)
• Concurrent Tobacco Use
And Morbid Obesity Puts The
Patient At Risk For Surgery.
• HIV.(active infection)
• Primary oxalosis.
• ABO incompatibility.
• Cystoxic antibodies against
HLA antigens of donor.
• Active vasculitis or
glomerulonephritis.
• Recent or metastatic
malignancy
• Psychiatric illness including
alcoholism and drug
addiction(Noncompliance)
BENEFITS
 Significantly reduced risk of mortality.
• Life expectancy can triple.
 Reduced risk of heart attack, stroke, heart failure.
 Reduced infection-related hospitalization.
 Improved quality of life.
 More likely to stay employed.
RISKS
 Acute rejection or failure (less with current meds).
 Anti-rejection medication effects:
 Infection
 Some malignancies, ex/skin cancer.
 Increased risk of diabetes,
 high blood pressure, high cholesterol.
 Graft loss over time.
 Overall in eligible candidates, the benefits far outweigh the risks.
THE KIDNEY DONOR
 Living – parents, siblings,
 Cadaver donor
Matching Recipient & Donor
 Highly motivated.
 Excellent medical condition with normal renal
function.
 ABO blood group-compatible.
 HLA-identical or haploidentical with negative cross-
match.
Common Complications of
Transplantation
 Early complications Infectious complications
- Surgical complications - Cytomegalovirus
- Delayed or slow graft - BK virus
function  Malignancy
- Lymphocele Chronic allograft dysfunction
Acute rejection
- Acute cellular rejection
- Antibody-mediated
rejection
Therapeutic Management
Before surgery
• Assess knowledge and reinforce teaching. Discuss concerns about surgery , the organ
donor and possible complications.
• Provide routine preoperative care
1. Pre-op blood
2. Imaging (CT scan, x-ray, ECG)
3. Consent
4. Social welfare
5. Counselor
After surgery

Post Operative Diet:

 Avoid grapes pomegranate and green tea products.

Monitor for kidney rejection .

Complication:
transplant rejection
infection and sepsis
electrolyte imbalances
Iatragenic side effects.