Transplant
During hospitalization for the transplant, the child
is cared for by a team of pediatric specialists and the
kidney transplant surgical team. Daily transplant rounds
include an attending pediatric nephrologist, pediatric
nephrology fellow, pediatric residents, an inpatient
dietician, nephrology social worker, pediatric pharmacists,
and a nephrology clinical nurse specialist. Child
life specialists provide child-centered education on the
surgery, incisions, and pain, and they address concerns
or fears the child may have. At the time of transplant,
the PNP assembles an immunosuppression
regimen and tapering schedule for the pharmacists and
medical staff. The immunosuppression plan is developed
before the transplant and is based on the results
of immunogenetic testing, age of the patient, type of
transplant, and history of previous transplants. The PNP
develops an individualized outpatient plan that includes
outpatient visits for 6 months, the surveillance biopsy
schedule, and home care instructions that include specific
symptoms and reasons to call the PNP or on-call
physician. The PNP is in daily communication with
the inpatient team regarding readiness for discharge or
posttransplant complications that require intervention.
However, at our center, the focus of our PNP practice
is the pretransplant workup and the outpatient followup
care of pediatric kidney transplant recipients.