Kidney Transplant Patient Guide
Lab Tests and Procedures
A usual lab test monitors blood count, kidney function, electrolytes, and medication levels in the patient's blood. Other tests may be ordered as necessary.
Tests for Blood Count
- WBC tell if the patient's white blood cells have increased (usually a sign of infection) or decreased (indicating a lower defense against infection).
- HCT measures the hematocrit, which is the percentage of red blood cells in the blood. Red blood cells carry oxygen to all parts of the body. When a patient's HCT is low, he may feel tired or have little energy.
- PLT measures the level of platelets. Platelet cells form a blood clot when the body is injured. Low platelet levels may cause someone to bruise easily and to bleed for a longer time when injured.
Test for Kidney Function
Creatinine and BUN tell how well the kidneys work by measuring levels of creatinine and blood urea nitrogen, waste products normally removed from the blood by the kidneys.
Tests for Electrolyes (dissolved minerals)
- Ca measures calcium, which is necessary for strong bones and teeth, blood clotting, and heart and nerve function.
- PO4 measures phosphate, which works closely with calcium to strengthen bones.
- Mg measures magnesium, which is necessary for normal functioning of muscles and for blood clotting.
- K measures potassium, which is needed for normal heart and muscle function.
- Na measures sodium, which helps maintain the balance of salt and water in the body.
- CO2 measures bicarbonate, which helps maintain acid balance in the body.
- Creatinine measures how well the kidneys are functioning. When this number rises, the cause may be rejection or a side effect of medication.
Other Blood Tests
Drug levels measure Tacrolimus (Prograf®) or Cyclosporine (Sandimmune®) in the blood. Tacrolimus or Cyclosporine blood levels must 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.
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.
Additional Tests and Procedures
The transplant team may perform one or more of the following tests and procedures to monitor a patient's transplant:
Ultrasound - This test is performed to make sure all the main blood vessels leading to the kidney are functioning normally. This test is also used to check for collections of fluid, such as blood. The procedure consists of placing a cool gel on the patient's abdomen, over which a wand (transducer) is moved to transmit sound waves. These are converted into images of the kidney and projected onto a television screen.
Kidney biopsy (test sample) - This test is usually performed to check for rejection, or other possible problems. This may be done in the hospital or in the outpatient/short-stay unit. The patient will receive special instructions regarding the procedure. Before the procedure, the patient will receive a numbing injection (local anesthetic) on the right side of his abdomen. Then a special needle will be inserted to withdraw a small sample of kidney tissue that will be examined with a microscope.
Computerized tomography (CT) scan - This is a type of X ray that allows the physician to view the patient's kidney from many different angles to detect infections, fluid collections, or other problems. The procedure requires that the patient drink a liquid that outlines his stomach and intestines and makes his kidney more visible; then he lies flat for 1 hour while the machine takes X rays around him.
Magnetic resonance imaging (MRI) - This is another type of test that produces an image. Somewhat like a CT scan, it also allows a patient's kidney to be viewed from different angles and in three-dimensional images. An MRI shows soft tissues, such as the kidney, more clearly than a CT scan does.