On the days you are scheduled to see the transplant team, bring your medication list. You need to be at the clinic to have your blood drawn one hour before your morning dosage of medication is due. Afterwards, you will take your medication. This is necessary so we can get an accurate reading of the immunosuppressant levels in your blood.
The lab tests we perform monitor your blood counts, kidney function, liver function, electrolytes, and the medication levels in your blood. Other tests may be ordered as necessary.
WBC tells us if your white blood cells have increased (usually a sign of infection) or decreased (indicating a lower defense against infection). HCT measures your hematocrit, the percentage of red blood cells present in your blood. Red blood cells carry oxygen to all parts of the body. When your HCT is low, you may feel tired or have little energy.
PLTS measures the level of platelets in your blood. Platelet cells form blood clots when your body is injured. Low platelet levels may cause you to bruise easily and to bleed for a longer time period.
Creatinine and BUN tell how well your kidney is working by measuring levels of creatinine and blood urea nitrogen, waste products normally removed from the blood by the kidneys.
Calcium, phosphorus, magnesium, potassium, and sodium are naturally occurring electrolytes in your blood. They all will be monitored and supplemented when necessary.
Drug levels measure the amount of Prograf®, Neoral®, and Rapamune® in your blood. They need to be checked regularly to avoid levels that are too high or too low. High levels could lead to toxicity or over-immunosuppression, and low levels may lead to rejection. Please Note: The desired level (normal range) will differ for each person, depending on the combination of immunosuppressive medications and the length of time since the transplant.
GLU measures glucose (levels of sugar) in the blood. Some medications may produce a diabetes-like condition in which blood sugar levels are too high.
A kidney biopsy is usually performed to check for rejection or drug toxicity and other possible problems. A local anesthetic 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 primary risk with kidney biopsy is bleeding from the site of the needle's entry into the kidney, but this occurs in less than 1% of patients. Other very rare complications include puncture of other organs such as the colon or a blood vessel. You will be monitored closely for several hours after the procedure to make sure no complications arise.
Instructions for Patients Having a Kidney Biopsy
The office staff will set up the appointment for your kidney biopsy and call you with the date, time, and location of the biopsy. Please be sure to follow these instructions:
- You must abstain from medications containing aspirin and ibuprofen, such as Advil®, Motrin®, Nuprin®, and Aleve®. Tylenol® is OK. Notify your physician if you are taking blood thinning medication such as Coumadin®, warfarin, or Plavix®.
- It is not recommended that you drive or return home unattended. Plan to have someone accompany you to the procedure or pick you up afterward.
- After the doctor performs the biopsy, you must rest in bed for several hours. Before you return home, your blood pressure will be monitored and your urine will be checked for bleeding.
- Call the Transplant office at 212-305-6469 if you experience any of the following symptoms after your biopsy:
- Bloody urine
- Swelling and/or pain near your kidney
- Low blood pressure
This non-invasive diagnostic test, which uses sound waves to image the internal organs, may be performed after your transplant operation, or when your kidney function tests change. An ultrasound allows us to be certain that the main blood vessels leading to the kidney are functioning normally. It can also be used to check for:
- the build-up of abnormal fluid around the kidney,
- an obstruction, or
- to localize for biopsy.
During the test, a gel is spread over your abdomen and a transducer (wand-like instrument) is passed over the abdomen's surface. Images of your kidney appear on a monitor and are recorded on film.