IVIG INFUSION 1 GM/KG FOR KIDNEY TRANSPLANT		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 2 weeks	S	Until S+180	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	FK506 Tacrolimus level, random	Once	S	1 treatment	
		STAT, Normal, Clinic Collect
	Please draw ONE time ONLY before the FIRST infusion.		
	☐	Comprehensive metabolic panel	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Please draw before the FIRST infusion of each month.		
	☐	CBC with platelet and differential	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Please draw before the FIRST and SECOND infusion of each month.		
	☐	Magnesium level	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Please draw before the FIRST and SECOND infusion of each month.		
	☐	CK total and CKMB	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Please draw before the FIRST and SECOND infusion of each month.		
	☐	Basic metabolic panel	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect
	Please draw before the SECOND infusion of each month.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication: Maintain IV access	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		RN is to monitor Vital Signs every 15 minutes for the first hour, and then hourly per unit protocol through the completion of each infusion.		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	sodium chloride 0.9% infusion 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Questions	Every visit	S	Until discont'd	
		For any questions about the orders, please call Transplant Coordinator 713-441-5451.		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Every visit	S	Until discont'd	
		650 mg, oral, once, Starting when released
	Administer 30 minutes before infusion.
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	Every visit	S	Until discont'd	
		25 mg, oral, once, Starting when released
	Administer 30 minutes before infusion.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	immune globulin (GAMUNEX-C) 10 % solution 1 g/kg (Adjusted)	Every 2 weeks	S	Until S+180	
		1 g/kg, intravenous, once, Starting 30 minutes after treatment start time
	Initiate infusion at 30 mL/hr for 30 minutes then double rate every 30 minutes as tolerated to a goal rate of 120 mL/hr in the inpatient setting and a maximum rate of 4.8mL/kg/hr in the outpatient setting. The patient is not tolerating the infusion if they develop headache, flushing, itching, rash, nausea & vomiting, muscle pain, tachycardia (heart rate >100 BPM), a temperature elevation of 1.8 degrees Fahrenheit, hypotension (SBP < 90 mmHg), hypertension (SBP > 180 mmHg), chills, problems breathing, or chest tightness.