Sexual Life, Pregnancy and Counseling After Renal Transplantation

Abstract

Kidney transplantation is considered the gold standard treatment for end-stage renal disease. Transplantation improves sexual health and quality of life by reducing the risk of death and increasing the chances of long-term survival. Approximately 40% of kidney transplant recipients are women and men who are able to become parents. Although kidney transplantation gives hope to kidney failure patients desiring to have children, transplantation brings some difficulties including sexual dysfunctions and unplanned pregnancies. Women receiving immunosuppressive therapy after kidney transplantation can be affected by sexual dysfunction, adverse pregnancy outcomes and breastfeeding concerns, and for men, sexual dysfunctions are common. Patient care and follow-up during the transplant process require a multidisciplinary team approach that includes a transplant surgeon, nephrologist, nephrology and transplant nurses, and organ transplant coordinator. Nephrology and transplantation nurses and other transplantation team members have important responsibilities before, during and after transplantation. To maximize the chances of graft survival and improve quality of life, nephrology and transplantation nurses need to take a holistic approach, and provide the patient with counseling on sexuality and reproduction, and also carefully manage pre- and post-operative care.

Keywords

• Kidney transplant
• Sexuality
• Pregnancy
• Breast-feeding
• Nursing

Böbrek Transplantasyonu Sonrası Cinsel Yaşam, Gebelik ve Danışmanlık/Sexual Life, Pregnancy and Counseling After Renal Transplantation

Abstract

Özet
Böbrek transplantasyonu, son dönem böbrek yetersizliğinde altın standart tedavi olarak kabul edilmektedir. Transplantasyon uzun vadeli sağkalım ile birlikte, ölüm riskini azaltarak cinsel sağlığı ve yaşam kalitesini iyileştirmektedir. Böbrek nakli alıcılarının yaklaşık %40’ını doğurganlık çağındaki kadın ve erkekler oluşturmaktadır. Böbrek transplantasyonu, böbrek yetersizliği hastalarına anne veya baba olmak için bir umut ışığı olsa da transplantasyonun beraberinde getirdiği birtakım zorluk-lar yer almaktadır. Cinsel işlev bozuklukları ve plansız gebe-likler bunların başında gelmektedir. Böbrek transplantasyonu sonrası immünsupresif tedavi alan kadınlarda cinsel fonksiyon bozuklukları, olumsuz gebelik sonuçları, emzirme endişeleri görülürken, immünsupresif tedavi alan erkeklerde cinsel işlev bozuklukları sık görülmektedir. Nakil sürecinde hasta bakımı ve izlemi trasplant cerrahı, nefrolog, nefroloji, transplantasyon hemşireleri ve organ nakil koordinatörü vd. içeren multidisip-liner bir ekip yaklaşımı gerektirmektedir. Böbrek transplantas-yonu öncesi, sırası ve sonrası nefroloji ve transplantasyon hem-şireleri ile diğer nakil ekibine önemli sorumluluklar düşmek-tedir. Nefroloji ve transplantasyon hemşirelerinin hastaya bütüncül yaklaşarak cinsellik ve üreme konusunda danışmanlık vermesi ayrıca greftin sağkalımını ve yaşam kalitesini en üst düzeye çıkarmak için hastanın ameliyat öncesi ve sonrası bakımını yönetmesi gerekmektedir.

Keywords

• Böbrek nakli
• Cinsellik
• Gebelik
• Emzirme
• Hemşirelik

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