Follow-up tests after kidney transplantation (2023)

Your guide to kidney transplant:
your kidney transplant🇧🇷 Follow-up examinations after a kidney transplant |Return of life after kidney transplant|Organ rejection after kidney transplantation|Nutrition after kidney transplantation|immunosuppressive drugs|Infection after kidney transplantation

Before you leave the hospital, you will be given a clinical follow-up schedule for laboratory tests and controls. The purpose of these important visits is to monitor the progress of your recovery and identify any potential complications as early as possible.

On the days you visit the transplant team, bring your medication list with you. You must be at the clinic to have blood drawn an hour before your morning dose of medication. Later, take your medication. This is necessary so that we can accurately read the levels of immunosuppressants in your blood.

(Video) What is the usual follow-up after a kidney transplant?

The laboratory tests we carry out monitor your blood count, kidney function, liver function, electrolytes and the concentration of medications in your blood. Other tests can be ordered as required.

  • number of blood cells
  • kidney function
  • electrolytes
  • additional blood tests
  • Nierenbiopsie
  • Ultrasonic

number of blood cells

WBC tells us whether your white blood cells have increased (usually a sign of infection) or decreased (indicating a lower defense against infection). The HCT measures hematocrit, the percentage of red blood cells present in the blood. Red blood cells carry oxygen to all parts of the body. If your HCT is low you may feel tired or have low energy.

PLTS measures the blood platelet level. Platelets form blood clots when your body is injured. Low platelet counts can cause you to bruise easily and bleed for a long time.

kidney function

Creatinine and BUN indicate how well your kidneys are working by measuring blood levels of creatinine and urea, waste products that are normally removed from the blood by the kidneys.


dissolved minerals

Calcium, phosphorus, magnesium, potassium and sodium are natural electrolytes in the blood. All are monitored and supplemented as necessary.

additional blood tests

Medication Level measures the amount of Prograf®, Neoral® and Rapamune® in your blood. They should be checked regularly to avoid reading too high or too low. High concentrations can cause toxicity or over-immunosuppression, and low concentrations can cause rejection. Note: The target level (normal range) is different for each person, depending on the combination of immunosuppressants and time since transplant.

GLU measures glucose (sugar levels) in the blood. Some medications can cause a diabetes-like condition where blood sugar levels are too high.

(Video) Renal Transplant Evaluation

Nierenbiopsie (Bx)

A kidney biopsy is usually done to check for drug rejection or toxicity and other possible problems. Local anesthesia is used, a biopsy needle is inserted, and a small piece of kidney tissue is removed.

What are the risks of a kidney biopsy?

The main risk of a kidney biopsy is bleeding where the needle enters the kidney, but this occurs in less than 1% of patients. Other very rare complications include perforation of other organs such as the colon or a blood vessel. After the procedure, you will be closely monitored for several hours to ensure there are no complications.

Instructions for patients undergoing kidney biopsy

The office staff will schedule your appointment for the kidney biopsy and will call you with the date, time and location of the biopsy. Make sure you follow these instructions:

  1. You should avoid medications containing aspirin and ibuprofen, such as Advil®, Motrin®, Nuprin® and Aleve®. Tylenol® is good. Tell your doctor if you're taking blood-thinning medications like Coumadin®, Warfarin, or Plavix®.
  2. It is not recommended to drive or come home unsupervised. Schedule someone to accompany you to the procedure or pick you up afterwards.
  3. After the doctor performs the biopsy, you need to stay in bed for several hours. Before you go home, your blood pressure will be measured and your urine checked for bleeding.
  4. Call the transplant office at (212) 305-6469 if you notice any of the following symptoms after the biopsy:
    • urine with blood
    • Swelling and/or pain near the kidney
    • Fever
    • dizziness/dizziness
    • low blood pressure


This noninvasive diagnostic test, which uses sound waves to image internal organs, can be done after a transplant or when there are changes in kidney function tests. With an ultrasound, we can be sure that the main blood vessels that lead to the kidney are functioning normally. It can also be used to check:

  • accumulation of abnormal fluid around the kidney
  • an obstacle or
  • to locate for a biopsy.

