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TRANSPLANT
Siti husni binti entoh
790210-12-5522
Sem 1 (0kt / 2016)
Explain contraindication for
transplantation
MALIGNANCY
RECURRENT
DISEASE
DM / SEVERE
PREGNANCY CARDIOVASCULAR
DISEASE
MENTAL
DISORDER HPT
DRUG
ABUSE
LIVING RELATED TRANSPLANT
Donor is from a family member e.g parents,
siblings
LIVING NON-RELATED
TRANSPLANT
Donor is patients spouse or friend
CADAVERIC TRANSPLANT
Kidney is taken from a brain dead pt
Recently died from an accident
DEMOGRAPHIC DATA
NAME : MR A
AGE : 19 YEARS OLD
RACE : MALAY
OCCUPATION : SALESMAN
SMOKER : NON SMOKER
YOUNGER BROTHER WITH 2
SISTERS
PARENTS STILL ALIVE
STAYING WITH SISTER @ BUKIT
JALIL
FATHER HYPERTENSION, EX
TEACHER
MOTHER FULLY HOUSEWIFE
PRIMARY DIAGNOSIS
ESRF 2 FOCAL SEGMENTAL
GLOMERULOSCLEROSIS
PRE TRANSPLANT (recipient)
POSITIVE CMV, EBV
FACTOR XII DEFICIENCY WITH
PROLONGED PTT
POST CADAVERIC RENAL
TRANSPLANT
one of the most common causes of
primary glomerular diseases in adults.
The condition causes asymptomatic
proteinuria or nephrotic syndrome with or
without renal insufficiency.
The most common clinical presenting
feature of FSGS (>70% of patients) is
nephrotic syndrome, characterized by
generalized edema, massive proteinuria,
hypoalbuminemia, and hyperlipidemia
FROM 2005 2007
WAS DIAGNOSED AS
FUNGAL PERITONITIS 2007
REMOVAL OF CATHETER
THEN CONVERT TO
HAEMODIALYSIS TILL THE
END OF 2009
Is a progressive, irreversible deterioration in renal
function
MAY BE AT
RISK OF
FORMING
FACTOR XII PLAY ROLE IN
THE
BLOOD CLOT DEFICIENCY COAGULATION
CASCADE
DOES NOT
LEAD TO
ABNORMAL
BLEEDING
8TH DEC 2009 TRANSPLANT DONE
@ HKL
LEFT RENAL ALLOGRAFT WAS
TRANSPLANTED INTO LEFT ILIAC
FOSSA
BIOPSY DONE INTRA OPERATIVELY
A FEW LYMPH NODE IN THE
RETROPERITONEAL REGION WHICH
IS REACTIVE HYPERPLASIA
PRE TRANSPLANT DIALYSIS
CORRECTION OF FLUID & MINIMAL HEPARINISATION
ELECTROLYTE DURING DIALYSIS
IMMUNOSUPRESIVE DRUGS
NURSING
MANAGEMENT
VITAL SIGN
CHECK DIALYSIS HISTORY
ENSURE DRY WEIGHT
ASSESS SIGN OF
OFFER EMOTIONAL INFECTION
SUPPORT
URINE OUTPUT
CONSENT, FASTING,
PROVIDE INFOMATION
BOWERL PREP
MEDICATION ISOLATION HAND
WASHING
INTERNAL J
DAILY IX
STENT
WOUND FLUID
DRAINAGE REPLACEMENT
u/s done
19/1/2010 Slightly dilated tubules, no tubulitis
cushingoid
22/1/2010
Creatinine 113, tacrolimus level height
Iv methylprednisolone for 1 week
Medication Myfortic 360mg bd, aspirin 3 week due to
graft infact (u/s)
11/2/2010 Removal of stent
No other complication detected
18/2/2010
Admitted due to developed urinoma
Pigtail drainage inserted 3/7, then CBD ESBL
Klebsiella UTI, antibiotic started
u/s revealed hydronephrosis & thickened uretherlid
18/3/2010
Weight 36.3kg
Creatinine and tacrolimus within normal range
Residual urine scan 0cc.
11/2/2011
Bp 128/84mmHg
Blood ix done, total white 11.0
Med PCM
Impression : viral fever
ABDOMEN
Graft scar at right illac
fossa region
No tender
Active peristalsis
activity GASTROINTERSTINAL
Peritoneal dialysis scar TRACK
Abdomen pain Abdominal pain
Loose stool
GENETALIA Vomiting contains foods
Able to passing urine with large amount particles
No hematuria no dysuria No blood or mucus
contain
LOWER EXTRIMITIES
No pedal edema
Capillary refill less than 2 sec
AMLODIPINE ATENOLOL 50MG MYCOPHENOLATE
10MG OD OD 360MG
ROCALTRIOL COTRIMAXAZOLE
SLOW K I/I OD
0.25MCG OD 480MG ON