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In-patient management post-transplant

  • Immunosuppression - see pages 24-31 .
  • Infection prophylaxis: see pages 32.
  • CMV prophylaxis: refer to the CMV protocol (see page 33).
  • Blood tests:
    •  U&Es daily
    • FBC daily
    • LFTs, glucose, CRP daily
    •  Tacrolimus level - M/W/F
  • MSU each Monday and at other times if clinically indicated.
  • 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.
  • A routine graft biopsy is performed around day 5 if there is delayed graft function and subsequently at weekly intervals until function is established. This is to diagnose acute rejection co-existing with ATN.
  • Management of delayed graft function is outlined on page 20.
  • Any deterioration in graft function may require a graft biopsy, which will be requested by a senior member of staff. See pages 21-23.

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