During the test, a gel is spread over the abdomen and a transducer (a wand-like instrument) is passed over the surface of the abdomen. Images of your kidney appear on a monitor and are captured on film.

Health problems after leaving the hospital

When you leave the hospital, you are NOT alone.

The company social worker supports you and your family in preparing for dismissal. The transplant coordinators will order your medication from the pharmacy of your choice so that all the necessary medication is available when you leave the hospital. Hospital nurses will help educate you on how to take care of yourself.

(Video) Do's & Dont's after Kidney Transplant & life expectancy-Dr Girish NS

Questions will inevitably arise upon leaving the hospital. An employee is always available to answer your questions. The central telephone number for the kidney transplant program is(212) 305-6469🇧🇷 Here are some general guidelines for caring for your health after a kidney transplant:

  • vital functions
  • At temperature
  • blood pressure
  • weight
  • How to reach the kidney transplant team

vital functions

After you leave the hospital, you will be asked to have your temperature, blood pressure and weight checked, as well as your laboratory values. The office can provide you with a registration table.

At temperature

It is important to take the temperature every morning in the morning. A rise in your normal temperature can be a symptom of organ rejection or infection. Both rejection and infection are easier to treat when caught early. Someone whose immune system is suppressed does not always have a high fever. Call the transplant team when your temperature reaches 39.5°C.

blood pressure

High blood pressure is a common side effect of Neoral and Prograf. It could also indicate that you are retaining fluid. After returning home, you must measure your blood pressure twice a day, once in the morning and once in the evening, and document the results.

You may be put on medications that control your blood pressure. You can help keep your blood pressure under control by eating a low-salt diet and losing extra weight. The team's nutritionist can help you achieve this goal.

Your nurse will teach you how to measure your blood pressure. The high (systolic) value is noted at the first sound you hear, and the low (diastolic) value is noted when the sound changes (does not stop). It's important to know your normal blood pressure, its normal range, and when to be concerned. You should notify your transplant team or local doctor if your blood pressure measures:

  • Systolic: more than 160 or less than 100
  • Diastolic: over 90 or under 60

Headaches can be a symptom of high blood pressure. If you have a headache, measure your blood pressure. If it's above normal for you, call the transplant team. Also check your blood pressure if you feel dizzy or light-headed. These symptoms can be caused by low blood pressure. If your blood pressure is unusually low, call the transplant team.

(Video) Kidney Transplant Education


You should weigh yourself on a standard bathroom scale at the same time every morning after using the bathroom. Record your weight. If you're gaining more than 2 pounds a day, you may be holding back fluids. Report this to your local transplant team or doctor.

How to stay in touch with your kidney transplant team


For non-urgent matters, the office is staffed from 9:00 a.m. to 5:00 p.m. This includes questions about your care, reports or inquiries about lab results, scheduling appointments, tests and procedures, and prescription refills. Please contact the office at(212) 305-6469.

emergency calls

A family doctor is available around the clock for medical emergencies. If you are ill and need to speak to us, please do not hesitate to give us a call(212) 305-6469🇧🇷 The answering machine lets the doctor call you back immediately.

Liga 911

If you have any of the following symptoms, you or someone close to you should call 911 to get an ambulance to take you to the hospital:

  • chest pain
  • difficult breathing
  • bleeding
  • loss of consciousness

contact information

Be sure to keep the transplant office informed of your correct address and phone number(s), as well as any changes in your referring doctor's name, address or phone number(s). In addition, it is important that you tell us who to contact in the event of an emergency, including your name, address, telephone and pager number.

Your guide to kidney transplant:
your kidney transplant🇧🇷 Follow-up examinations after a kidney transplant |Return of life after kidney transplant|Organ rejection after kidney transplantation|Nutrition after kidney transplantation|immunosuppressive drugs|Infection after kidney transplantation

Transplantation is a life-changing procedure. We are here to be your partner every step of the way. call us around(212) 305-6469to get started today or sign up using one of our online forms:
I need a transplant »|I want to donate my kidney »

(Video) Life After Kidney Transplant


How often do you have to see the doctor after a kidney transplant? ›

Although the schedule of clinic visits can vary, most patients have follow-up appointments twice a week for the first two weeks after transplantation surgery, and once a week for the next two weeks.

