Where will I go for my follow-up appointments?
Your follow-up appointments will be at the Transplant Clinic located in the Transplant Center at Desk A-110. At each of these appointments, you will be seen by the transplant coordinator and your physician. Because these appointments play a vital role in effectively monitoring your progress as well as your kidney function, it is very important that you consistently visit the Transplant Clinic as scheduled.
You will receive a thorough physical examination and have blood tests at each appointment. Many times, these are the only ways rejection or infection can be detected.
Please note: Clinic visits may be frequent at first, but will gradually taper off as your condition improves.
What happens during my follow-up appointments?
- Arrive at Cleveland Clinic.
- Go to Desk A-15 (located on the first floor of the Crile or A Building).
- Report to the lab. Do not take your medications before your scheduled blood work appointment.
- Eat breakfast and take your medications after your blood work appointment.
- Check-in at the Transplant Center, Desk A-110 (located on the 11th floor of the Crile/A Building). Remember to bring your daily notebook and medications with you to each visit.
- A nurse will weigh you, take your vital signs and ask for a urine sample. He or she will also review your medications.
- Meet with your physician. He or she will discuss your present condition, review current labwork and make any necessary changes in your medications
How often do I need to have my blood drawn?
In order for the Transplant Team to effectively monitor your kidney function and evaluate your treatment, it is important that you have frequent blood tests. The blood work usually must be completed by 8:30 a.m. every Monday and Thursday for the first three months after the transplant surgery.
Routine blood work includes the following tests which are done in a laboratory:
Evaluates levels of the following:
- Potassium (K)
- Chloride (Cl)
- Carbon Dioxide (CO2)
- Blood Urea Nitrogen (BUN)
- Creatinine (CR)
Complete Blood Count (CBC)
- Evaluates the following:
- White Blood Count (WBC)
- Hemoglobin (HGB)
- Hematocrit (HCT)
- Platelets (PLT)
Analyzes the level of immunosuppressive medication in your blood.
After the initial three months following transplant surgery, the frequency of your labwork will be determined at each clinic visit. If your kidney function is remaining stable, your labwork may become less frequent — but it will always be necessary.
What do my blood work and tests tell the Transplant Team?
The following information will help you understand the meaning of both your blood work and tests:
Blood Urea Nitrogen(BUN)
Blood urea nitrogen (BUN) is the result of protein broken down by the body. It is regularly removed from the blood by the kidneys and eliminated in the urine. A rise in BUN may indicate any of the following: kidney failure; dehydration; high protein intake; increase in the break down of protein from infection; fever; or bleeding ulcers. Normal levels are 8 to 25, but may be as high as 30 to 35 in patients who take steroids.
Creatinine is a waste product in the blood. Like BUN, it is removed by the kidneys and eliminated in the urine. Analyzing creatinine is a highly reliable way of testing your kidney function. A decrease in your kidney function results in a rise in the creatinine level. Normal levels range from 0.7 to 1.4.
Potassium is an important mineral your body relies upon daily. Sources that are rich in potassium to include in your daily diet include fruits and fruit juices. While a high potassium level may be harmful, a healthy kidney aids in eliminating extra potassium from the body. Normal potassium levels range from 3.5 to 5.0.
Complete Blood Count(CBC)
The Complete Blood Count is a series of tests that are usually done all at once by an electronic counter. The CBC provides information on the components in the blood, including:
- Red blood cells (erythrocytes): Disk-shaped cells that contain hemoglobin and give blood its color. Red blood cells make up about 40% of the volume of blood. Hemoglobin is an iron-containing protein that carries oxygen from the lungs to tissues throughout the body) and carries waste products (mainly carbon dioxide) back to the lungs to be exhaled.
- White blood cells (leukocytes): Cells that are part of the immune system and play an important role in fighting infection in your body. White blood cells are colorless and have a granular appearance, with a flexible membrane.
- Platelets: The smallest blood cells produced by bone marrow that help the blood to clot when blood vessels become injured. Platelets create a mesh at the wound site, called a fibrin strand, to trap red blood cells and form a clot.
- White Blood Cell Count (WBC): A rise in the number of white blood cells may indicate a bacterial infection in your body. In contrast, a very low white blood cell count may indicate a viral infection. The white blood count is checked routinely to effectively guard against infection.
- Normal white blood count levels range from 4,000 to 10,000.
- Hemoglobin (HGB): Hemoglobin is the iron-containing pigment of the red blood cells. The main function of hemoglobin is to carry oxygen from the lungs to tissues in your body. Normal hemoglobin levels range from 12.0 to 16.0 for women, and 13.5 to 17.5 for men.
- Hematocrit Measure (HCT): This measurement shows the percentage of red blood cells in the blood. Because the kidney plays an important role in helping the body produce red blood cells, an unhealthy or diseased kidney may cause the number of healthy red blood cells to decrease. By the second or third month following transplantation, the hematocrit level will generally rise to normal.
- Normal hematocrit levels range from 37 to 47 for women and 40 to 52 for men.
- Platelet Count (PLT): Platelets are cells that play an important role in the clotting of blood. Some transplant medications may cause the number of platelets to decrease, making you more susceptible to bruising. Low levels of platelets may cause a cut to bleed longer – a symptom you may notice after having your blood drawn.
- The normal platelet count ranges from 150,000 to 400,000.
For More Information
If you have any questions or concerns, please call us at 216.444.6996. We will be happy to answer your questions.