Nursing problems in the care of patient with heart failure after heart and kidney transplantation — a case report

Abstract

Heart transplantation is an effective treatment for end-stage heart failure. Long-term survive is still limiting due to infections, the risk of cancer and damage caused by the toxicity of immunosuppressive drugs, especially renal failure caused by calcineuryn inhibitor. A selected group of recipients is qualified for renal replacement therapy, including kidney transplantation. The condition after kidney predisposes to heart failure. There was analyzed a case of a 50-year-old patient after a heart transplantation in 1995 and double kidney transplant (2009, 2013), with right-sided heart failure due to the presence of thrombus. During hospitalization, the patient developed acute kidney failure and urinary tract infection. Based on an analysis of medical records and nursing observation emerged the most important issues in nursing: a threat to life caused by heart failure, hypotension, acute injury of the transplanted kidney, the risk of rejection of transplanted hearts and kidney, anxiety, urinary tract infection. Implemented nursing interventions erode the negative effects of diseases and medical activities and prevent possible complications. The patient was discharged home with restored renal graft function and a stable cardiovascular system. The echocardiographic examinations were not visualized thrombus.