Health Care After Kidney Transplant

• After transplant, you can expect weekly follow-up appointments with a nephrologist and sometimes the transplant surgeon for at least the first month.
• Follow-ups every other week to every month until three months post-transplant.
• If all goes well at your three-month follow-up appointment, the doctor may decide to see you back every two to three months, until you are one year post-transplant.
• After one year post-transplant, you will be seen every four months.

Eye Care

It is important to schedule a regular yearly follow-up appointment with the eye doctor (ophthalmologist). See the eye doctor if you notice any changes in your vision.

Hair Care

Your hair may get thicker and grow faster or in places where it did not grow before if you are on Neoral. It is OK to use over-the-counter (OTC) hair removal products but you should not use them for a long time.

Skin Care

Wear sunscreen with an SPF of 15 or more. You may get acne. Wash your face twice a day with soap and water. There are medicines the doctor can prescribe for acne if it becomes a problem.

Dental Care

Brush and floss every day. Do not have any dental work done during the first three months after your transplant. Make sure your dentist knows you had a transplant.

• Blood tests — Since your body might harm the new kidney right after the transplant, it is important to have your labs checked frequently.
  • For the first three months, you will have blood tests done two times a week on Monday and Thursday.
  • Three to six months after transplant lab tests will be done one time a week.
  • Six to 12 months after transplant lab tests will be done every other week.
• After the first year post transplant, lab tests will be done once a month for the rest of your life!
  • If you are taking Prograf (Tacrolimus), have your blood drawn before your morning Prograf dose so the drug level can be checked.
  • If you are taking Neoral, get your blood drawn two hours after your morning Neoral dose so the drug level can be checked.
  • All other immunosuppression medicine levels are to be drawn before taking your medicines.
• You may call the lab and request your or your child’s lab.
• You also can sign up to view labs online using MyChart at your next Nephrology clinic visit.
• Write down the blood test results in your notebook.
• Please call the Nationwide Children’s Transplant Coordinator if results are out of their normal range.
• Regular labs that are checked include:
  • Creatinine and BUN which show how the new kidney is working. If both go up, it means the kidney is not working as well as we want.
  • Sodium (Na), Potassium (K), Chloride (Cl): These are electrolytes, which you need for your body to work well. The lab tests help us check these levels.
  • Carbon Dioxide (CO2): checks balance of acids and bases in your body.
  • Hemoglobin (Hgb): tells us about your red blood cells (if it’s low, you have anemia).
  • White Blood Cell Count (WBC): white blood cells help your body fight infections.
  • Glucose (Gluc): blood sugar
  • Platelet Count: Platelets help clot the blood when needed.
• Other labs tests that the team checks include your
  • Calcium (Ca)
  • Phosphorous (Phos)
  • Alkaline Phosphatase (ALK Phos)
  • Direct Albumin
  • Total Bilirubin
  • SGOT
  • SGPT
  • SGGT
• Increased Creatinine
  • If your lab tests show an increase in creatinine, then it may be:
    • You are not drinking enough.
    • You are ill.
    • You have a urinary tract infection (UTI).
    • Your drug levels may be too high (cyclosporine and/or Rapamune®).
    • You may be experiencing a rejection episode.
• The first thing the transplant coordinator will do is ask you to drink more fluids and repeat the creatinine test and drug levels.
• The transplant coordinator will also ask you many details including if you have been ill recently.
• You may need to see your local doctor for a check-up and some tests.
• If the repeat creatinine is still high and the drug levels are ok, then we need to make sure it is not a rejection episode.

Walking After You Go Home

Walk as much as you were walking before you left the hospital. Slowly increase the distance and speed or pace of your walking. If you become short of breath or extremely tired, then slow down your pace.

Lifting, Driving and Bathing

Do not lift anything that weighs more than five pounds for three months after your transplant. No pushing or pulling for six weeks. No driving for two weeks. You may shower, but no tub baths for two weeks.

Returning to School/Work

Generally you can go back to school or work four weeks after the transplant. You will need to get the final okay to return to work from your transplant team.

After a kidney transplant, it is very important to know which medications you are allowed to take on days when you aren't feeling well.

Colds and Flu

Please check with the transplant nurse if you are not sure about taking a certain medicine.

Constipation (when it is hard to have a bowel movement)

Metamucil® is OK with water. You can also take Colace. You can buy either medicine over the counter.

Chicken Pox, Measles, Mumps, German Measles, Tuberculosis (TB)

STAY AWAY from people with any of these illnesses. Transplant patients can get VERY sick if they catch any of these diseases. If you are around anyone with these diseases, call the transplant nurse.

Vaccines and Shots

Ask the transplant office before you get any shots. There are certain “live” vaccines that transplant patients cannot have.