Page 39 - beaumont_book_3
P. 39

High Prograf or Cyclosporine level                    destruction of the transplanted kidney. If the
           Even though Cyclosporine, Rapamune and             condition is diagnosed early enough it is possible
        Prograf allow renal transplants to be successful      to reduce the amount of transplant drugs you are
        both these drugs can damage the kidney over           taking and allow the infection to clear up before
        time. There is a very fine line between giving you    severe damage has occurred in the transplant.
        enough medication to prevent rejection and not           You will require regular blood tests to check
        too much to cause kidney damage. Sometimes            for the first 12 months post transplant.
        this problem can be solved by measuring the drug      A schedule of these tests is printed inside
        levels in your blood, but a kidney biopsy may be      your passport.
        performed to determine if there is chronic damage
        to your kidney from medication. Your doctor may       Recurrence of original disease
        recommend changing your medication.                      Certain diseases, that originally caused kidney
                                                              disease, may return in the new transplanted
        Acute transplant rejection                            kidney causing slow damage to it. The most
           Acute (sudden)                                     common disease to return, in new transplants, are
        transplant rejection          “Acute (sudden)         FSGS (Focal Segmental Glomerulosclerosis) and
        usually occurs in the                                   MPGN (Membranoproliferative
        first three months,         transplant rejection          Glomerulonephritis). Even when these
        after the                    usually occurs in            diseases do recur after kidney
        transplant, but it        the first three months,          transplantation, they generally only cause
        can happen at any          after the transplant,           very slow deterioration of the transplanted
        stage after                  but it can happen            kidney.
        transplantation. The         at any stage after
        diagnosis of acute           transplantation.”          Transplant artery stenosis
        transplant rejection will                                Some patients develop a narrowing of the
        require a kidney biopsy and                           transplant artery, where it is stitched onto the
        the treatment usually involves 3 to 5 cycles of       blood vessel going to the leg. If this happens it
        high dose steroids given intravenously.               may cause severe high blood pressure and a rise
                                                              in the creatinine level. This condition will
        Chronic transplant rejection                          generally be diagnosed by a MRI scan or
           Even with modern immunosuppression, chronic        Angiogram. Transplant artery stenosis can be
        transplant rejection may still develop. Chronic       treated, by a balloon dilation of the narrowed
        rejection is more likely to develop if you            artery and, sometimes, the placement of a metal
        previously had an episode of acute transplant         tube called a stent to keep the artery open. It may
        rejection. Chronic transplant rejection and chronic   occasionally require an operation to remedy the
        Prograf or Cyclosporine damage can be very            problem.
        difficult to distinguish. The treatment
        of chronic rejection may involve                      What happens if the kidney transplant fails
        adjustment of your transplant                              If the kidney transplant shows progressive
        medicines and the addition of                                 signs of failing, and nothing can be done
        another immunosuppressant                                      to reverse the situation, your doctor will
        Cellcept or Sirolimus.                                                   discuss plans for you to go
                                                                                       back on dialysis and,
        Polyoma infection                                                              indeed, to go back on the
           Recently it has become                                               kidney transplant pool. If you are
        apparent that some                                           a suitable candidate it is sometimes
        kidney transplants fail as a result of the            possible to get a subsequent transplant, without
        development of an infection called Polyoma Virus.     having to go back on dialysis. Once again your
        This is a viral infection that only affects           family can contact the Transplant office to discuss
        transplant patients and can cause slow                possible live donation.

   34   35   36   37   38   39   40   41   42   43   44