Kidney Transplant Induction		version 2/19/2026		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		
	☑	Nursing communication	Every visit	S	Until discont'd	
		Please continue to schedule subsequent infusion appointments manually as appropriate.		

Treatment Conditions 	

	
	Interval	Defer Until	Duration	
	☐	Treatment conditions	Once	S	1 treatment	
		Kidney Transplant Induction Immunosuppression.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☑	Insert Peripheral IV or Access Portacath	Every visit	S	 treatments	
		No details available for preview		
	☑	Vital signs - T/P/R/BP	Every visit	S	 treatments	
		Clinic Performed, Normal		
	☑	sodium chloride 0.9% flush 10 mL	Every visit	S	 treatments	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☑	sodium chloride 0.9 % infusion (PERFUSION)	Every visit	S	 treatments	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag., Starting when released, Until Discontinued		
	☑	HEParin, porcine (PF) 100 unit/mL injection 500 Units	Every visit	S	 treatments	
		500 Units, intra-catheter, once PRN, line care, Starting when released, Until Discontinued		
	☑	Discontinue IV	Every visit	S	 treatments	
		Normal		
	☐	Nursing communication	Every visit	S	 treatments	
		o Review CBC prior to releasing Thymoglobulin orders.
	o Call transplant pharmacist if WBC LESS than 3 or Platelets LESS than 75 (WBC 2 to 3 or Platelets 50 to 75 will require dose adjustment; WBC LESS than 2 or Platelets LESS than 50 require holding the dose for one day).		
	☑	Nursing communication	Every visit	S	 treatments	
		Notify provider for any infusion reaction.		
	☐	Nursing communication	Once	S	1 treatment	
		For antithymocyte only:  Notify physician for severe chills		
	☐	Nursing communication	Once	S	1 treatment	
		For antithymocyte only:  Notify physician for vitals: temperature greater than 100.5, systolic BP greater than 160, systolic BP less than 90, diastolic BP greater than 100, diastolic BP less than 60, heart rate greater than 110, heart rate less than 60, respiratory rate greater than 25, respiratory rate less than 8, SpO2 less than 92		

Labs 	

	
	Interval	Defer Until	Duration	
	☑	CBC with Platelet and Differential	Every visit	S	 treatments	
		STAT, Status: Future, Expected: S, Expires: S+365, Clinic Collect		
	☑	Basic metabolic panel	Every visit	S	 treatments	
		Routine, Status: Future, Expected: S, Expires: S+365, Clinic Collect		
	☑	Magnesium level	Every visit	S	 treatments	
		Routine, Status: Future, Expected: S, Expires: S+365, Clinic Collect		
	☑	Phosphorus level	Every visit	S	 treatments	
		Routine, Status: Future, Expected: S, Expires: S+365, Clinic Collect		
	☑	FK506 Tacrolimus level, random	Every visit	S	 treatments	
		Routine, Status: Future, Expected: S, Expires: S+365, Clinic Collect		
	☐	CD3 enumeration	Every visit	S	 treatments	
		Routine, Status: Future, Expected: S, Expires: S+365, Clinic Collect		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Once	S	1 treatment	
		650 mg, oral, every 6 hours PRN, Starting when released, Until Discontinued
	Give 30 minutes PRIOR to Antithymocyte Globulin 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	Once	S	1 treatment	
		25 mg, oral, once, Starting when released
	Give 30 minutes PRIOR to Antithymocyte Globulin infusion.		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 40 mg	Once	S	1 treatment	
		40 mg, intravenous, once, Starting when released
	Give 30 minutes PRIOR to Antithymocyte Globulin infusion.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	antithymocyte globulin (rabbit) (THYMOGLOBULIN) 1.5 mg/kg, HEParin, porcine (PF) 500 Units, hydrocortisone sodium succinate (PF) (Solu-CORTEF) 12.5 mg in sodium chloride 0.9% 244.75 mL IVPB - for PERIPHERAL line	Once	S	1 treatment	
		1.5 mg/kg, intravenous, Administer over: 6 Hours, daily, Starting S As Scheduled, Until Discontinued
	Administer via 0.2-micron low protein binding filter into a PERIPHERAL vein 
	Administer via 0.2 micron low protein binding filter into a PERIPHERAL vein		
	☐	basiliximab (SIMULECT) 20 mg in sodium chloride 0.9% 50 mL IVPB	Once	S	1 treatment	
		20 mg, intravenous, Administer over: 30 Minutes, once, Starting when released		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☑	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	 treatments	
		650 mg, oral, Administer over: 6 Hours, every 6 hours PRN, fever, Temperature > 100F, Starting when released, for 1 dose
	Every 6 hours PRN, for fever, for temperature greater than 100 F.
	
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☑	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	 treatments	
		25 mg, intravenous, once PRN, for minor infusion reaction., Starting when released, Until Discontinued		
	☑	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	 treatments	
		100 mg, intravenous, once, Starting when released
	Once PRN, for infusion reaction