What are important labs for kidney transplant patients? ›

There are three main blood tests that will determine if a patient and a potential donor are a kidney match. They are blood typing, tissue typing and cross-matching.

What is a normal tacrolimus level after kidney transplant? ›

The Kidney Disease Improving Global Outcomes has recommended 5–15 ng/mL of tacrolimus at the early posttransplant stage.

What is the normal creatinine level after transplant? ›

Serum creatinine started to rise from a baseline of 1.7–1.8 to 2.2 mg/dl and then, 2.4 mg/dl.

What routine tests are done after kidney transplant? ›

Blood tests.

Blood tests are used to check the function of your heart, kidneys, liver, thyroid, and immune system. You will also be checked for problems with blood sugar control and electrolyte balance. Special tests that look for certain viruses (CMU, EBV, hepatitis and HIV/AIDS) will also be done.

How long does it take for kidney function to improve after transplant? ›

Most transplanted kidneys will start working within a week or two. You may need to have dialysis until your transplanted kidney is working properly.

What is the patient at highest risk for after kidney transplant? ›

Cardiovascular disease is the leading cause of morbidity and mortality after kidney transplantation. Death from cardiovascular disease is also the most common cause of graft loss. This topic reviews the risk factors for cardiovascular disease among kidney transplant recipients.

Why do kidney transplants only last 10 years? ›

While transplanted organs can last the rest of your life, many don't. Some of the reasons may be beyond your control: low-grade inflammation from the transplant could wear on the organ, or a persisting disease or condition could do to the new organ what it did to the previous one.

What is a patient high risk for after a kidney transplant? ›

Infection. Minor infections, such as urinary tract infections (UTIs), colds and flu, are common after kidney transplants. You can also get more serious infections, such as pneumonia and cytomegalovirus (CMV), which may require hospital treatment.

What is a normal eGFR after a kidney transplant? ›

A kidney transplant should provide sufficient function to provide the recipient a survival benefit. This analysis suggests an eGFR-1 > 30 ml/min is required (in the US), but global applicability needs to be assessed.

What foods affect tacrolimus levels? ›

Does tacrolimus interact with any foods or beverages? Avoid excessive intake of high potassium foods (bananas, oranges, orange juice, potatoes, spinach, etc). Do not eat grapefruits, grapefruit juice or any soda (Fresca) or fruit juice blend that contains grapefruit juice.

Is 1.6 creatinine level OK in transplant patient? ›

If the potential recipient of the kidney transplant has a serum creatinine of 1.6 milligrams per deciliter (mg/dl) then a kidney transplant is not needed. If the potential donor has a serum creatinine of 1.6 and is a live donor, this should not be done.

What is the best creatinine level after kidney transplant? ›

A very well functioning renal transplant should have a serum creatinine of around 100 to 120 umol/L.

How do you know if a kidney transplant is successful? ›

My advice is usually this: If you're feeling well and your body is accepting the new organ, you may be released from the hospital within a few days. In the weeks and months after your procedure, you'll have regular check-ups and blood tests to ensure you're healthy and your new kidney is functioning properly.

Why is my creatinine going up after transplant? ›

Increased serum creatinine that is not explained by dehy- dration, urinary obstruction, high calcineurin inhibitor (CNI) levels or other apparent causes is most likely due to an intragraft parenchymal process, such as acute rejection, chronic allograft injury (CAI), drug toxicity, recurrent or de novo kidney disease, ...

How long is your immune system compromised after a kidney transplant? ›

About 6 months to a year after transplant, the immunosuppression is usually lowered and the chance of side effects should be low. If you still have side effects, speak to your transplant team to either change the dose or switch to a different medicine.

What drugs do you have to take after a kidney transplant? ›

After your transplant surgery you will be prescribed medications that may include:
  • Tacrolimus (Prograf) or cyclosporine (Neoral, Gengraf)
  • Prednisone.
  • Mycophenolate (CellCept, Myfortic) or azathioprine (Imuran)
  • Sirolimus (Rapamune)
  • Everolimus (Zortress)

Do you still have CKD after kidney transplant? ›

After transplantation, the levels of chronic kidney disease (CKD) are still based on the estimated glomerular filtration rate (eGFR). The stages remain the same but are designated with a "T" for transplant.

