Professional Documents
Culture Documents
Review
Organ donation
A kidney donor describes and reflects on her experience, from her partner's
diagnosis with kidney failure, through assessment to transplantation and recovery
5 key
points
Live donation
addresses the
problem that there
are too few kidneys
available for
deceased donors
Without a
kidney
transplant people
with end-stage
renal failure need
haemodialysis
Research
suggests that
survival rates of
transplanted
kidneys is greater
than those of
cadaveric organs
Polycystic
kidney disease
can profoundly
enlarge the
kidneys, replacing
much of the normal
structure and
reducing kidney
function
Around half of
patients with
the most common
type of PKD will
progress to
end-stage renal
failure
2
3
Nursing is fantastically
rewarding if you get it right
Susan Stewart
p24
On diagnosis,
13 May 2011
During haemodialysis,
9 July 2011
After transplant,
15 December 2011
Normal values
Creatinine (mol/L)
815mol/L
690
124
60-120
Urea
30.1mmol/L
13.8
5.1
2.5-6.7
Potassium
6.2mmol/L
3.6
4.3
3.5-5.0
Haemoglobin
11.3g/dL
10.3
14.1
12-14
Estimated glomerular
filtration rate
6ml/min
52 ml/min
>90ml/min
Treatment
Assessment
Glomerular filtration
rate (ml/min)
Description
90+
60-89
3B
45-59
3B
30-44
15-29
Less than 15 or
dependent on dialysis
Nursing Practice
Review
Table 3. Summary of the investigations in preparation for transplant
Recipient (Howard)
Donor (myself)
Ultrasound of kidneys
Magnetic resonance angiogram (MRA)
Nuclear medicine test for glomerular filtration rate total
function and nuclear medicine test for GFR each kidney
Exercise ECG test
Chest X-ray
Routine blood tests
ABO blood group and HLA compatibility
24-hour urine collection
MRSA swabs
Box 1. resources
A short article by the lead author on her
feelings about being a live donor
www.nursingtimes.net/livedonation
National Kidney Federation
www.kidney.org.uk
Kidney Patients Association
www.britishkidney-pa.co.uk
NHS Blood and Transplant (organ
donation) www.organdonation.nhs.uk
You can join the NHS Organ Donor
register by filling in a form online or
calling the NHS Donor Line on 0300 123
23 23. Lines are open 24 hours per day
all year. Calls are charged at your
contracted rate for local calls.
Nursing
Times.net
Diseased kidneys
Inferior vena cava
Aorta
Ureters
Transplanted
kidney
Transplanted
ureter
Bladder
References
British Transplant Association and Renal
Association (2011) United Kingdom Guidelines for
Living Donor Kidney Transplantation. tinyurl.com/
TTS-living-donor
Gross P, Pistrosch F (2004) Hyperkalaemia again.
Nephrology Dialysis Transplant; 19, 2163-2166.
Hudak CM et al (1998) Critical Care Nursing: a
Holistic Approach. Philadelphia, PA: Lippincott.
Huether SE, McCance KL (2004) Understanding
Pathophysiology. St Louis, MO: Mosby.
Human Tissue Authority (2013) Code of Practice
2: Donation of Solid Organs for Transplantation.
tinyurl.com/HTA-transplant-code
Jacob E (2012) Polycystic Kidney Disease: a
Comprehensive Guide to Symptoms, Treatment,
Research and Support. Silver Spring, MD:
Medifocus.
Kalble T et al (2010) Guidelines on Renal
Transplantation and Kidney Donation. Arnhem,
the Netherlands: European Association of
Urology.
Kindlen S (2003) Physiology for Health Care and
Nursing. Edinburgh: Churchill Livingstone.
Mc Kay DB, Steinberg SM (eds) ( 2010) Kidney
Transplantation: a Guide to the Care of Kidney
Transplant Patient. Thousand Oaks, CA: Springer
Science
National Institute for Health and Clinical
Excellence (2011) Hypertension: Clinical
Management of Primary Hypertension in Adults.
London: NICE. www.nice.org.uk/CG127
National Institute of Health and Clinical
Excellence (2008) Chronic Kidney Disease: Early
Identification and Management in Chronic Kidney
Disease in Adults in Primary and Secondary Care.
London: NICE. www.nice.org.uk/CG73
Peate I, Dutton H (2012) Acute Nursing Care:
Recognising and Responding to Medical
Emergencies. London: Pearson Education Limited.
Papalois VE et al (2000) Pre-emptive transplants
for patients with renal failure: an argument against
waiting until dialysis. Transplantation; 70: 4,
625- 631.
Thomas N (ed) (2008) Renal Nursing. 3rd edition.
London: Baillire Tindall.
l nits focused
U
on case-based
scenarios to
help you transfer
theory into
clinical practice
l ptional extra
O
written activities
enable you to
continue your
learning offline
CPD
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