What do you need to teach W.V. regarding therapy with mycophenolate?

W.V. is a 51-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease 15 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or a cadaver kidney. He recovered without complications, and his serum lab values returned to normal. He started immunosuppression therapy with prednisone and tacrolimus before his discharge to home. True or False? During transplant surgery, the old kidney is surgically removed and the new one is sewn in its place. Defend your response.

What are the collaborative care options to save the kidney if rejection is present?

W.V. is a 51-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease 15 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or a cadaver kidney. He recovered without complications, and his serum lab values returned to normal. He started immunosuppression therapy with prednisone and tacrolimus before his discharge to home. If W.V.s kidney is producing enough urine and he is feeling well, why is ongoing lab monitoring necessary?

W.V. is a 51-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease 15 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or a cadaver kidney. He recovered without complications, and his serum lab values returned to normal. He started immunosuppression therapy with prednisone and tacrolimus before his discharge to home. Why are kidney transplants done?

W.V. is a 51-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease 15 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or a cadaver kidney. He recovered without complications, and his serum lab values returned to normal. He started immunosuppression therapy with prednisone and tacrolimus before his discharge to home. Name 4 ways in which W.V. might have difficulty adjusting after an organ transplant.

WV. is a 57-year-old man who lives with his wife and two teenage sons. WV. developed chronic kidney disease 20 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. WV. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or cadaver kidney. He recovered without complications, and his serum laboratory values returned to normal. He was placed on triple immunosuppression therapy, including prednisone (Deltasone), cyclosporine (lmuran), and tacrolimus (Prograf), and was discharged to home.
Why must W.V. be concerned about infection?

W.V. is a 51-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease 15 years ago after using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for 5 years before receiving a cadaveric transplant, or a cadaver kidney. He recovered without complications, and his serum lab values returned to normal. He started immunosuppression therapy with prednisone and tacrolimus before his discharge to home. By what criteria was W.V. considered a suitable candidate for a kidney transplant?

Today, W.V. reports to his physician for a 12-week follow-up. W.V. has gained 5 pounds since his last appointment 2 weeks ago.
What is the possible significance of WV's BP?

W.V. is a $57$-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease $20$ years ago after he developed acute kidney disease from using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for $5$ years before receiving a cadaveric transplant, or cadaver kidney. He recovered without complications, and his serum laboratory values returned to normal. He was placed on triple immunosuppression therapy, including prednisone (Deltasone), cyclosporine (Imuran), and tacrolimus (Prograf), and was discharged to home.

Today, W.V. reports to his physician for a $12$-week follow-up. He returned to work $3$ weeks ago. W.V. has gained $5$ pounds since his last appointment $2$ weeks ago.

$$\begin{aligned} &\text { Vital Signs }\\ &\begin{array}{ll} \text { Blood pressure } & 148 / 82 \mathrm{~mm} \mathrm{Hg} \\ \text { Pulse rate } & 88 \text { beats } / \mathrm{min} \\ \text { Respiratory rate } & 24 \text { breaths } / \mathrm{min} \\ \text { Temperature } & 99.2^{\circ} \mathrm{F}\left(37.3^{\circ} \mathrm{C}\right) \end{array} \end{aligned}$$

$$\begin{aligned} &\text { Laboratory Test Results }\\ &\begin{array}{ll} \text { Creatinine } & 1.2 \mathrm{mg} / \mathrm{dL} \\ \text { BUN } & 22 \mathrm{mg} / \mathrm{dL} \end{array} \end{aligned}$$

By what criteria was W.V. considered a good candidate for renal transplantation?

W.V. is a $57$-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease $20$ years ago after he developed acute kidney disease from using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for $5$ years before receiving a cadaveric transplant, or cadaver kidney. He recovered without complications, and his serum laboratory values returned to normal. He was placed on triple immunosuppression therapy, including prednisone (Deltasone), cyclosporine (Imuran), and tacrolimus (Prograf), and was discharged to home.

Today, W.V. reports to his physician for a $12$-week follow-up. He returned to work $3$ weeks ago. W.V. has gained $5$ pounds since his last appointment $2$ weeks ago.

$$\begin{aligned} &\text { Vital Signs }\\ &\begin{array}{ll} \text { Blood pressure } & 148 / 82 \mathrm{~mm} \mathrm{Hg} \\ \text { Pulse rate } & 88 \text { beats } / \mathrm{min} \\ \text { Respiratory rate } & 24 \text { breaths } / \mathrm{min} \\ \text { Temperature } & 99.2^{\circ} \mathrm{F}\left(37.3^{\circ} \mathrm{C}\right) \end{array} \end{aligned}$$

$$\begin{aligned} &\text { Laboratory Test Results }\\ &\begin{array}{ll} \text { Creatinine } & 1.2 \mathrm{mg} / \mathrm{dL} \\ \text { BUN } & 22 \mathrm{mg} / \mathrm{dL} \end{array} \end{aligned}$$

Identify at least four ways that W.V. might experience difficulty adjusting to his organ transplant.

By what criteria was W.V. considered a good candidate for renal transplantation?

What histocompatibility studies are generally performed before renal transplant, and why are they important?

W.V. is a $57$-year-old man who lives with his wife and two teenage sons. W.V. developed chronic kidney disease $20$ years ago after he developed acute kidney disease from using a drug for migraine headaches that was later shown to cause severe nephrotoxicity. W.V. underwent hemodialysis for $5$ years before receiving a cadaveric transplant, or cadaver kidney. He recovered without complications, and his serum laboratory values returned to normal. He was placed on triple immunosuppression therapy, including prednisone (Deltasone), cyclosporine (Imuran), and tacrolimus (Prograf), and was discharged to home.

Today, W.V. reports to his physician for a $12$-week follow-up. He returned to work $3$ weeks ago. W.V. has gained $5$ pounds since his last appointment $2$ weeks ago.

$$\begin{aligned} &\text { Vital Signs }\\ &\begin{array}{ll} \text { Blood pressure } & 148 / 82 \mathrm{~mm} \mathrm{Hg} \\ \text { Pulse rate } & 88 \text { beats } / \mathrm{min} \\ \text { Respiratory rate } & 24 \text { breaths } / \mathrm{min} \\ \text { Temperature } & 99.2^{\circ} \mathrm{F}\left(37.3^{\circ} \mathrm{C}\right) \end{array} \end{aligned}$$

$$\begin{aligned} &\text { Laboratory Test Results }\\ &\begin{array}{ll} \text { Creatinine } & 1.2 \mathrm{mg} / \mathrm{dL} \\ \text { BUN } & 22 \mathrm{mg} / \mathrm{dL} \end{array} \end{aligned}$$

How would the physician determine whether W.V. was experiencing organ rejection?