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Managing Medication Adverse Effects Post Kidney Transplant

Immediate Post Transplant

Joan did very well in the immediate post transplant period, with good urine output, and did not require hemodialysis. She received a total of 4 doses of Thymoglobulin®, prednisone, CellCept® and was started on tacrolimus prior to discharge as per protocol. Her renal parameters continued to improve, and creatinine was down to 1.7mg/dl from 10mg/dl.

However, approximately 2 weeks post transplant, she had some worsening of renal function with an increase of creatinine to 2.4, and on ultrasound was found to have fluid collection around the transplant kidney on left side. She received 3 doses of Solu-Medrol® which was started empirically for possible rejection. Fluid was drained, was found to be lymphocele, renal function also improved and creatinine was back to baseline.