In-patient management post-transplant
Prescribing – check that these are as intended:
- Immunosuppression (follow link to detailed info).
- Infection prophylaxis (follow link to detailed info).
Investigations
- Blood tests:
- U&E, Ca+P daily
- FBC daily
- LFTs, glucose, CRP daily
- Tacrolimus level – M/W/F
- MSU each Monday and at other times if clinically indicated.
Urinary catheter
- Early catheter replacement/ manipulations should be undertaken by a surgeon. Same applies after the first week if any complications suspected.
- Urinary catheter removed at day 5 unless directed by transplant surgeon.
- If a patient develops urinary retention after removal of catheter in the post-operative period it should be replaced as soon as possible. This does not need to be a surgeon if it will cause undue delay.
Delayed graft function
- Usually a Doppler ultrasound examination will be requested early on
- A routine graft biopsy is usually performed around day 5 – see Management of Delayed Graft Function.
Altered graft function
- Later changes in graft function may require a graft biopsy, which will be requested by a senior member of staff. See Management of Altered Graft Function.