Post-transplant clinic and appointments

Outpatient transplant clinic 

You will need to attend regular follow-up appointments at our Transplant Outpatient Clinic at Hammersmith Hospital. These start as soon as you leave hospital after your transplant.

Finding the clinic
The Transplant outpatient clinic is at:

Renal Outpatients  
Ground Floor 
A block  
Hammersmith Hospital 
Du Cane Road 
London W12 0HS

When entering the hospital from Du Cane Road, follow the signs to main outpatients. Turn right in front of Subway restaurant. Take the first left by the Friends shop. Keep walking straight towards the main outpatient area. The transplant clinic is on the left, opposite Lloyds Outpatient Pharmacy.

Clinic times
The Transplant outpatient clinic runs every: 

• Monday
• Wednesday
• Thursday
• Friday.

This service runs telephone clinics as well as face-to-face appointments. At first, you will need to attend at least two appointments each week. As you recover from surgery, we will reduce the number of appointments you need to attend. If you have had a simultaneous pancreas and a kidney transplant (SPK), you might be asked to come to the clinic more often.

Transplant clinic follow-up schedule

• week 0 – 6: appointments twice a week
• week 7 – 12: appointments once a week
• month 4 – 6: an appointment every two weeks
• month 7 – 12: an appointment monthly
• month 13 – 18: an appointment every two months
• month 19 – 24: an appointment every three months

Who you will see

Outpatient clinic appointments will alternate between the nephrologist and the transplant clinical nurse specialist (CNS). The outpatient pharmacist will see you within two weeks of discharge to give you advice on taking your medications and again at three months after your transplant. 

What will happen at an appointment?

• Your blood pressure and heart rate measured
• You will be weighed
• Your urine will be tested
• Your blood will be tested
• You will get an ureteric stent (your ureteric stent will be removed at three weeks post-transplant unless your transplant surgeon / nephrologist says it needs to stay in)
• Your blood pressure (BP) will be checked

Please measure your BP at home if you can and bring your readings to clinic. You can watch this video to learn how to check your blood pressure at home

Diabetes

If you have diabetes, keep a blood glucose diary and bring it with you to clinic. If you need to change your appointment, please call the clinic on 020 3313 8333.

What happens to your dialysis access (Tesio line), PD catheter or fistula

 

In most cases your tunnelled line for dialysis (Tesio line) will be removed before you are discharged from hospital, after your surgery.

If you have a peritoneal dialysis (PD) catheter, this is normally removed at the time of your transplant surgery.

We will not usually close a fistula or an arteriovenous graft. However, in some cases we may close a fistula or an arteriovenous graft if it is affecting your heart function or you develop complications such as arm swelling or thrombosis.

If you have any symptoms please let us know. Our vascular access team will assess your fistula or arteriovenous graft and discuss the next steps with you.

Your blood results

During every appointment, we will ask you to have a blood test to help us to monitor your health after the transplant.

We will measure:

• your kidney function (see below for more explanation)
• your blood count (haemoglobin, white cells and platelets)
• your electrolytes (salt, potassium, phosphate, calcium)
• your liver function
• your blood sugars
• the level of the anti-rejection medicines (tacrolimus or mycophenolate).

If there is a problem with your blood results you will receive a call from your nurse or doctor.

How we measure your new kidney function

Your new kidney function will be measured by a blood test that tells us how much creatinine (waste) there is in your blood.

A number called the estimated glomerular filtration rate (eGFR) is calculated which will tell you the level of kidney function. The table below explains the stages of kidney function and how it relates to GFR.

The function expected from a transplanted kidney is different for each patient. How your kidney function is changing over time is often more important than the actual eGFR itself.