After a renal transplant

Last updated: Monday, September 14, 2015

Once a kidney transplant has stabilised, these patients should ideally have a reasonably healthy GFR of greater than 40mL/min. Consequently dose reduction of drugs that are renally-eliminated is not usually needed. However, graft function does tend to diminish with time, so it is imperative to check renal function.

A transplanted kidney is positioned lower in the pelvis than the patient's own kidneys 
and attached to the common iliac artery and vein
Courtesy of, Wikimedia Commons 

Many of the immunosuppressants taken post-transplant interact with a variety of drugs and you should always check for interactions. Common immunosuppressants used to prevent transplant rejection include:

  • Ciclosporin
  • Tacrolimus
  • Mycophenolate
  • Sirolimus
  • Azathioprine
  • Steroids

Bear in mind that transplant patients only have one kidney, and it may not have perfect function, so it is vital to avoid all potentially nephrotoxic insults (e.g. NSAIDs).