THE ROLE OF THE
NURSE IN RENAL
TRANSPLANTATION
Betty M . Tyman, R.N.
Today, homotransplantation is one of the
most exciting and rewarding fields of medi-
cine. Most of us have pursued with interest the
numerous accomplished procedures which
have been performed throughout the world. In
practically every journal published today,
there frequently appears a paper or summary
directly related to transplant surgery.
In this expanding specialty area, renal
transplants lead the field. Many of the
problems involving renal transplantation have
fortunately been solved. Our most difficult
barrier remains the immunological situation
surrounding physical rejection. The field of
immunology is supported by research teams
and must function as an integral facet of
patient care and the successful transplant
program.
Though the efforts of the Human Trans-
plant Registry, we are aware of over 4,000
renal transplants which have been performed
throughout the world. The program with
which I have been associated as a professional
operating room nurse has been active since
December, 19a,at the Duke University
Betty M. Tyman, R.N., is Assistant Supervisor of
Operating Room Nursing at the Duke University
Medical Center, Durham, North Carolina. She is
a graduate of the Watts Hospital School of Nursing,
Durham, North Carolina, and is currently secretary
of AORN of Tarheels East Chapter. This paper was
presented at the “Teaching Day” sponsored by the
AORN of Upstate New York in Rochester. The
author acknowledges the assistance of Sue T. Cable,
R.N., Head Nurse, Operating Room, Duke and Norma
L. Hams, R.N., Clinical Nurse Specialist for Dr.
Delford L. Stickel, Associate Professor of Surgery,
Duke University Medical Center.
September 1969
Medical Center. Of the 51 patients who
received renal transplants, 33 living donors
and 18 cadaveric donors have been involved.
The nursing care of the critically and
chronically ill patients requires a wide
spectrum of knowledge. There are four clear-
ly delineated phases of nursing which involve
the transplant candidate: 1 ) pre-operative,
2) surgical, 3) post-operative, and 4) reha-
bilitative. The nurse must equip herself with
many facts and principles to initiate this high-
ly coordinated plan of care. We are seeking, as
our final goal, a return to society of a readjust-
ed and rehabilitated human being who, for
many months or years, has constantly lived on
the brink of despair, and even death. Among
her resources, the nurse must be able to rely
on her knowledge of pharmacology, microbiol-
ogy, genetics, and immunology, as well as
basic medical-surgical abilities. She must also
have a full comprehension of psychological
and sociological involvements.
The research phase of transplants involves
the dialysis unit and tissue and leukocyte
matching facilities. Usually, the dialysis
nursing unit is located adjacent or convenient
to the research facilities. These phases of
transplantation are related to the highly
technical aspect of the program and are quite
involved with non-patient specifics. .
Pre-operatively, the patient you will be re-
ceiving into the nursing unit will more than
likely be in a state of either chronic or m e r e
renal failure. This phase of care can often be
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