University of Virginia Health System

Kidney Transplantation

After the Transplant

Hospitalization

Receiving a kidney transplant is a life-altering operation with potentially great benefits. Consider, for instance, the joy of a new life free from the stress and inconvenience of dialysis. Receiving a transplant also means a lifetime of medication, frequent follow-up with local nephrologists and ongoing monitoring by nurse coordinators, transplant surgeons, and transplant nephrologists at UVa. The benefits are potentially great; the requirement for ongoing care are significant. A new life with a transplanted organ begins in the hopital, right after the transplant operation.

Patients admitted for transplant are provided with semi-private or a private room accommodation on one of two UVa inpatient nursing units. Nurses on these units specialize in the care of transplant recipients and are assisted by a complete team of health care professionals: nutritionists, physical and occupational therapists, social workers, as well as resident and attending physicians.

Living donor transplant recipients usually remain in the hospital for three to four nights. For deceased donor transplants the stay can be as short as three or four nights or may be extended as needed.

During the inpatient stay, recipients receive careful monitoring of blood pressure, urinary output and blood chemistries. Special diagnostic testing may be used to check on the kidney's function which may include an isotope renogram scan (called a Mag-3 scan), a renal ultrasound, or a CT scan. If there is further question about the transplanted kidney's function, a kidney biopsy may be done to look more closely at the individual cells of the transplanted kidney. In addition, the inpatient will also receive extensive training on self-care at home and the drugs used to protect the transplanted organ from rejection (called immunosuppressants). The main three immunosuppressant drugs used are CellCept®, Prograf®, and prednisone.

After Discharge

Following discharge, patients check their own vital signs daily (tempreature, weight, blood pressure and pulse) and take medications as prescribed. Recipients also complete routine lab tests regularly (at a laboratory that is convenient to home) according to a regular schedule set by the transplant nurse coordinator:

• from 0-3 months, twice per week
• from 4-6 months, once per week
• from 6-9 months, once every two weeks
• monthly thereafter

The laboratory will fax the results of laboratory tests to the UVa Transplant department and are reviewed by nurses and physicians. Medication dosages or other treatments may be changed in response to these test results in order to protect both the patient and the newly transplanted organ.

Routine Follow Up

Follow-up appointments will be scheduled in the transplant clinic on a routine basis immediately after transplant. Once things have stabilized, patients will be seen on a semi-annual or annual basis, (as recommended by the transplant physicians and nurse coordinators) or more frequently as needed.

Although the patient and transplant team jointly remain focused on the good health of the patient, the patient now holds the key to success. Faithful adherence to medications and to submission of lab results together with annual reviews at our clinic give the greatest level of assurance that the transplanted kidney will continue to contribute to a healthy and vigorous new lifestyle.