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          Sometimes, when rejection starts,           When rejection is suspected, it is usually confirmed by a
          you may feel fine, with no                  kidney biopsy, as this is the most precise test to diagnose
          symptoms. More often, there will            rejection. The earlier rejection is detected, the better the
          be signs to alert you to possible           chance of reversing it. Most commonly a mild to moderate
          rejection. If these occur, you should       episode of rejection is treated successfully, with a 3 to 5
          immediately contact your                    day course of Methylprednisolone (steroid). Where a
          transplant team. Quick action can           rejection episode is very severe, more potent forms of
          make the difference between                 immunosuppression, such as ATG, are sometimes used.
          keeping and losing your transplant.         Some forms of rejection (antibody mediated), however,
            Although you may experience               need to be treated with a course of plasmapheresis.
          symptoms of rejection, it is also
          possible to have no symptoms at
          all. That is why it is so important
          that you have all of the tests
          indicated by your transplant team.
          Blood tests are the best way to
          monitor kidney function and catch
          early warning signs of rejection. A
          rise in the patient's creatinine level
          may often be the first sign of

          6. Diabetes
          Glucose is a simple sugar and is the main source of energy in the body's cells. A condition called diabetes
          mellitus occurs if glucose accumulates, because your body is not using it properly and/or not enough
          insulin is produced. Some of your prescribed anti-rejection medicines may cause diabetes. The onset of
          diabetes post-transplant is usually mild and early signs can include: tiredness, thirst, weight loss,
                                                                 excessive production of urine, blurred vision
                                                                 and confusion.
                                                                   If you have any of these symptoms you
                                                                 should inform your transplant team. You will be
                                                                 monitored, in clinic, for this condition by regular
                                                                 blood and/or urine tests. Post-transplant
                                                                 diabetes is often resolved, by reducing some of
                                                                 your anti-rejection medicines or converting you
                                                                 to different ones, though you may need a
                                                                 specific oral diabetic medicine or insulin
                                                                 injections. Should you develop diabetes, your
                                                                 transplant team will give you specific advice.
                                                                 Careful diet, weight loss and exercise are all
          helpful in controlling this condition. If you were diabetic, prior to your transplant, you may have problems
          with blood sugar control following your surgery. This will be discussed with you on an individual basis.

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