1.

2. Case 1:Bumpy Road Transplantation
3. 51 years old female
ESRD for one year and then on HD 9 months before transplantation
House wife has 6 children all are well
Had blood transfusion at time of dialysis
Known hypertensive for 13 years and was on regular medication not diabetic
No family history of renal disease or other relevant diseases
She was accepted for kidney transplantation .
4. Assessment
CVS
ENT
Obstetric
Surgical
Psychological
All no contraindication to transplantation
5. Examination
At time of transplantation 21st-23rd of December 2008
BP 130/85
Pulse 80 reg normal
Not pale
CVS , RS , Abd , LL ,Locomotor all no significant finding
AVF
Counseled for transplantation
Admitted to hospital for pre-transplant testing and final cross-matching to be transplanted on 23/8/08
Treatment for transplantation started 2 days before surgery
6. 22/12/08
Hb 51%
Urea 66 mg/dl
Cr 4 mg/dl
Alb 3.5 mg/dl
LFT normal
EF 54%
Patient stable with no complaint
Had dialysis 48 hrs ago
Ready for RXT
7. Donor
Her daughter
No significant history of note
Normal examination
Primary and final cross-matching ve
HLA 1/1/0 mismatches
Donor discharged after surgery in good condition
8. Treatment
She is on :
Diltiazem60 mg tds
Oscal , one alpha
Atorvastatin 20 mg
Eprex and iron dextran
Regular HD
9. Methylprednislone500 mg theatre
Prograf5/5 mg
Imuran 100 mg/day
Prednisolone 20 mg/day
Aciclovir 400 mg/day
Fortuminj1 gmbd
Fluconazol 50 mg/day
Pantoprazol40 mg/day
Charts of follow up
10. What do you think
11. 23/12/08 24/12/08 (day 0 1 )
Patient transplanted with immediate function
Prograf level 33 ng/ml
Output reasonable
12. 25/12/08 26/12/09 (day 2 3 )
Needed lazix for urine output