After discharge, you will need blood tests completed twice a week. Our routine lab days for testing are Monday and Thursday. These blood test are very important as they can indicate problems before they are too serious.

Depending on the type of transplant you have, there may be different laboratory tests ordered. Your liver transplant coordinator will cover the necessary tests and the normal expected values for you specifically. It is always handy to carry a notebook to record this information as there may be special directions that must be followed for the tests.

For example:

• Can you eat or drink after the blood is drawn?
• Should I stop eating or drinking prior to the test? If so, how many hours?
• After taking certain medications, how much time should pass before having blood drawn?

It is very important to follow the exact instructions when you have blood levels drawn. Remember DO NOT take Neoral or Prograf medication until after all your blood work is completed. Draw blood 12 hours after you take Neoral or Prograf.

You may want to take your Neoral and/or Prograf medication to the lab with you on testing days so that it may be taken after the blood is drawn.

Establishing a routine of measuring your temperature, blood pressure, and pulse once every morning and once in the evening is an important task. Changes in these measures can be early indicators of symptoms that you may need to alert your doctor. By maintaining these recordings in a daily log, it can provide insight and patterns that may be needed.

Weight
Using the same scale at the same time, weigh yourself every morning after going to the bathroom but BEFORE eating breakfast. Make sure that you are wearing about the same amount of clothes each time.

Your weight is important as your immunosuppression doses may be adjusted according to your weight. Rapid weight gain usually indicates retention of fluids which can be a side effect result of your medications or it could be a sign that kidney functioning has decreased. On the other hand, rapid weight loss may be a sign of dehydration, which is unhealthy for the entire body, especially the heart and kidneys.

IMPORTANT: REPORT IF YOU HAVE HAD A RAPID WEIGHT GAIN OR LOSS OF OVER/UNDER TWO POUNDS PER DAY FOR TWO DAYS IN A ROW.

Temperature
Take your temperature two times a day. If there are times that you feel cold, hot, achy or chilly, take your temperature again. Chills may indicate that your temperature is rising.

WARNING: Do not take Tylenol unless you have been told otherwise.

Fevers can be a symptom of rejection or infection. Tylenol can take away the fever but will mask the real problem leaving it to go untreated. Any fever of 100°F ( 37.8 °C) or higher for 24 hours should be reported. If the temperature is greater than 101° F (38.5°C) call IMMEDIATELY.

Pulse
Your pulse is the number of times your heart beats in one minute. Some medications can affect your pulse rate. Learn how to check your pulse and how your medications can affect your own pulse rate. Be aware of irregular pulse or pulse rates less than 60 or greater than 120 per minute.

Blood Pressure
Take your blood pressure two times a day, once in the morning and once in the evening. High blood pressure problems are common for transplant patients. Knowing how to take your own blood pressure will help you become comfortable with your personal fluctuations and to put you in tune when it is necessary to seek medical help.

Never take your blood pressure if you have either exercised or eating in the past 15-30 minutes. Always rest for 5 minutes with your feet flat on the floor and your arm position unchanged at heart level. Initial blood pressure reading should be taken on the lowest reading arm on a regular basis and never measure the pressure in both arms for comparison. Report systolic blood pressure (top number) greater than 180 or less than 100 or diastolic blood pressure (bottom number) greater than 100 or less than 60 immediately.

Your blood pressure normally changes throughout the day. Typically it increases in the afternoon and evenings and decreases in the late hours of sleep.

You may use a manual or a digital blood pressure device for your reading. Both are considered accurate and safe.

Accuracy of readings is very important. You should compare your equipment readings along side the readings by the hospital, clinic or doctor's office for about a month or so to verify accuracy of your home device.

There will be times that blood pressure equipment must be recalibrated. When you purchase your device, check to see how to have the equipment fixed in the future.