Recipient Clerking

Recipient Clerking Date:

Name:

Age:

I/C:


Occupation:

Referred by:


ESRD


Primary Etiology:

Duration:

Mode of RRT

Stab PD:

IPD:

CAPD:

HD: Place of HD: Vascular access:
Previous Femoral catheterization:

Surgical History:

Previous Op:


Other Medical Problems:

1. 2.

3. 4.

5. 6.

7. 8.



Dry Wt:


Residual Urine Output:


Uro-Nephro conference:


Renal transplant date:


Allergies:

Op site:

Latest Medications:







Work-up

USG
1. Native kidneys
2. Doppler Femoral Vessels

IVU

GFR DTPA



GFR Cr EDTA



Cardiac Assessment
1. Chest X Ray
2. ECG
3. Echocardiography
4. Exercise Stress Test
5. Coronary angiography


Lung Function Test


HLA, Cross match results




Psychiatry assessment


Blood Ix

Infectious screen

HIV- Hep B- Hep C- VDRL- CMV-

HSV- EBV- VZV- Toxo-


Urine FEME


Urine Cysteine


24h urine protein


24h urine urate


24h urine calcium


24h urine phosphate


24h creatinine clearance


Renal Angiogram

Plan:-

Pre-transplant investigations:

Renal Profile

Ca PO4

LFT

RBS

FBC

PT/PTT/INR

Urine C&S

Swab C&S

Nasal

Throat

Ear

CXR

ECG

GXM 4 pint PC

Tacrolimus Level


Consent

Informed consent for Blood transfusion


Prophylactic Antibiotic
IV Cefuroxime 750mg TDS

Medications:

IV Hydrocortisone 200mg IV stat on call to OT
Then IV Hydrocotisone 200mg TDS

IV Methylprednisolone 500mg at anastomosis

Tacrolimus 0.2mg/kg/d in 2 divided doses (0.3mg/kg/d for cadaveric transplant)
ie

Tacrolimus level daily
Tacrolimus level
<6months: 10-15 ng/ml 6 months or more: 5-10 ng/ml Mycophenolate Mofetil 1g BD IV Basiliximab 20mg on call to OT (Day 1) and Day 4 Day 1: Day 4: IV Ranitidine 50mg TDS

Cyclosporin
Living related 8mg/kg/day x 5 days
Cadaveric transplant 10mg/kg/day

Post Operative Care

• Isolation nursing until tubes/drains removed
• Proper hand washing before and after examining patient
• Hourly Input/Output charting
• Daily Weight
• RP BD for 2 days then,
• Daily RP, Ca, PO4, FBC, LFT, Urine C&S
• Intravenous Fluids
o Replace with previous hours’ urine output
o Use Normal Saline alternate with D5%
• CXR post op
• Daily Tacrolimus Level
• USG Doppler Appointment
• DTPA Scan Appt
• Syr Nystatin 250,000uto gargle and swallow QID for 3 months
• T. Bactrim 480mg dly when renal function normalized