History | Examination | Investigations
Particular points of note:
History
- cause of renal failure
- dialysis - type, when commenced
- time of last dialysis –normal target or dry weight
- access and any related problems
- volume of urine output + history of past/present, urinary tract problems
- infections - any recent
- urinary
- CAPD peritonitis/exit site/access related
- other operations
- ischaemic heart disease
- peripheral vascular disease
Recipient blood group, tissue typing and virology (CMV, EBV,HIV, HBV and HCV) must be recorded in the notes.
Donor details should also be included in recipient clerking - age, cause of death, blood group, tissue typing, virology and cross clamp time if known. The transplant co-ordinator will provide this information.
NOTE: Donor confidentiality must be maintained at all times.
Examination
A full physical examination of the patient should be performed and should include observation of:
- fluid status
- peripheral pulses
- abdominal scars/hernias
Investigations
Blood - phone laboratory to alert staff that sample is arriving. Samples must be hand delivered. Dialysis may be required prior to operation depending on this result (if so, repeat U& Es are required 30 minutes following dialysis).
60-70 mls blood required for initial set and should be taken as soon as patient is admitted.
- *FBC -*U&E's + creatinine and glucose
- Baseline calcium/LFT's
- *Clotting screen/INR (if on Warfarin)
- *Blood Group and save
- *Tissue Typing (white clotted bottle for lymphocytotoxic Antibody, plus 5 ml EDTA sample.) see appendix IV*Clotting screen/INR (if on Warfarin)
- Virology - CMV, HIV, HBV and HCV (only if >1/12 since last test, this will be tested the next working day)
- BM test on ward
*Results must be requested as Urgent and be available before theatre.
Chest X-ray
ECG
MSSU - for gram stain and subsequent culture
PD fluid for WCC and gram stain / culture if appropriate
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