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 http://kidney.niddk.nih.gov/kudiseases/pubs/transplant, 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).