Nursing care for patients with Kidney transplantation
| Site: | EHC | Egyptian Health Council |
| Course: | Nursing Procedures Guidelines for Hemodialysis |
| Book: | Nursing care for patients with Kidney transplantation |
| Printed by: | Guest user |
| Date: | Tuesday, 5 May 2026, 11:38 PM |
Description
"last update: 10 March 2025"
- Prepared by
Under supervision
- Prof. Dr. Mohamed Latif, CEO of the Egyptian Health Council
Dr. Kawthar Mahmoud, Head of the Egyptian Nursing Syndicate - Member of the Senate
Prepared by
|
Title |
Name |
NO. |
|
Dean Of Faculty Nursing, Professor of Medical and Surgical Nursing, Tanta University |
Dr Afaf Abdel Aziz Abdel Aziz Basal |
1 |
|
Professor Of Critical Care Nursing |
Prof.Dr/Zeinab Hussain Ali |
2 |
|
Professor And Head of the Department of Medical Surgical Nursing. Faculty-. Benha University |
Amal Said Taha Refaie |
3 |
|
Supervisor Of the Education Sector at Port Said University |
Amal Ahmed Khalil Morsy |
4 |
|
Professor Of Medical Surgical Nursing- Faculty of Nursing- Cairo University |
Dr. Hanan Ahmed Al Sebaee |
5 |
|
Head of central administration on secondment at MOHP |
Dr Neveen ab drab al0nabi Mohamed |
6 |
|
Director Of Primary Health Care Nursing Department at MOHP. |
Maysa Hosny Ahmed Tammam |
7 |
|
Supervisor Of Technical Education- EHA |
Nancy Alaa Eldeen Abd-Elbaset Ali |
8 |
|
Supervisor Of Nursing Services Development- EHA |
Sherien Mohamed Saad |
9 |
|
Assistant Professor of Maternity and Neonatal Health Nursing - Faculty of Nursing- Ain Shams University |
Assist.Perof. Dr./Heba Mahmoud Mohammed |
10 |
|
General manager of general administration of health institutes affairs |
Dr Mai Galal Ibrahim Al-Assal |
11 |
|
Participants |
||
|
member of the Nursing administration at EHA, port said branch |
Mr. Ahmed Zarq Al-Sayed |
12 |
|
member of the Nursing administration at EHA, ismailia branch |
Mrs. Radwa Al-Sayd Al-Nagdi
|
13 |
|
member of the Nursing administration at EHA, ismailia branch |
Mrs. Omnia Hassan Absi |
14 |
- Kidney transplantation
➡️introduction
Kidney transplantation is the best treatment for chronic kidney failure, as the transplanted kidney performs the functions of the original kidneys, while dialysis plays a limited role in ridding the body of metabolic waste and excess fluids. The operation is performed by a specialized surgical team, and the kidney is obtained from a living or deceased donor. The kidney is usually transplanted in the right lower abdominal cavity, where it is connected to the right pelvic artery and vein, and the ureter is connected to the urinary bladder in an operation that usually takes about three hours. Urine is expected to begin immediately after connecting the kidney taken from a living donor, while the kidney taken from a deceased may need some time to start working fully efficiently. The patient is subject to intensive medical and surgical supervision after the operation to control the percentage of fluids, salts, and immune medications in the blood, and remains in the hospital for one to two weeks. After his discharge, he remains under the continuous supervision of kidney transplant doctors
➡️Get a new kidney
A patient with chronic kidney failure can obtain a new kidney for transplantation from one of the following sources
First: Living relative donors
In order for a relative to be considered a suitable donor, he must meet the following conditions
• To be of legal age, which is (21 years) according to the law.
• To be in full possession of his mental faculties, responsible for his actions, and well-versed in the procedures, results, and even complications associated with the kidney donation process.
• The necessary medical tests and analyses must prove that he is medically fit. It is also important that he does not suffer from any chronic diseases, such as diabetes, high blood pressure, and viral hepatitis.
• To be immunologically compatible according to blood type and tissue analysis results.
Second: Living donors who are not related
A large number of people come to the organ transplant center with their desire to donate one of their kidneys to patients with chronic renal failure. In order for their desire to donate to be approved, the following must be confirmed
• Fulfilling all the conditions mentioned for relative donors
• There is no suspicion of trafficking or taking drugs for money
• The donation should not be made under threat or blackmail
• That the donation be approved by the special committee to interview these donors, which was formed by a ministerial decision
➡️Note
Some people travel to some Asian countries to buy a kidney, but as a result of performing the operation in unqualified centers whose primary goal is financial gain, the resulting complications rate is unacceptable and sometimes dangerous for patients.
