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SW Transplant

Post operative responsibilities

Call consultant nephrologist on call with any questions

Ensure patient is intravascularly well filled

  • Note volume of fluids given intraoperatively
  • Ensure CVP 10-15
  • Correct low CVP with 50% normal saline / 50% colloid (Gelofusin)
  • Monitor O2 saturations. Check CXR

Ensure patient is not hypotensive

  • Aim for BP above 120/60
  • Maintain CVP 10-15
  • Evidence for cardiac problem (Check ECG/troponin)
  • Evidence for bleeding (Check Hb / drains / abdomen)

Fluid replacement

  • Alternate 5% glucose and 0.9% NaCl
  • Give urine output + 50ml on hourly basis for first 24 hrs
  • Discuss need for transfusion with consultant

Oliguria

  • Ensure CVP 10-15
  • If good CVP and oliguric give furosemide 100mg iv
  • If remains oliguric ensure fluid replacement is urine output + 50ml /hr
  • Ensure bladder catheter patent
  • Arrange US scan to ensure renal transplant perfusion

Blood tests

  • Repeat U&Es and FBC at 4 and 12 hrs post operatively then daily
  • Take blood for tacrolimus or ciclosporin levels on Monday , Wednesday and Friday

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