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| ===Data Collection for Renal Transplant Patients=== | | ===Data Collection for Renal Transplant Patients=== |
| * If there are no renal transplant patients elsewhere, or if the same information applies to them, this should really be in the diagnosis code page or the overall renal coding considerations page rather than here. Concern is that, if someone asks for this data, no one would look in the HSC collection info to find out what the data means. Ttenbergen 11:16, 2013 January 21 (EST) {{discussion}}
| | see [[Renal Transplant]] |
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| * Patient Type (Registry): Surgical
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| * Admit diagnosis:Pre-Optimization-893
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| * Complication is '''only one of''':
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| **Renal Transplant-living donor-805-04
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| **Renal Transplant-Cadaver donor-805-05
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| *See [[Renal Coding Considerations]]
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| *usually patients are admitted from their home.If the recipient patient is not living in Winnipeg and is receiving a cadaveric donor kidney they may be instructed to go to their nearest hospital and arrangements will be made to transport them to HSC.
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| *The living donor recipients are scheduled by the renal clinic.The clinic will forward this information the week prior to surgery with the names of both the donor and recipient.Living renal transplants are performed on Thursdays and the patients are admitted Wednesday afternoon.
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| *Usually these patients have a co-morbidity of chronic renal failure. These patients are treated with hemodialysis or peritoneal dialysis.Occasionally the patient may receive a transplant before needing dialysis,in that case code chronic renal insufficiency mild or moderate depending on their creatinine.
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| *Once the patient has received a successful renal transplant and is discharged from the hospital,the next time they are admitted to hospital chronic renal failure will not be captured as a co-morbidity unless the transplanted kidney fails to function and dialysis is started again.
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| *Immune compromised renal transplants very occasionally become CMV+ or EBV+. This occurs when the donor is positive for CMV or EBV and the recipient was negative.The blood test is done by the Cadham Lab.The nephologist will document his in the history or progress notes.The transplant recipient will be started on anti-viral medications approximately one week post-op and will continue these medications for six months and in conjunction their immune suppression drug dosage will be titrated lower.
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| *ADL's are to reflect the patient's level of independence prior to surgery (home).
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| *N.B Chronic renal failure patients who receive a transplant that is not successful,cannot have acute renal failure as an acquired diagnosis for our medical collection data program.This might be captured as delayed graft function/renal transplant problems other,or sometimes it is related to acute tubular necrosis and can be proven by renal biopsy. Other problems will be documented by the Nephrologists.Some problems are:
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| **[[ARI]] (364-00)
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| **[[Acute Tubular Necrosis | ATN]] (352-00)
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| **[[ARF (Diagnosis)]] (350 **)
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| ===Renal Donor Patient=== | | ===Renal Donor Patient=== |