Post Date April, 15 2023
Renal transplantation is the beginning of the rebirth of uremic patients. After that, a series of processes can be divided into several stages like human life, and the key content of care in each stage will be different.
According to the current understanding and understanding, kidney transplantation can be divided into the following stages:
1
The first two weeks after kidney transplantation
These two weeks are mainly about the rehabilitation after surgery and the recovery of transplanted kidney function. In these two weeks, we should pay attention to surgical complications such as bleeding, urinary fistula, lymphatic leakage, etc. At the same time, the immunosuppressive agent should be used within this time, and the concentration of immunosuppressive agent should be tested. The wound should heal gradually after the operation, and the suture can be removed about 2 weeks after the operation. During this time, we should also pay attention to the types of immunosuppressants and possible side effects.
Two weeks after operation is also the high incidence of acute rejection. It is necessary to add immunosuppressants in time and measure the concentration to avoid the acute rejection caused by low drug concentration. About 2 weeks after the operation, if the transplanted kidney function recovers well and the wound heals well, the patient can be considered to be discharged.
2
2 weeks to 6 months after kidney transplantation
During this period, the patient has been discharged and lived in a house near the hospital. During this period, the focus is to visit the kidney transplant doctor's clinic regularly, and monitor the drug concentration and various indicators at the same time. The most important is blood routine, including blood WBC count, blood lymphocyte count, hemoglobin, platelet count, blood biochemistry, including liver and kidney function, blood lipids, electrolyte, etc., drug concentration, and urine routine.
During this period, the focus of care is to prevent infection, keep a diary at home, and record the post-transplant diary: weight, urine volume, body temperature, medication and other contents. Meanwhile, prevent rejection. During this period, transplant doctors need to adjust the immunosuppressive drugs according to the patient's situation to achieve the level of non-infection and non-rejection, and the skills can only be expressed in words. The experience of each migration center will be different. The frequency of follow-up during this period is once a week in 3 months and once every two weeks in 3-6 months.
3
6 months to 3 years after operation
If the patient's condition is stable in the past 6 months after kidney transplantation, he will be relatively liberated. Patients can consider returning to their hometown, or returning to study and work. The focus of this period is mainly to prevent long-term complications, prevent the occurrence of chronic rejection, long-term infection such as urinary system infection, skin infection and other complications. At the same time, attention should be paid to monitoring the side effects of various drugs, especially the side effects of immunosuppressants. The frequency of follow-up during this period is once every 1-2 months
4
After 3 years
With the extension of the time of kidney transplantation, the transplanted kidney gradually settles down in the recipient's body. This phase of care focuses on chronic rejection of kidney transplantation and long-term complications such as tumor, osteoporosis, diabetes, hypertension, coronary heart disease, hyperlipidemia and other such complications.
Because these complications will affect the kidney transplant and patient life. Therefore, the immunosuppressive regimen should also be adjusted in time according to the patient's situation. Some patients will have proteinuria and hematuria, which need to consider the recurrence of transplanted kidney disease.
5
5. More than 10 years after operation
This type of patients is similar to those who have been more than 3 years. However, with the extension of the time limit for transplantation, the nervous psychology of kidney transplant recipients will relax, and it is easy to relax their requirements and monitoring, which may increase some corresponding risks.
6
Period of long-term problems in kidney transplantation
This refers to a kind of special situation, mainly refers to the abnormal function of the transplanted kidney, with the clinical manifestations of elevated serum creatinine, proteinuria and hematuria. This period is the period of relatively large adjustment of various immunosuppressants and the most drastic change of human state, so it needs to be specially raised.
This is mainly to prevent the complications caused by excessive use of immunosuppressants, such as various long-term infections, especially severe lung infections. At the same time, pay attention to gastrointestinal tract infection, urinary tract infection, etc. We should take a holistic view of this period. Don't damage the health of the whole body and cause serious complications in order to desperately protect the transplanted kidney. If so, we will lose sesame seeds and watermelon.
