keep him healthy enough for the actual problems, and to learn methods of in 400,000 is truly tissue compatible."
transplant. coping with the problems. Compatibility is based on several  
Even after the operation, their Her work with the family is scientific determinants especially the  
involvement never stops. The nurse especially important because, usually Human Leukocyte Antigens (HLA). i
will follow the patient through the the donor with the best tissue match is a HLAs are attached to white blood cells t
transplant clinics and provide a 24-hour sibling. "We have to look at the and are more difiicult to match than
call service for them. Most patients will motivation," Hughes explains. "There red cells. Perhaps eight to ten tests are I
come to the clinic at least twice a year can be spoken or unspoken pressures to required to match red blood cells but
for the rest of their lives. donate from other members ofthe over 250 may be necessary to match ,
As of this year, the nurses are family, but the potential donor may not white cells. These tests can take from l
following nearly 160 new referral want to. It may not be feasible or three and a half to four hours and must  
patients waiting for a transplant and possible to use a live donor in some be done separately for each potential -
over 400 who have already had the circumstances. Everyone needs to donor. l,
operation. "It can be frustrating express their feelings and work Usually a sibling will turn out to be a
because of the heavy work load but we them out." near perfect HLA match. If the sibling
have a positive attitude because we · The social workers, like the nurses, becomes the actual live donor, the
. have a better success rate," Brown spend so much time with the patients patient’s chances of accepting the l
I says. "Our clinics are full of successes. that they become involved with them. kidney are around 90 percent or  
It’s very satisfying." Patients who have had a transplant 10 greater.  
According to Bruce A. Lucas, M.D., or 13 years ago will still drop by to see Perfect matches are not always ll
Y chief renal transplant surgeon, the Hughes. possible, however. According to I
nurse coordinators are the key elements According to Hughes, one of the Thompson, in the case of cadaver
in the integration and continuity of care biggest challenges she has after a donations, the laboratory tries to get
, for the patient. "They are most transplant, is helping the patient not to the closest match that can be achieved.
. important to a successful program." view himself as sick. Some are afraid to "The one year survival rate for cadaver
  SOCIAL WORKERS work because they think it will cause kidneys is 89 percent at the University l
1 Besides the nurse Coordinators, the rejection. Hughes refers these people of Kentucky. The three year rate is  
. next people a prospective patient will tothe rehabilitation counselor, Jo 83-84 percent. But both are well above
· become involved with are the renal Kirkland, who can train them for new the national averages, ’ Thompson
_ Social workers. work 1f necessary. H indicates. l ·
Shirley Hughes, M·S.W" has been As Hughes states, The doctors The fact that finding a good tissue i
at the UK Chandler Medical Center address the medical and renal match 1S so difficult is the reason some  
\ for 13 vcars listening and Caring for problems. The social workers address patients stay on the waiting list longer ,
. pmicms with cud Stage renal disease' the social and psychological problems; thanothers. But Thompson believes
Q It is hcl.jOb’ along   Joni Johnson, E.V€I`y{hl1'1g 1S 1l'l']pOI‘{21I1[ to {l'1€ [Cam. W3.1UHg 1S pI`€fi€I“3Dl€ to t1'1lSI'l'12t[(?lC11I‘1g
to identity and work with the Tissue TYPING LAB “%‘l‘°’“_ th° Pauem IS MPICUY fa‘h“€ On
psychological and social problems that The survival rates for kidney dlall/SIS'
develop with such a disease. transplants have been steadily rising TRANSPLANT NURSES
"These people are always anxious," over the years due, in part, to the more After the actual transplant operation,
Hughes says. "First there’s the fear of complex series of tests for matching the persons most directly responsible _
dying and if they get a transplant, then donors and recipients. John S. for the care of the patient are the renal ,
there is the fear of rejection. They Thompson, M.D., professor and transplant nurses. Juanita Burchett is i
never are able to settle their emotional chairman of the Department of one of them.
state." Medicine and co-director with Darryl “Our patients must learn to take i
Hughes secs her role as one of Jennings of the Tissue Typing Lab, care of themselves," Burchett says. {
counseling and teaching. Her input has been directly involved in these "We give them the rationale as to why ,
into the renal transplant team is to new tests. they have to do what they do." i
evaluate whether a person is "We can have a definite impact on The nurses begin instructing the y
emotionally and socially capable of kidney success by matching," patients even before the operation.  
handling a transplant or dialysis. She Thompson says. "However, only one They make sure that all the necessary I
works closely with the patient and his I ~ tests have been run before the l
family to overcome fears, spot potential t  .   `` L transplant. After the operation, the l
 ’ f  H;   teaching aspects get more intense. l
-  {gr  _ > A patient will need from 20 to 25
  pills a day. The nurses must not only ,
V '‘'‘ “   \ show the patient when to take the
"’°"" medication but also why each pill is j
necessary and its proper name and ,
dosage.
The nurses also instruct the patient
in the care of his incision. Patients must ‘
know how the incision feels and the
l0 UK