Third: Obtaining a kidney from the deceased
Chronic renal failure patients are registered in special lists according to their blood type. When a kidney from a deceased donor is available, a number of these patients are called according to priority to the Organ Transplantation Department, where they undergo a medical examination, as well as some tests and examinations, as well as immunological tests. Patients are selected according to a points system given to patients registered in the waiting lists, taking into account the patient’s age, the period of treatment with kidney dialysis, medical fitness, and tissue compatibility
- Nursing procedures before kidney transplantation
➡️Preparing for a kidney transplant
Kidney transplantation is considered the optimal treatment for patients with chronic renal failure because kidney transplantation
• It gives the patient a longer life span and a better quality of life.
• A less expensive method of treatment.
• It gives them the opportunity for normal physical and mental growth.
• It gives them a better chance of attending school and achieving academic achievement.
• To avoid the repeated suffering (psychological and health) that accompanies dialysis .
➡️Medical procedures that must be completed before kidney transplantation
Obtaining a detailed medical report from the treating physician in the kidney disease unit to which the patient belongs. This report includes the following
• Medical history of the patient referred for kidney transplantation.
• Clinical examination results.
• Laboratory test results, especially hepatitis viral tests.
• Endoscopic examination results of the esophagus, stomach and duodenum.
• Examination of the bladder and urethra with colored rays, and sometimes if necessary, or conducting special tests on the function of the urinary bladder and examination of the bladder with an endoscope.
• Absence of chronic inflammatory focus such as dental caries and tuberculosis (which requires chest x-ray and skin tuberculosis examination).
• Results of tests that indicate the heart’s fitness for kidney transplantation (planning, ultrasound, and nuclear radiation).
• The patient is free from any malignant tumors.
• Breast screening for women over 40
- Nursing procedures during kidney transplantation
The kidney transplantation procedure is performed under general anesthesia and usually takes 3-4 hours. The kidney is placed on the right or left side of the pelvis outside the peritoneal cavity. The blood vessels of the kidney are connected to those in the pelvis, and the ureter of the new kidney is implanted in the patient’s bladder.
➡️The patient stays in the hospital for one to two weeks after the kidney transplant. During which
• Close monitoring of the patient's health condition.
• Giving intravenous solutions of appropriate types and volumes.
• Giving immunosuppressive drugs and adjusting the doses according to the patient's need.
• Monitoring the function of the transplanted kidney.
• Educating the patient about the different types of medications he should take, especially the dosage and time of taking the medication before leaving the hospital.
• After leaving the hospital, the patient must strictly adhere to the outpatient clinic appointments given to him.
• The patient must visit the organ transplant center if he experiences any medical symptom.
➡️Kidney transplant results
Kidney transplantation is currently considered a very successful surgical procedure by all standards for the following reasons:
Surgical complications are few and can be controlled and treated.
The mortality rate associated with the procedure is very low and almost negligible, and this rate does not exceed that associated with any other major surgical procedure.
The success rate of kidney transplantation depends on the source of the transplanted kidney, as the rate is better in the case of kidney transplantation from living donors compared to kidney transplantation taken from deceased people. There is no effect of the patient’s age or tissue compatibility on the success rate in the short term.
- Nursing procedures post kidney transplantation
The patient is given the required solutions
and medications on a daily basis until his condition stabilizes.
- Reducing visits to the patient, while following the instructions of the treating physicians and the nursing staff responsible for the patient, so that he is not exposed to infections and infectious diseases from others, due to his intensive use of immunosuppressive medications, which cause the body’s resistance to these diseases to weaken.
- Some patients require a biopsy of the transplanted kidney when there is a temporary weakness in kidney function, in order to diagnose early cases of rejection or other conditions and provide appropriate treatment.
- When the patient is discharged from the hospital, he is given detailed instructions regarding medications, diet, and appointments for outpatient visits, along with the prescribed sick leave.
- Health education for kidney transplant patients
1. Kidney patients often also suffer from high blood pressure.
2. Therefore, the amount of salt consumed should be reduced, especially that found in canned cheese, processed meats, and ready-made meals.)
