Transplant anti-rejection medications. What's your advice?

Posted by jolinda @jolinda, Apr 23, 2020

Weight gain? Hair loss? Headaches? Never missed a beat? What has your experience with transplant medications been? Have you developed a methods to deal with a side-effect? Have your meds changed at all over time? What advice do you have for others in our community that may make their experience better?

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@hello1234

Thank you so much @tjdog 😊 I am very happy to meet you. You are a fabulous and unique combination of a recent kidney transplant patient AND a person with a wealth of knowledge from years of transplant experience! ❤ I am happy to report that my kidney function is good. My creatinine is 1.0 and my BUN is 21. Is that close to what you are experiencing too?

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A creatinine of 1.0 is excellent! Mine goes up and down between 1.4 and 1.7. My latest BUN is 31. But my doctor is fine with that. My problem is I don’t always drink enough water. They want 8-10 cups daily. My creatinine was never under 2.0 with my first transplant in 1994. And it lasted almost 25 years. So you never know. Everyone reacts differently to the transplant and the drugs.

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Thank you so much @tjdog 😊 I am very happy to meet you. You are a fabulous and unique combination of a recent kidney transplant patient AND a person with a wealth of knowledge from years of transplant experience! ❤ I am happy to report that my kidney function is good. My creatinine is 1.0 and my BUN is 21. Is that close to what you are experiencing too?

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@hello1234

Good morning @tjdog 😊 Wow, you definitely have years of experience with your kidney transplants. It sounds like your first kidney functioned well from 1994 to 2017, so 20 years, right? That's wonderful! Did you have a living donor?
I am a one year post kidney transplant patient on MMF and Tac too.
Congrats on your new transplant in 2019! My question is, what has been your experience with protocol kidney biopsies? How often did you have them and were they helpful for "catching" signs of rejection or problems or did your docs use other tests to diagnose? Thanks @tjdog

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Hello @hello1234, I hope you are doing well with your new kidney. Both of my transplants were from deceased donors. As for biopsies, I think I got 2 after my first transplant and so far I’ve had 2 after my transplant in 2019. Both of the biopsies on my second transplant were routine. Mayo in AZ has follow up appointments 1 year and 2 years post transplant that includes an ultrasound biopsy. I’ve been fortunate to not have any problems with rejection. Now, my doctor uses lab results to see how my kidney is doing. They monitor my creatinine levels every 2-3 months. They would probably do a biopsy if my level started going up on every test. So far that hasn’t happened. Be happy to answer any questions you have.

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@rosemarya

Good Morning, @nimalw. Welcome to Mayo Connect with a special Congratulations on your recent kidney transplant!
My combined liver/kidney transplant occurred 12 years ago, and I needed dialysis before my transplant because of acute kidney failure along with end stage liver failure. I can only remember immediately feeling better upon waking from the surgery , and relieved that I did not require anymore dialysis. I remember that my Creatinine level was normalized right away because my kidney doctor 'danced' into my room while singing "0.8" over and over. I am only one of many patients, so my situation is not representative everyone.
As for bladder retention, I did not experience any. I know this because when the catheter was remover, and I was on my own to pass urine, the nurse performed ultrasound bladder clearance scans. These are also performed annually as part of my routine annual evaluation.
At 2 months post transplant, and at any time and every time you are concerned/or just have questions, I encourage you to communicate with your transplant team. Did you transplant at Mayo? Are you registered on the patient portal? It is the perfect place to ask non emergency questions.

When do you have a follow-up with your transplant team?

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Dear I am in Asia . Here we go direct to Nephrologist weekly visits now it's by weekly . I had a mild elevated creatnine in my last test scan was done kidney was fine but bladder retention was there so the doctor thinks it could be the retention that's causing the creatnine spike. He put me on urimax feel much better after taking it . Next test this Saturday. Hope it has settled down . I did pre emotive transplant never did dyalisis. I feel the drug dosage is high . I feel really good just finished golf. Hate creatnine spikes !!! I geuss who likes it !

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@nimalw

Hi has anyone experienced urine retention in the Bladder after kidney transplant with elevated creatnine???

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Good Morning, @nimalw. Welcome to Mayo Connect with a special Congratulations on your recent kidney transplant!
My combined liver/kidney transplant occurred 12 years ago, and I needed dialysis before my transplant because of acute kidney failure along with end stage liver failure. I can only remember immediately feeling better upon waking from the surgery , and relieved that I did not require anymore dialysis. I remember that my Creatinine level was normalized right away because my kidney doctor 'danced' into my room while singing "0.8" over and over. I am only one of many patients, so my situation is not representative everyone.
As for bladder retention, I did not experience any. I know this because when the catheter was remover, and I was on my own to pass urine, the nurse performed ultrasound bladder clearance scans. These are also performed annually as part of my routine annual evaluation.
At 2 months post transplant, and at any time and every time you are concerned/or just have questions, I encourage you to communicate with your transplant team. Did you transplant at Mayo? Are you registered on the patient portal? It is the perfect place to ask non emergency questions.

