After a Kidney Transplant
After a kidney transplant at Dartmouth-Hitchcock (D-H) Transplantation Surgery, you should be able to return to work and eat a regular diet. You can typically resume normal activities, though you need to take some extra precautions.
When to call after transplantation surgery
- Weight gain of 2 pounds in one day or 4 pounds in one week
- Fever - Temperature over 100.6° F
- Pain or tenderness over the transplanted organ
- Decreased urine output
- Extremity edema (swelling)
- Breathing problems - problems breathing when you lay flat in bed
- Incisional area - increased pain, redness, tenderness, swelling, and/or drainage
- Urinary symptoms - pain, burning, tenderness when you urinate; more frequent urination; cloudy or foul-smelling urine
- Nausea and vomiting - that lasts greater than 24 hours and/or you can’t keep your pills or fluids down
- Excessive pain not controlled with pain medication
- Blood in your urine
- Prolonged constipation or diarrhea (that lasts longer than 3 days)
- Light-headedness, dizziness
- Low blood pressure - systolic BP (top number) less than 100
- High blood pressure - systolic BP (top number) greater than 185
For all other medical complaints and symptoms, please first call your primary care physician who can contact the transplant team if needed.
Precautions after transplantation surgery
- Wash all fruits and vegetables before eating them to reduce the chance of getting infections. Our team dietitian will assist you in creating healthy eating habits to help control your weight, blood sugar levels, blood pressure, and body fluid retention.
- Do not drive for two weeks after you leave the hospital. Be sure to check with your transplant team before starting to drive again.
- Avoid strenuous lifting for at least 6-8 weeks after your transplant. Some exercise, like walking, bike riding and swimming, is recommended. Consult your transplant team before starting an exercise routine.
- Sexual activity can be resumed after checking with your transplant team. Certain medications can interfere with sexual function. Women who have had a kidney transplant usually return to a regular menstrual cycle in two or three months.
- Avoid becoming pregnant for one year after a kidney transplant to avoid dangerous complications for mother and baby. Women should check with the Dartmouth-Hitchcock (D-H) Transplantation Surgery team before conceiving so that medications can be adjusted for safe pregnancy and childbirth.
- Quit smoking. Ask your transplant team or regular doctor if you need help quitting.
- Ask your transplant team if an occasional alcoholic drink is all right when combined with the medications you are taking.
- Pets can be a hazard. Cats are fine, as long as the transplant recipient does not change the litter box, which can be a source of toxoplasmosis. Fish are questionable, as aquarium water can spread unusual infections, especially through cuts and sores on a recipient's hands. Dogs are permitted, as long as they have regular vaccinations and checkups. The greatest risk comes from dogs drinking toilet water, and then coming into contact with the transplant recipient. Birds are not permitted, as they can carry diseases that are transmitted to people. If any pets show signs of illness, seek out your veterinarian at once.
- Health maintenance: Have yearly eye exams, GYN visits (for women), dental appointments, and any other tests your regular doctor feels you may need.
- Medical alert: All transplant recipients should wear a medical alert identification bracelet. Have documents about your medical history with you at all times.
After surgery, the transplant recipient is the eyes, ears, and monitor for the transplant team. You will notice the first signs of any problem. To help us catch any problems early, please do the following at home:
Take your weight
Weigh yourself every morning at the same time of day, after you first empty your bladder. If you gain more than three pounds, tell the transplant team.
Take your blood pressure
Blood pressure should be monitored at least once a day, at the same time you weigh yourself. Know your baseline (normal) blood pressure reading. If your blood pressure is out of your normal range, and it has been at least an hour since you took your blood pressure medications, tell the transplant team. If a reading is high and you haven't yet taken your medication, wait at least an hour to take another reading, so your medication has had time to work.
Take your temperature
Any time you have chills, hot flashes, aches, or feel ill, take your temperature. Increases in temperature could be the first sign of an infection, or of your body trying to reject your new kidney. Tell your transplant team immediately if your temperature is above normal (98.6 degrees Fahrenheit).
Check your pulse
By keeping track of your pulse, you can see if any medications affect your heart rate in unusual ways.
Keep track of your intake and output
Newly transplanted patients are asked to monitor fluid intake and output for about 6 weeks post-surgery. You will receive logging paperwork to help you keep track. If you need to print more copies, download a PDF version below.
After a transplant, medications will always be needed to stop the body from rejecting the kidney. These drugs are called immunosuppressants.
The key to the success of your transplant is to take your medications exactly as prescribed. Because the body can reject the kidney at any time, the medications must be taken every day, even if you feel fine.
Make sure you know
- The name of your medications, and what they do
- When you need to take your medications
- How to prepare and take your medications
- The main side effects of each medication
- What to do if you forget to take a dose of medication
- When to order medications so there is no lapse of time without medications.
- How to obtain medications and prescription renewals. Don't forget that most pharmacies are closed on holidays!
When you leave the hospital, you will receive an appointment card for a follow-up clinic visit. This is usually for the third day after your discharge from the hospital. Please come an hour early for this appointment so we can take some lab tests to track your progress and find any potential problems.
Although the schedule of clinic visits can vary, most patients have follow-up appointments twice a week for the first two weeks after transplantation surgery, and once a week for the next two weeks. In the second month after surgery, most patients have follow-up appointments every other week, and then once a month until the sixth month after surgery. You'll come in for an appointment one year after your tranplantation surgery, and once a year afterwards.
At these visits, you can meet with any member of your transplant team. The visits usually last about thirty minutes.
What is expected of you at the clinic visits
- Bring your medication list and post-surgery handbook (given to you before you leave the hospital).
- We'll ask about your current weight, blood pressure, and pulse, so make sure you have a scale and blood pressure cuff at home.
- It is important to come to appointments on time so the transplant team can give their full attention to any problems you may have
At the end of the clinic visit we'll give you instructions on when to return to the clinic, and when to get lab tests. Because some lab results won't be available until after you have left the clinic, we may sometimes call you after your visit to change your medication dosages.