Follow-up care after kidney transplant abroad: who checks what, and how often
The operation is the short part. A transplanted kidney needs checking for the rest of its working life, and after a transplant in Turkey most of those checks happen in your home country, by a doctor who did not do the surgery.
Quick answer
Follow-up care after a kidney transplant abroad continues with your own nephrologist, working from the transplant centre's written handover: operation report, medication plan and monitoring schedule. Blood tests track kidney function and anti-rejection drug levels, often several times a week at first and every two to three months after the first year. Never change a dose on your own.
For the operation itself, see kidney transplant in Turkey. This page is for the patient and for the nephrologist who will receive them. It sets out the minimum monitoring schedule from the KDIGO guideline, what the level checks for anti-rejection medicine involve, and how the Turkish team and your home team stay connected. You remain your home doctor's patient; Nexwell does not take over clinical decisions.
Follow-up care after kidney transplant abroad: who is responsible for what
Responsibility is shared, and it helps to know the split before you leave Turkey. The organ transplant team at ASV Yaşam Hospital has its roots in Akdeniz University.
| Who | What they do |
|---|---|
| Transplant centre, ASV Yaşam Hospital, Antalya | Performs the operation, writes the discharge handover, and under the regulation its responsible specialist is answerable for the recipient's follow-up (Regulation, Art. 25(2)). Stays available to your nephrologist for advice. |
| Your home nephrologist | Runs the routine monitoring, reads the results against the handover, and contacts the transplant team about changes. |
| You | Take the medicine exactly as written, keep every blood-test appointment, and report fever, pain or any change in how you feel straight away. |
| Nexwell | Passes questions and documents between the teams and arranges logistics. Does not prescribe, adjust doses or interpret results. |
Source for the regulation row: Organ Transplantation Services Regulation, Official Gazette 9 December 2022.
What the handover should contain
Before you travel, the transplant centre gives you documents for your home team: the operation report, your immunosuppression plan, a monitoring schedule and vaccination advice. Ask for them in English, with units written out, and check that your nephrologist has agreed to follow you before the flight.
Add two items yourself. Ask which results the Turkish team wants to see and how often, and ask in writing who at the centre your nephrologist should contact. For the wider picture of aftercare for international patients, see our guide to post-treatment follow-up and aftercare.
The monitoring schedule: how often blood is checked
KDIGO recommends measuring serum creatinine at least daily for 7 days or until discharge, two to three times a week for weeks 2 to 4, weekly for months 2 and 3, every 2 weeks for months 4 to 6, monthly for months 7 to 12 and every 2 to 3 months after that (KDIGO 2009, rec. 8.3).
| Time after transplant | Serum creatinine | Urine protein |
|---|---|---|
| Week 1 | Daily | Once in the first month, as a baseline |
| Weeks 2 to 4 | 2 to 3 times a week | Once in the first month, as a baseline |
| Months 2 to 3 | Weekly | Every 3 months during year 1 |
| Months 4 to 6 | Every 2 weeks | Every 3 months during year 1 |
| Months 7 to 12 | Monthly | Every 3 months during year 1 |
| After 12 months | Every 2 to 3 months | Yearly |
Source: KDIGO 2009, chapter 8, rec. 8.2, 8.3 and Table 4. Separately, KDIGO suggests a blood test for BK virus every month for the first 3 to 6 months, every 3 months until the end of year 1, and whenever the creatinine rises without explanation (rec. 13.1.1).
These are minimums for a typical adult recipient. Your team may test more often, and a rising creatinine or an infection changes the plan. Which row you are in when you fly depends on when the transplant team clears you to travel, so ask for your own schedule rather than assuming one.
Anti-rejection drug levels: what the checks involve
KDIGO recommends measuring blood levels of calcineurin inhibitors, the drug class that includes tacrolimus and cyclosporine. Levels should be measured at least every other day right after the operation until the target is reached, whenever a medicine or your condition changes in a way that could alter the level, and whenever kidney function declines (KDIGO 2009, rec. 5.1).
For tacrolimus the guideline suggests a 12-hour trough level, a blood sample drawn about 12 hours after the previous dose (rec. 5.1.2). Ask your transplant team exactly when to take your dose on blood-test days, because a sample drawn after the dose reads differently.