When do you have a follow-up with your transplant team?

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@tjdog

I’ve been on anti-rejection meds for almost 28 years. First kidney transplant in 1994. I started on Sandimmune (Cyclosporine) and prednisone. Switched to Cellcept a few years later, then to Mycophenolate a few years after that. First transplant started to fail about 4 years ago and I was lucky enough to get a second transplant in 2019. Now. I’m taking Mycophenolate, Tacrolimus and Prednisone.

Side-effects have been acid reflux, skin issues, low magnesium, high blood pressure and recently hair loss. But I’m 69 now, so some of these could be age related.

My dosage of the anti-rejection meds frequently changes depending on lab results. So make sure you don’t run low on them. The dosage could go up and you don’t want to run out.

My advice is to follow your doctor’s orders and always tell them when something is bothering you, no matter how insignificant you think it might be. Try to get some exercise a few days a week, even if it’s just walking, and stay hydrated.

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Good morning @tjdog 😊 Wow, you definitely have years of experience with your kidney transplants. It sounds like your first kidney functioned well from 1994 to 2017, so 20 years, right? That's wonderful! Did you have a living donor?
I am a one year post kidney transplant patient on MMF and Tac too.
Congrats on your new transplant in 2019! My question is, what has been your experience with protocol kidney biopsies? How often did you have them and were they helpful for "catching" signs of rejection or problems or did your docs use other tests to diagnose? Thanks @tjdog

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@dflyfisherman

I'm in my 8th year post transplant. Kidneys on Tac. have been failing for several years. Creatinine level has run to .275. Stable now. Imuran will not repair the damage but I think I've gone into a holding pattern. No dialysis yet.

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Holding pattern is a good sign . You are long way from dyalisis . Wish you all the best I know it's hard on the mind I battled with CKD for 20 yrs

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@azdan99

I am post heart transplant 19 years. The entire time I have been taking mycophenolate and tacrolimus. Doses have been adjusted a few times. I have not experienced rejection nor kidney stress. My doctor monitors with labs. At 75 yo, I feel good.
I am not recommending these drugs, just telling my experience.

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As Rosemary says, wow! Very inspiring. Thank you for sharing.

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@rosemarya

Hi, @azdan99. Wow! Your message of 19 years on the immunosuppressant meds, mycophenolate and tacrolimus, are an inspiration for me!
I had a liver and kidney transplant in 2009, and if my math is correct, that is 12 years for me on mycophenolate and tacrolimus. I also used to take prednisone , because that is what my doctors prescribed according to the current research at the time. Like @athenalee, I used to ask about my medications. One year I decided to stop asking, and that is the year that my doctors told me that they wanted to take me off the prednisone. I was surprised and asked them, "Why now". They said that research indicated that for some patients, the prednisone could be stopped. I was in the 'could be stopped' category.
@azdan99, I am happy to be like you - rejection free with a healthy (transplanted) kidney. I am also, happy that my transplant team prescribed my medications according to the research that related to my current and underlying conditions. @athenalee, I commend you and I thank you for continuing to share relevant /reliable research and information in e transplant discussions. We all benefit.

@athenalee, What is your purpose in wanting to change medications?
Will you post a follow-up after you have your appointment?

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I’ve had several infections over the past six months and an ongoing sore throat, along with peripheral neuropathy, chronic muscle pain, and tremors. The first two symptoms I believe may be caused my Mycophenolate, but could be from Sjogren’s Syndrome. My neuromuscular doctor believes the later three are caused by a combination of Sjogren’s, having undiagnosed PBC and liver disease for a number of years, and Tacrolimus.

In mid-February, I’m seeing a Rheumatologist at Lahey, which is my transplant medical center and who supposedly knows about Sjogren’s. So, I’m hoping to get some sort of coordinated care going as all of my symptoms continue to worsen. Unfortunately, many of the treatments for neuropathy interact with Tacrolimus and, one of the few drugs for control of Sjogren’s does as well. Mycophenolate is another drug used for Sjogren’s, however, and it’s certainly doing nothing. So, honestly, I don’t know, but I’m just hoping for some help.

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I’ve been on anti-rejection meds for almost 28 years. First kidney transplant in 1994. I started on Sandimmune (Cyclosporine) and prednisone. Switched to Cellcept a few years later, then to Mycophenolate a few years after that. First transplant started to fail about 4 years ago and I was lucky enough to get a second transplant in 2019. Now. I’m taking Mycophenolate, Tacrolimus and Prednisone.

Side-effects have been acid reflux, skin issues, low magnesium, high blood pressure and recently hair loss. But I’m 69 now, so some of these could be age related.

My dosage of the anti-rejection meds frequently changes depending on lab results. So make sure you don’t run low on them. The dosage could go up and you don’t want to run out.

My advice is to follow your doctor’s orders and always tell them when something is bothering you, no matter how insignificant you think it might be. Try to get some exercise a few days a week, even if it’s just walking, and stay hydrated.

REPLY
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