E Nosarzewska, M Kotomska, A Nowak, A Ksit-Bąbel, M Chodorowska-Machnio
Ann Transplant 2009; 14(1): 82-82
Kidney and liver transplant recipients receive immunosuppressive medications to prevent and combat rejection of the transplanted organ. Some degree of deficiency of the immune system affects those patients already in the pre-transplant period, during the end-stage of organ failure, to become a frank immunodeficient state post-transplant, due to anti-rejection medications as well as treatment for bacterial, fungal or viral infections. Some of the above medications, e.g. cyclosporine A, have side effects such as gingival hyperplasia and other periodontal lesions. Inadequate oral hygiene or total lack thereof may negatively affect the transplanted organ's function. The pathological hyperplasia may result in the nearly complete covering of dental crowns by overgrown gingival tissue which negatively inï¬‚uences chewing ability. Insufficient oral hygiene and chronic inï¬‚ammatory periodontal pathologies lead to further hyperplasia. Untreated disease may spread to deeper periodontal structures resulting in the destruction of dental periosteum and bone, eventually leading to tooth loss. Intensive bacterial growth in gingival and periodontal pockets has a negative inï¬‚uence on the transplanted organ and the whole body. A prevention and treatment program for transplant recipients, led by dental specialists, may help to minimize local and general complications. Nursing staff that remains in more frequent contact with the transplant patients, if trained and conscious of possible complications, has the possibility to observe and educate patients, thus preventing the development of pathologies. Nursing competences in the care of transplant patients include independent assessment, planning and implementing nursing care according to the chosen nursing model. An aware and trained nurse providing nursing and hygienic services has the unique possibility to spend more time with the patient, allowing careful observation and anamnesis. This exceptional position in the course of treatment allows for effective nurse-physician teamwork, especially in conditions which limit the time physicians spend with their patients.
Keywords: Liver Transplant