Anita Boswell
Transplant Renal Nurse, Nottingham
City Hospital
Transplantation is the
preferred option for treatment of end stage kidney disease. With the
introduction of more potent, newer immunosuppressive regimens long-term graft
function is becoming more achievable in the majority of patients. However some
of these drugs are associated with a number of unwanted side effects, which may
have a negative impact on patients’ perceived quality of life following transplantation.
In a recent purpose designed survey
investigating side effects of immunosuppressive therapies and how they impact
on quality of life issues we found that excessive hair growth, weight gain and
gastrointestinal (GI) symptoms were the most common seen. In particular GI side
effects such as diarrhoea, indigestion, nausea and vomiting had an overall
negative impact on quality of life issues.
With the
evolution of the specialist transplant nurse practitioner role and the
introduction of nurse led clinics it has enabled us to provide a holistic care
approach. Transplant follow up care has moved on from monitoring of graft
function and drug monitoring to include management of long term drug side
effects, compliance of therapeutic regimens, disease prevention and health
promotion. Alongside this we need to consider quality of life issues such as
the ability to work, formation of intimate and social relationships and overall
psychological well-being.