Following an organ transplant, you will have regular follow-up visits to the transplant clinic that involve physical examinations and tests to check that your transplanted organ is working properly, and to detect early signs of organ rejection or infection.
In order to look after your transplanted organ, it is important that you know what tests and results to expect. For a lot of the tests, a ‘normal’ result will be slightly different for each person – you can ask your own transplant team what your target values are.
If you have questions or concerns about any of your test results, ask your transplant team.
The transplant360 web app can be used for free to help you keep track of your key lab results as well as setting yourself targets and keeping track of your medication schedule.
all transplant recipients
Alanine aminotransferase (ALT): ALT is released from damaged liver cells, so if blood levels of ALT become high, this can mean your liver may be damaged.
Albumin: Urine is produced by the kidneys and does not normally contain proteins (such as albumin). If a urine test shows that albumin is present, it can mean the kidneys are damaged.
Albumin-creatinine ratio (also known as ACR): The ACR measures whether the amount of albumin present in the urine is as expected given the amount of creatinine. If the amount of albumin in the urine is higher than expected (known as albuminuria), this can mean the kidneys are damaged, allowing albumin to leak from the blood into the urine.
Alkaline phosphatase (AlkP or ALP): ALP is released from cells near bile ducts (which are found in the liver). If blood levels of ALP are high this can mean the bile ducts are damaged or blocked.
Aspartate aminotransferase (AST): AST is released from damaged liver cells, so if blood levels of AST become high, this can mean your liver may be damaged.
Bilirubin: Bilirubin is mainly made from haemoglobin in the liver. If levels become high, this can mean your liver may not be working properly. High levels of bilirubin can cause the white of your eyes and your skin to look yellow (known as jaundice).
Blood pressure: A blood pressure that is consistently 140/90 mm/Hg or above is classed as high and is known as hypertension. It is very important to keep blood pressure at or below the target that has been set by your transplant team to help minimise the risk of damage to your kidneys and your risk of heart attack and stroke.
Cholesterol: Cholesterol is a fatty substance carried around the body in the blood. High levels of blood cholesterol can increase the risk of problems such as narrowing of the main blood vessels, heart attack and stroke. Cholesterol levels should be less than 5 mmol/L.
Creatinine: Creatinine is a waste product from the muscles and is normally removed from the blood by the kidneys. If the kidneys are not working properly, a blood test may show high creatinine levels remaining in the blood.
Drug levels: A blood test is used to measure the amount of anti-rejection drugs (immunosuppressant) in your blood. This must be done regularly to keep blood levels within a range that is right for you. Drugs that are monitored include ciclosporin, everolimus, sirolimus and tacrolimus.
Electrolytes: Electrolytes are minerals found in the blood and have various functions.
- Potassium (K) is important for heart and muscle function
- Calcium (Ca) is important for strong bones, teeth, blood clotting and heart function
- Sodium (Na) is important for balancing salt and water levels in the body
- Bicarbonate (HCO3) is important for acid balance in the body
Estimated glomerular filtration rate (eGFR): The eGFR is used to assess how well the kidneys filter blood. The eGFR is worked out using a formula that takes into account your age, gender and blood creatinine levels. If your eGFR falls, this can mean the kidneys have been damaged.
Gamma-glutamyltransferase (GGT): GGT is released from damaged cells near bile ducts (which are found in the liver). If blood levels of GGT are high this can mean the liver is damaged or the bile ducts are damaged or blocked.
Glucose: High blood glucose levels can indicate the development of diabetes. Glucose is absorbed from the food you eat so a blood sample will usually be taken before you have eaten anything that day.
Haematocrit (HCT): Haematocrit tells you the proportion of blood cells that are red blood cells (RBC). Red blood cells carry oxygen around the body, so if levels are low you might feel tired.
Haemoglobin (also identified as Hb): Haemoglobin is found in red blood cells and carries oxygen around the body. If haemoglobin levels are low, you may be anaemic and experience tiredness. Normal haemoglobin levels are 110-165 g/L for women and 120-180 g/L for men.
HbA1c: People with diabetes have this test to measure how much of the blood haemoglobin (found in red blood cells) has glucose (sugar) attached to it. If levels are high, this means that their diabetes has not been well controlled over the past 2-3 months (the life span of a red blood cell).
Platelets: Platelets are cells that allow the blood to clot, so if levels are low you might bruise more easily and bleed for longer.
Protein-creatinine ratio (also known as PCR): The PCR measures whether the total protein in urine is at the level expected given the amount of creatinine that has been released. If too much protein has been released in to the urine (known as proteinuria), this can mean the kidneys are damaged.
Triglycerides (also identified as TG): Triglycerides are a type of fat that are found in the blood. Avoiding eating a lot of fatty foods can help to keep your blood triglyceride levels low, which can reduce your risk of cardiovascular disease which can lead to heart attack and stroke.
Urea (also known as Blood Urea Nitrogen, BUN): Urea is produced by the liver from protein and is removed from the blood by the kidneys. This means that if blood levels of urea rise, the kidneys might not be working properly. If levels fall, this can be a sign of liver damage. Urea levels can change depending on how much protein you eat and can be high if you have not drunk enough.
White blood cells (WBC): WBCs are part of your immune system and are needed to fight infection. High levels of WBCs in the blood can mean you have an infection.
Weight: To look after your body, it is important to maintain a healthy weight by eating a balanced diet and exercising regularly.
pancreas transplant recipients
Amylase: Amylase is produced by the pancreas to help digest food. Amylase levels in the blood can be used to monitor the function of the pancreas. An increase in blood amylase levels can mean the pancreas is swollen. If you have a pancreas which drains into your bladder, amylase can also be measured in the urine; a decrease in amylase levels can be a sign of organ rejection.
heart or lung transplant recipients
Lung function tests: Lung function tests are used to measure how well the lungs fill with air, and how well oxygen is transferred to the blood.