For what I do, for liver, intestine, kidney, if you’re a small child, you end up in the ICU. All the livers and intestines end up in the ICU for at least a day or two. If there’s good organ function, then the post-op course is going to be pretty smooth: they usually spend a few days in ICU, and then up to the floor for another week or two, and then home. But obviously, there is a high rate of complications in transplants, so whatever comes up, we deal with it as best we can.

Heung Bae Kim, MD, Surgical Director for Liver, Intestine, and Kidney Transplant Programs, Director of the Pediatric Transplant Center

 

After transplant, there’s a whole new set of medications that the family needs to learn, so we’re doing lots of teaching every day. Our transplant nurses and our transplant pharmacist do that inpatient teaching, so the families (and the children if they’re old enough) get to know what their meds are, what they do, what the doses are, and we sort of give the family a quiz to make sure that they’re really ready. Other than medication, we need to make sure their fluid intake is adequate. Additionally, we need to make sure that the drug levels in their body are appropriate as well prior to discharge.

We make sure the family has extra support if one of the family members is the donor. We never expect the donor to have the responsibility of doing the teaching in-house because they’re healing and getting better, but there’s always support people involved to help the other parent or other family member do the teaching and learning.

Rachel Blumenthal, RN, BSN, CNN, Transplant Coordinator, Kidney Transplant Program

 

How do you know when a family is ready to go home?
The younger children tend to go home after about two to three weeks on average, and the older kids tend to go home within about a week to ten days. If we do a living donor transplant, the donor usually goes home after about two or three days.

We know they’re ready to go home when they’re drinking more than at least their minimum, they’re taking their meds and knowing their meds, their drug levels are therapeutic and overall, by the time they’re ready to go home, they’re feeling pretty well.

Courtney Loper, RN, MSN, CPNP, Transplant Coordinator, Kidney Transplant Program