How long does the average person live after a kidney transplant? ›

On the other hand, patients who receive a kidney transplant typically live longer than those who stay on dialysis. A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years.

Why am I so tired after my kidney transplant? ›

Fatigue is an extremely common symptom among kidney transplant recipients (KTRs), with prevalence ranging from 39% to 59%. Fatigue can be described as an awareness of negative balance between available energy and the cost in physical, cognitive, emotional, or/and functional components.

How long after a transplant can the kidney reject? ›

When a new kidney is placed, your body reacts as if it's a foreign body. Immunosuppressive medicines can help prevent your immune system from damaging your new kidney. Rejection can occur at any time after your transplant, but it's more likely to happen within the first 6 months.

What foods should kidney transplant patients avoid? ›

During the early stages after a transplant, while you're on higher doses of immunosuppressant medicine, you should avoid eating foods that carry a high risk of food poisoning, including: unpasteurised cheese, milk or yoghurt. foods containing raw eggs (such as mayonnaise) undercooked or raw meats, fish and shellfish.

How do you know if your kidney transplant is failing? ›

"Flu-like" symptoms: chills, aches, headache, dizziness, nausea and/or vomiting. New pain or tenderness around the kidney. Fluid retention (swelling) Sudden weight gain greater than two to four pounds within a 24-hour period.

What are two disadvantages of kidney transplants? ›

Disadvantages — Kidney transplantation is a major surgical procedure that has risks both during and after the surgery. The risks of the surgery include infection, bleeding, and damage to the surrounding organs. Even death can occur, although this is very rare.

What is 20 year survival for kidney transplant? ›

Results: Excellent patient survival rates of 95.1% at 20 years for living donor KT and 96.2% at 15 years for deceased donor KT were observed. Graft survival rates at 1, 5, 10, 15, and 20 years were 96.8%, 95.4%, 83.1%, 61.8%, and 56.2% in living donor KT, respectively.

What is the longest lasting kidney transplant? ›

Missouri farmer, 80, boasts one of the world's longest lasting transplanted kidneys. His sister's kidney has lasted 56 years and counting. Back in 1966, when kidney transplants were new and dangerous, Butch Newman was days from death.

Can you have 2 kidney transplants? ›

People who donate a kidney can live healthy lives with one healthy kidney. A person getting a transplant most often gets just 1 kidney. In rare situations, he or she may get 2 kidneys from a deceased donor. The diseased kidneys are usually left in place.

What is the most common cause of death in kidney transplant patients? ›

Table 2
Cause of DeathMean Age at Transplant, yrMean Survival, mo
Gastrointestinal tract disorder36.412.1
Malignant neoplasm49.029.5
5 more rows

What is the biggest risk for transplant patients? ›

Potential Risks of Transplant Surgery
  • Risk of rejection of the transplanted organ.
  • Increased risk of infection due to the immunosuppressant medications.
  • Any of the side effects of the immunosuppressant medications as previously discussed.

What is a good eGFR for one kidney? ›

An estimated glomerular filtration rate (eGFR) of 56 milliliters per minute per 1.73 meters squared is normal for a single kidney.

Can eGFR go back to normal? ›

While it's possible to improve your GFR, you're more likely to do so with acute kidney injuries rather than with chronic kidney disease. For most people with chronic disease, positive lifestyle changes may help slow the loss of kidney function.

When should I worry about creatinine eGFR? ›

A creatinine level of greater than 1.2 for women and greater than 1.4 for men may be an early sign that the kidneys are not working properly. As kidney disease progresses, the level of creatinine in the blood rises.

What fruits to avoid after kidney transplant? ›

Most foods and drinks are completely safe for you to take after transplant. Please AVOID grapefruit, pomegranate, pomelo, blood orange, and black licorice, as these can increase the amount of anti- rejection medication in your body and this could harm you.

Does coffee affect tacrolimus levels? ›

No interactions were found between caffeine and tacrolimus.

