Protocolo de evaluación neuropsicológica para pacientes previo a trasplante renal, usuarios del Hospital de Especialidades Teodoro Maldonado Carbo

Abstract

A kidney transplant is not just a surgery, it is a life-changing process for the patient. Chronic kidney disease affects not only kidney function but also cognitive state, emotional well-being, and overall quality of life. However, pre-transplant preparation often focuses solely on medical aspects, overlooking key factors such as memory, attention, and emotional stability. Assessing these aspects is essential to ensure that patients not only receive a new organ but are also prepared to face the challenges of transplantation. This study systematizes the application of the Neuropsychological Assessment Protocol for patients on the kidney transplant waiting list at the Hospital de Especialidades Teodoro Maldonado Carbo (HTMC). Its purpose is to analyze the assessment experience to identify achievements, difficulties, and necessary improvements, optimizing the detection of cognitive and emotional alterations, strengthening treatment adherence, and enhancing the patient’s overall preparation. A qualitative and descriptive methodology was used, including semi-structured interviews, field diaries, direct observations, and assessment instruments (MoCA, NEUROPSI, SALAMANCA, MINI-MULT, NPI-Q, HADS, SF-36, WHOQOL-BREF, ARMS-e, APGAR family, MOSS, and Barthel Index). These tools enabled the analysis of cognitive functions such as memory, attention, and executive functions, as well as emotional and psychosocial aspects that influence transplant adaptation. The findings revealed cognitive impairments that may affect patients' understanding of medical instructions and adherence to treatment. Additionally, family support was identified as a key factor in emotional stability. At a methodological level, challenges such as cognitive fatigue caused by the length of assessments and the need to adapt the protocol to each patient were noted. Improvements such as optimizing assessment times, strengthening psychological support, and implementing post-evaluation follow-up are proposed. Integrating neuropsychological assessment into kidney transplant programs in Ecuador is not just a technical enhancement but a step toward more humane and effective healthcare. Because a successful transplant depends not only on a compatible organ but also on a patient prepared in both body and mind.