3. Also suffers from high blood cholesterol or triglycerides.
4. Therefore, the amount of fats he consumes should be reduced, which is often found in full-fat dairy products, meat, fried foods, chocolate, and nuts.)
5. The rates of diabetes are high in our country, especially since it is one of the main causes of kidney failure. A significant percentage of kidney transplant patients suffer from this disease.
6. Therefore, it is necessary to adhere to a special diet that prevents high blood sugar and, more importantly, prevents the emergence of new cases of those who are predisposed to this disease due to genetic factors or other health reasons).
7.Kidney transplant medications may be responsible for some nutritional problems such as appetite suppression, increased obesity, high blood pressure, and diabetes. This can be controlled by following the necessary diet for all types of these health problems. They may also cause digestive system disorders, resulting in dehydration or malnutrition.
➡️Fasting after kidney transplant
Kidney transplant patients are considered patients, as they need continuous medical follow-up and a special regimen for food, drink, and taking medications. If this regimen is compatible with fasting and his kidney functions are normal, he is permitted to fast, after consulting his treating physician
The effect of fasting on the functions of the transplanted kidney was monitored in a number of patients who wished to fast - after reviewing their health condition - and compared to their counterparts who did not fast, and we did not find any differences between them. This allowed us to identify the conditions that enable kidney transplant patients to fast, which are
• Kidney function must be stable for at least six months before fasting.
• Creatinine level should not exceed 200 micromol/L.
• The number of times any of the essential medications should be taken should not exceed twice a day (i.e. every 15 hours at least).
• Not to suffer from kidney stones or acute or chronic stomach ulcers.
➡️The following must be taken into account:
• Eat the suhoor meal, then take your morning medication 15 minutes before the dawn call to prayer with two cups of water.
• Drink water and dates or a little soup at sunset, then take your evening medication and perform the sunset prayer (to give the medication a chance to settle in the stomach), and then eat breakfast.
• It is advisable to drink plenty of water during breakfast.
• It is recommended to eat a light suhoor meal with a reduced amount of salt and proteins to avoid urination during fasting.
• It is recommended not to eat too much sugar, starch and fat, especially for diabetics, and to eat moderate meals to avoid stomach and digestive system problems.
➡️Sports after kidney transplantation
Kidney transplantation is performed to rehabilitate a patient with chronic renal failure to perform his duties in a normal and easy way and participate in public life effectively. The patient begins to move out of bed on the second day of the operation and upon his discharge from the hospital he walks normally. After three months, he begins to practice sports exercises that gradually increase in intensity until he reaches full athletic activity six months after the operation.
➡️Pregnancy after implantation
Kidney failure often leads to decreased fertility and fertility is not fully restored after transplantation, but a kidney transplant patient can become pregnant and give birth naturally after the transplantation and a period of stability in the medical condition for one to two years after the operation, knowing that there is an increased possibility of kidney rejection with pregnancy and childbirth. This is prepared for by regular follow-up at the women's clinic and the transplant clinic, adjusting medications according to the development of the condition, and taking the necessary precautions before, during, and after childbirth in coordination with the obstetrician and gynecologist.
➡️Protecting the transplanted kidney
A kidney transplant patient must protect his kidney from rejection by
Selecting the most suitable donor whose tissues are compatible with him, and taking kidney transplant medications regularly and regularly, especially immunosuppressive medications, diabetes medications, and blood pressure medications, and medical follow-up at the outpatient clinic according to the scheduled appointments
And to conduct periodic examinations to check the kidney function according to the advice of the treating physician, and to follow his instructions and advice and not to compare his condition to the condition of other patients because the nature of the disease and his condition differ from one patient to another, and not to take any medication or undergo major or minor surgical operations except after consulting him.
- References
◾ Bissonnette, J., Woodend, K., Davies, B., Stacey, D. & Knoll, G.A. (2023) Evaluation of a collaborative chronic care approach to improve outcomes in kidney transplant recipients. Clinical Transplantation, 27(2), 232–238. Available from: https://doi.org/10.1111/ctr.12068
◾ respo, M., Mazuecos, A. & Domínguez-Gil, B. (2021) Global perspective on kidney transplantation:. Kidney, 360, 2(11), 1840–1843. Available from: https://doi.org/10.34067/KID.0002502021
◾ International Council of Nurses. (2020) Guidelines on Advanced Practice Nursing 2020. Available from: https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf [Accessed 14th March 2022].