Which fruit is good for kidney transplant patients? ›

As long as your transplant is working well, you should be able to eat normal amounts of potassium from your food. However, some transplant medicines can increase your blood level of potassium, while other medicines may decrease it. Foods high in potassium include: Oranges.

Does tacrolimus raise creatinine levels? ›

On the other hand, high doses of tacrolimus significantly increased serum creatinine levels when compared with the control group and the SHAM group but lower doses did not cause significant changes.

How can I lower my creatinine after kidney transplant? ›

Here are 8 ways to naturally lower your creatinine levels.
  1. Don't take supplements containing creatine. ...
  2. Reduce your protein intake. ...
  3. Eat more fiber. ...
  4. Talk with your healthcare provider about how much fluid you should drink. ...
  5. Lower your salt intake. ...
  6. Avoid overusing NSAIDs. ...
  7. Avoid smoking. ...
  8. Limit your alcohol intake.

What are normal tacrolimus levels? ›

The general therapeutic range for tacrolimus is 5-20 ng/mL.

What is the average life expectancy after a kidney transplant? ›

A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years. Patients who get a kidney transplant before dialysis live an average of 10 to 15 years longer than if they stayed on dialysis.

What is a post kidney transplant patient at highest risk for? ›

Infection. Minor infections, such as urinary tract infections (UTIs), colds and flu, are common after kidney transplants. You can also get more serious infections, such as pneumonia and cytomegalovirus (CMV), which may require hospital treatment.

How long does a kidney last after a kidney transplant? ›

What is the life expectancy of a transplanted kidney? On average, a kidney transplant from a living donor lasts for 20-25 years, while a kidney from a deceased donor lasts 15-20 years.

How do you live longer after a kidney transplant? ›

Life After Kidney Transplant
  1. Healthy Diet And Regular Exercise. A kidney transplant surgery will require you to eat foods that are low in salt and fat, to keep your blood pressure in check. ...
  2. Immunosuppressants. ...
  3. Ensure Positive Mental Health. ...
  4. Lifestyle Changes. ...
  5. Keeping Your New Kidney Healthy.
Mar 1, 2019

What cancers are common after kidney transplant? ›

Short-term studies showed an increased risk of a wide range of cancers associated with kidney transplantation: a 2-fold higher risk of colorectal, lung, prostate, stomach, esophagus, pancreas, ovarian and breast cancer; a 3-fold higher risk of testicular and bladder cancer; a 5-fold higher risk of melanoma, leukaemia, ...

What are the signs of a kidney transplant failing? ›

Please contact your transplant team if you experience any of the following:
  • A high temperature of 38C or above.
  • Feeling hot and shivery.
  • Severe headache.
  • Diarrhoea.
  • Vomiting.
  • Shortness of breath.
  • New chest pain.
  • Fatigue or generally feeling 'rough'

What is the best exercise for kidney health? ›

Choose continuous activity such as walking, swimming, bicycling (indoors or out), skiing, aerobic dancing or any other activities in which you need to move large muscle groups continuously. Low-level strengthening exercises may also be beneficial as part of your program.

Why is my stomach big after kidney transplant? ›

Bulge after kidney transplant, also seen relatively commonly after spinal surgery, is often an area of the abdominal wall that is not innervated, from the prior surgery. That area bulges out, rather than flexes, whenever you use your abdominal muscles, and therefore over time stretches.

What snacks can kidney transplant patients have? ›

Choose low-calorie snacks, such as fresh fruit, low-fat cookies or crackers and unsalted pretzels. Remember, just because a food is "low-fat" does not mean that you won't gain weight if you eat too much. Continue to limit salt intake and high-sodium foods to control blood pressure.


1. Improving Long-Term Outcomes After Renal Transplantation
(PeerView CME)
2. When Your Body Rejects Your New Kidney
(Cleveland Clinic)
3. Post Renal Transplant Care for Patients | Dr Sudeep Sachdeva
(Narayana Health)
4. Facebook Live: Optimizing your health before and after kidney transplant.
(MedStar Health)
5. Introduction to Kidney Transplant: A Step by Step Process
(BC Transplant)
6. After Kidney Transplant with Dr Brent Alper


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