After a new transplant, recently discharged patients usually attend 3 times weekly. Aberdeen, Dundee and Inverness patients: Usually transferred when stable as in-patients to the Renal Unit at the referring Hospital. Fife patients: Discharged home from RIE when stable. Contact Fife consultant prior to discharge to update and make arrangements for outpatient review in Fife.
In Edinburgh Transplant clinics are on Monday, Wednesday and Friday mornings in OPD1. If there is no clinic or if a patient needs to be seen more frequently then they will be seen on the Transplant ward following discussion with the nurse in charge. Appointments should be recorded in the Diary including what tests are required, any special arrangements and the date of the next appointment. Patients should always attend before 9.15 am so that their drug assays may be run the same day. Complete blood forms in advance so that the phlebotomist can take their blood during the ward round. The responsibility for checking the results on such patients lies with the ward SHO and registrar covering the unit.
Regular outpatient reviews
At each out-patient review the following are checked:
- Blood pressure ( pulse, temperature only if necessary)
- Weight
- Blood U&E, LFT, CAP, FBC and Tacrolimus/Ciclosporin. Blood should not be taken from or IV cannulas inserted into limbs with established AV fistulas.
- MSU
- Urine dipstick
- Medication - any alteration to immunosuppression required should be documented on the patient’s medication sheet which was issued to the patient on discharge, and updated on the Proton computerised record by the clinician making the alteration. Prograf / Advagraf should be recorded on patient’s computerised records.
- PTH checked 1 month, 3 months and 6 months
- Post-transplant antibody samples at 1, 2, 3, 6, 12 months and all subsequent anniversaries or rejection episodes.
Results of out-patient bloods must be checked as soon as possible and patients may be recalled for repeat checks or phoned to alter their dose of Prograf/Advagraf or ciclosporin. Any alteration to dose should be documented in the patient’s case notes and on the drug screen of Proton.
Three months
Ureteric stent and CAPD catheter if present normally removed at 3 months post transplant.
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