After kidney transplantation is the beginning of a new life for uremic patients, and the subsequent series of processes can be divided into several stages just like a person’s life, and the focus of each stage of care will be different. According to current knowledge and understanding, post-transplantation can be divided into the following stages: 1. The first two weeks after kidney transplantation These two weeks are mainly for rehabilitation after surgery and recovery of transplanted kidney function, and these two weeks focus on surgical complications such as bleeding, urinary fistula and lymphatic leakage. At the same time, the use of immunosuppressants is started during this time, and the concentration of immunosuppressants needs to be tested, as well as the wound healing gradually after surgery, and the stitches can be removed in about 2 weeks after surgery. During this time, attention should also be paid to helping patients understand the types of immunosuppressants and possible side effects. Two weeks after surgery is also the period of high incidence of acute rejection, so it is necessary to add immunosuppressants and measure the concentration in time to avoid acute rejection induced by too low concentration of drugs. About 2 weeks after surgery, if the function of the transplanted kidney recovers well and the wound heals well, then discharge from the hospital can be considered. Wen Jiqiu, Department of Nephrology, General Hospital of Nanjing Military Region 2. 2 weeks to 6 months after kidney transplantation This period is when the patient has been discharged from the hospital and lives in a house near the hospital. The focus of this period is to visit the kidney transplant physician’s clinic regularly, while monitoring the drug concentration and various indicators, most notably blood routine, including blood WBC count, blood lymphocyte count, hemoglobin, platelet count, blood biochemistry including liver and kidney function, blood lipids, electrolytes, etc., drug concentration, and urine routine. The focus of care during this period is to prevent infection and to keep a diary at home to record the post-transplant diary: weight, urine output, temperature, medications taken, etc. It is also important to prevent rejection. During this time, the transplant surgeon needs to adjust the immunosuppressant medication according to the patient’s condition to achieve the level of no infection and no rejection, which is a skill that can only be understood. Each transplant center’s experience will be different. The frequency of follow-up during this period is once a week for 3 months and once every two weeks from 3 to 6 months. 3. 6 months to 3 years after surgery In the 6 months after kidney transplantation if it passes and the patient is stable, he/she is relatively liberated. Patients can consider starting to return to their old home or return to study and work. The focus during this period is mainly on prevention of long-term complications, prevention of chronic rejection, and complications of long-term infections such as urinary tract infections, skin infections, etc. It is also necessary to monitor various medication side effects, especially immunosuppressive side effects. The frequency of follow-up during this period is once every 1-2 months 4. After 3 years postoperatively With the extension of kidney transplantation time, the transplanted kidney gradually settles in the recipient’s body, the focus of care during this period is on chronic rejection of kidney transplantation and long-term complications such as tumor, osteoporosis, diabetes, hypertension, coronary heart disease, hyperlipidemia and other such complications, because these complications can affect the transplanted kidney and the patient’s life expectancy. Therefore, this time, it is also important to adjust the immunosuppressive regimen according to the patient’s condition in a timely manner. Some patients will have proteinuria and hematuria, and these need to be considered as transplant nephropathy recurrence. 5. More than 10 years after surgery These patients are much the same as more than 3 years, except that with the extension of the transplantation time frame, the nervousness of the kidney transplant recipient will loosen up and easily relax the requirements and monitoring, which may increase some corresponding risks. 6. the period when the transplanted kidney has distant problems This refers to a special category of cases, mainly referring to the abnormal function of the transplanted kidney, with clinical manifestations such as elevated blood creatinine and proteinuric hematuria. This period is the period when the relative adjustment of various immunosuppressants is greater and the human state changes most drastically, so it needs to be especially raised. This kind of mainly prevents complications of too strong use of immunosuppressants, such as various infections in the distant period, especially serious lung infections. It is also important to pay attention to gastrointestinal infections, urinary tract infections, etc. It is also important to pay attention to the need for a holistic view in treating this period, so as not to damage the health of the whole organism in order to desperately protect the transplanted kidney, resulting in serious complications throughout the body, if so, it is picking up the sesame seeds and losing the watermelon. There is no value in preserving the kidney. This is just our experience divided into various periods after kidney transplantation, but this staging is not absolute, it is a relatively continuous process. It is of great benefit to kidney transplant recipients and doctors to be able to grasp different priorities of care at each time. And should immunosuppression be different at different times? Should they be adjusted over time? In the next article, we will focus on this.