Suggestions

Permission for Use

Kidney Transplant

Evaluation

Hemodialysis Education

By this time Sam had a serum creatinine of 11.8, a BUN of 116, and a hematocrit of 25%. He continued to work, but everything became more and more difficult as his welding job demanded the strength to routinely lift materials over 100 pounds and the patience to supervise many people working under him. He was tired, cold and lacked an appetite. As his kidney function continued to decrease and his anemia worsened, he was placed on Epogen® to help increase his hematocrit prior to surgery.

After the transplant evaluation process was underway, the predialysis educator met with Sam and his wife again to provide information on hemodialysis, and on temporary types of dialysis access to the bloodstream. Hemodialysis is sometimes necessary before and even temporarily after transplant surgery. Self-care types of dialysis were not discussed at this point because it was already known that Sam and his brother, Charles, were well matched for a transplant. Had there been no possible donor for Sam at that time, he would have had to go on dialysis and be placed on a waiting list for a wait for a cadaveric transplant that would match him. The wait can take from six months to two years given the lack of donors and demand for transplants. If this had been the case, Sam and his wife would have received education about both in-center hemodialysis and options that could be done at home such as home hemodialysis or peritoneal dialysis.