Consultations at hospital and laboratory analyses

 

CONSULTATIONS AT HOSPITAL

Children are inspected regularly after the graft depending on the needs. Typically, the rhythm of consultations at our Centre is as follows: every 3 months during the first year, every 6 months during the second year, then once a year. This is a generalised follow-up schedule that is individualised for every child. Normally, these follow-ups require a stay in Geneva for one day. Your child can either be hospitalised in the paediatric surgical ward or examined as an out-patient in the day surgery centre (unité de chirurgie ambulatoire, UCA) or at the polyclinic. Between these consultations at the hospital, you also have follow-up examinations at your paediatrician or gastroenterologist.

The follow-ups often are more frequently during the first year due to problems associated with the graft or the immunosuppression. During these appointments, the surgeon, the gastroenterologist and/or the nurse perform an evaluation. Other team members may meet you as well during these appointments in case of need. For every appointment, you must bring with you the data regarding the pressure and the temperature of your child, his drugs, his certificate of vaccination and all other information that we ask you to provide us with.
 

LABORATORY ANALYSES

It is necessary to perform frequent laboratory analyses during the first month after the graft. The sampling schedule depends on prior results and on the symptoms of your child. In the absence of problems, laboratory analyses take place about once per week, then once per month and finally half-yearly. The internal specialist examines the results of the analyses together with the other physicians of the transplant team and calls you when the medication should be changed. The results of the analyses are important to detect possible problems of the liver or the kidneys. It is also very important that the transplant team follows these results closely in order to be able to give your child the best possible treatment. Problems regarding the liver can be solved more easily when detected early. A change in the results sometimes is the only evidence of the presence of an infection or a problem with the transplanted liver. During these laboratory analyses, we often verify the concentrations of the drugs. This is why blood samples must be taken at a particular time: in general, at the moment of the usual administration of the anti-rejection treatment. It is important as well that you arrive at the time stated on the notice sent to you by the transplant secretary. When you have any question regarding this letter or the time of the appointment, please contact the transplant secretary as soon as possible after having received the letter. In fact, it is not easy to organise these evaluations and the fact of changing the time of arrival may make the other intended examinations impossible. Other laboratory analyses will sometimes be performed by your attending physician or at the hospital near your home. This is a generalised follow-up plan that will be individualised for your child. When you live far from Geneva, we will ask you to have the analyses performed near your home and to consult your local gastroenterologist and your paediatrician for the follow-up. Make sure to comply with these appointments as strictly as with those performed at our Centre in Geneva (in particular compliance with the sampling time).

Caution: Blood samples must be taken at the time of the usual administration of the anti-rejection treatment. This means that you must not give your child the morning dose of the anti-rejection drug before you come to the hospital. You can administer it after the blood sample has been taken, a delay of some minutes does not involve any risk.