Trasplante renal y rechazo vascular. Papel de enfermería en el tratamiento con plasmaféresis / Kidney transplant and vascular rejection. Role of nursing in treatment with plasmapheresis

La plasmaféresis (PF) es una técnica que se aplica en el servicio de trasplante renal (TR) de nuestro Hospital desde el año 1999, como tratamiento en el TR que presenta rechazo vascular. Este rechazo puede ser de dos tipos: mediado por anticuerpos o mediado por linfocitos T. El tratamiento con PF consigue eliminar los anticuerpos en sangre del paciente, y por tanto puede ser efectiva en el caso de que el rechazo vascular sea mediado por anticuerpos. La técnica es llevada a cabo por la enfermera dela unidad de trasplante. Esta debe conocer la técnica, los parámetros, sus indicaciones y las posibles complicaciones que puedan presentarse. El objetivo principal de nuestro estudio es ver la efectividad del tratamiento con PF y los cuidados de enfermería que se le proporcionan. Se realizó un estudio retrospectivo, observacional y descriptivo en una muestra de 15 pacientes. Los datos estudiados se han clasificado según el perfil del paciente, parámetros de la PF, evolución del TR, cuidados de enfermería y controles analíticos. Los resultados obtenidos demuestran que el tratamiento con PF es eficaz en el rechazo vascular mediado por anticuerpos ofreciéndose además cuidados integrales al paciente trasplantado, ya que la enfermera de la unidad de TR es la responsable de efectuar la técnica (AU)

Plasmapheresis (PPH) is a technique that has been applied in the kidney transplant service (KT)of our Hospital since 1999, as a treatment in KT that presents vascular rejection. This rejection can be of two types: caused by antibodies or caused by T lymphocytes. Treatment with PPH manages to eliminate the antibodies in the patient’s blood, and can therefore be effective when the vascular rejection is caused by antibodies. The technique is carried out by the nurse of the transplant unit. The nurse must be familiar with the technique, the parameters, its indications and the possible complications that may arise. The main purpose of our study is to see the effectiveness of treatment with PPH and the nursing care provided. A retrospective, observational and descriptive study was carried out of a sample of 15 patients. The data studied were classified according to the patient profile, PPH parameters, evolution of the KT, nursing care and analytical controls. The results obtained show that treatment with PPH is efficacious in vascular rejection caused by antibodies, also offering integral care to the transplant patient, since the nurse of the KT unit is responsible for carrying out the technique (AU)

Technical considerations of therapeutic plasma exchange as a nephrology nursing procedure.

In the past, therapeutic plasma exchange (TPE) has had limited appreciation and lacked acceptance as a treatment modality. Jokingly, it has been referred to as a procedure looking for a disease because of seemingly broad historical applications to practice. In current clinical practice, TPE has earned its place as an aggressive therapeutic modality for treating a wide spectrum of diseases and/or syndromes. The acceptance of TPE has coincided with changes in equipment, technology, and the emergence of highly qualified professionals involved in performing the treatments. This article will describe these variables related to nephrology nurses becoming more involved in the use of TPE.