KDIGO names other drugs, diet and intestinal motility as factors that can change cyclosporine levels (chapter 5 rationale). Ask your transplant team whether the same applies to your medicine, and tell them before you start anything new or when you have vomiting or diarrhoea. Do not stop or change anti-rejection medicine without your transplant team.
Vaccines, infections and sun
KDIGO suggests avoiding live vaccines after a kidney transplant, and avoiding other vaccines except influenza in the first 6 months (rec. 12.2, 12.3). It recommends an annual flu vaccine for recipients who are at least 1 month past transplant, whatever their level of immunosuppression (rec. 12.3.2).
It also recommends that recipients minimise lifelong sun exposure to reduce skin cancer risk (rec. 18.2). Travel vaccines, such as rabies or meningococcal, are judged by risk and need your team's advice before you book a trip.
Staying in touch with the Turkish team
Your nephrologist can ask the transplant centre for advice, and the centre stays available for that. In practice the questions that need the Turkish team are the unusual ones: a creatinine that will not settle, a level that is off target after a medicine change, or a question about the operation itself.
Send results in a form the other team can read: dates, units and the previous value next to the new one. Your Nexwell coordinator can pass documents and questions between the teams, but the clinical answer always comes from a doctor.
Missed doses and warning signs
KDIGO says to consider education on taking immunosuppressants reliably for every recipient and family members, with closer screening for those at higher risk of missing doses (rec. 11.1, 11.2). Set phone alarms, keep a written list of doses, and carry a spare supply when you travel.
Call your home team the same day for fever, pain over the graft, much less urine than usual, or any new illness. Do not wait for the next scheduled visit.
For information only, not medical advice and not an offer of treatment, organs or donors. Eligibility for any transplant is decided by the transplant centre and, where the law requires it, by an ethics commission.
Frequently asked questions
Who manages my anti-rejection medicine after I return home?
Your home nephrologist, working from the transplant centre's written medication plan. The centre stays available to your nephrologist for advice. You should never stop or change a dose without your transplant team, even if you feel well.
How often are blood tests needed after a kidney transplant?
KDIGO's minimum for serum creatinine is daily for the first week, then 2 to 3 times a week for weeks 2 to 4, weekly for months 2 and 3, every 2 weeks for months 4 to 6, monthly for months 7 to 12 and every 2 to 3 months after that. Your team may test more often.
What is a tacrolimus trough level?
It is a blood sample taken about 12 hours after your previous dose, just before the next one. KDIGO suggests this timing for tacrolimus. Ask your transplant team when to take your tablet on test days so the sample reflects the lowest point.
Can I still contact the Turkish transplant team from home?
Your nephrologist can ask the transplant centre for advice, and your Nexwell coordinator can pass documents and questions between the teams. Nexwell does not give clinical answers or change doses. Ask the centre in writing who your nephrologist should contact.
Which vaccines can I have after a kidney transplant?
KDIGO suggests avoiding live vaccines and, in the first 6 months, vaccines other than influenza. An annual flu vaccine is recommended from 1 month after transplant. Ask your transplant team before any other vaccine, including travel vaccines.
Send your records for an eligibility review
Nexwell does not find, supply or pay donors.
Related guides
Kidney transplant in Turkey
Living-donor rules, work-up and follow-up for kidney patients.
Read the guide →Organ transplants in Turkey
The legal framework and process for every transplant type.
Read the guide →Nephrology and kidney care
Kidney disease care from early stages to transplant evaluation.
Read the guide →Sources
- Law No. 2238 on the Removal, Storage, Grafting and Transplantation of Organs and Tissues (mevzuat.gov.tr)
- Organ Transplantation Services Regulation, Official Gazette of 9 December 2022 (resmigazete.gov.tr)
For information only, not medical advice and not an offer of treatment, organs or donors. Eligibility for any transplant is decided by the transplant centre and, where the law requires it, by an ethics commission. See our editorial policy and medical disclaimer. Nexwell Clinics is a medical tourism company (Nexwell Global Solutions FZCO, Dubai); treatment is provided by independent, Ministry of Health–licensed hospitals and clinicians. Last updated 31 October 2026.