Top tips about kidney transplants

In this article we will describe top tips about kidney transplants. This will focus on the period after a transplant, especially the first year. Remember ..

“A good transplant is one that is working well at one year with a blood creatinine level of under 150 mcmol/L”

Typical scar after a kidney transplant

1. Take all your medications as directed

Because your body first recognises your new kidney as a ‘foreign object’, it will normally try to get rid of it or ‘reject’ it. But you will be given immunosuppressant drugs to prevent rejection.

These include:

After the first 3-6 months, the risk of transplant rejection is lower, and your immunosuppressant drugs will be reduced. You should have more energy and be able to start doing more.

2. Know your numbers

You should know your latest blood creatinine level at all times. It is not just up to your doctors to follow your blood tests. If you have had blood taken in the morning in transplant clinic, ring late afternoon to find out (and write down) the result.

The normal level is 60-120 mcmol/L. The lower the level, the better – i.e. the better the transplant is working.

Look out for diabetes

Diabetes is common (very) after a kidney transplant, occurring in upto 30% of people on tacrolimus.

So when you check your numbers, check your glucose too (it should be 4-6 mmol/L). An early switch from tacrolimus to ciclosporin (or another drug) can stop diabetes progressing, and the glucose may return to normal. When diabetes does develop it usually requires treatment for life.

3. No driving for six weeks

Driving can aggravate or damage your surgical wound, so you should not get behind the wheel for at least six weeks after your transplant.

4. Take it easy

Sorry, gym rats, but your body needs a little bit of a break. So avoid lifting heavy objects and strenuous physical work for at least eight weeks following surgery.

Start exercising … slowly and gently

Lifting may be a no-go, but in general, exercise can go a long way toward helping you heal. Your doctor will recommend when to start walking; and as you begin to feel better, you can add in activities like jogging, cycling, tennis, golf, swimming and aerobics.

5. Stay hydrated and measure urine output daily

One of the keys to a successful recovery is staying well-hydrated. You should drink plenty of liquid (a mix of water, squash and tea is good) — typically at least 0.5 litres (1 pint) more than your previous days urine output.

You should measure your urine output daily until the doctors say to stop.

6. Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs)

Some very common over-the-counter (OTC) drugs, including aspirin, ibuprofen and naproxen, can cause decrease the function of the kidney. You should not take them.

7. Avoid certain vitamins and herbal supplements

Non-prescription pills, including vitamins or supplements, are not safe for use – in general, and especially after a kidney transplant.

For example, St. John’s wort, Schisandra and some herbal teas and other natural supplements may reduce the effectiveness of your immunosuppressant drugs (making rejection more likely).

8. Keep your follow-up appointments

To make sure you are healing well, it is critical that you go to all of your follow-up appointments with your transplant team.

You will be seen in transplant outpatients very often initially, usually 3 times a week (or perhaps) daily. Attend all these appointments carefully.

The risks of kidney transplantation are the same as those of any surgery. There is the risk of bleeding, infection or breathing problems.

You may also experience side effects from the medications, and you will be more prone to infections (since the medicine you will take after transplantation lowers your body’s ability to fight infection).

Act if get these symptoms

If you experience any of the following symptoms, you should contact your transplant team immediately:

A temperature of 38C or more. Unusual infections occur after a kidney transplant
New pain or tenderness around your kidney
Swelling (oedema) – especially in your legs
Flu-like symptoms, including chills, headaches, dizziness or nausea and vomiting
A noticeable decrease in the amount of pee (urine) you produce
Shortness-of-breath.

9. Skin cancer prevention

Immunosuppressant drugs also cause an increase in the likelihood of cancer, especially skin cancer. This is because the immune system protects you from cancer, not just infection. But there are things you can do to reduce the chance of getting skin cancer:

Dress for protection. Wear a hat, sunglasses, long-sleeve shirt and trousers
Limit sun exposure. Stay out of the sun when UV light is strongest (10 a.m. to 4 p.m.). Remember that UV light exposure doesn’t just occur when it’s sunny – you’re also exposed on cloudy days. UV rays can also reach you when riding in a car or sitting near a window.
Wear suntan lotion daily. Choose a sunscreen with a sun protection factor (SPF) of at least 50. The higher the SPF, the longer the protection. Put sunscreen on liberally and evenly. Don’t forget to cover your face, scalp, ears, hands and feet. Reapply every four hours for the best protection.

Post transplant lymphoproliferative disorder (PTLD; lymphoma)

This is a form of blood cancer that occurs in 2% of people who have had a kidney transplant (Kaminska, 2020). There are no specific symptoms to suggest you have it. This is why you should report any strange symptoms to your transplant team.

10. Planning a family after a transplant

You can try for a baby after a kidney transplant
Your fertility will improve
You should wait a year before trying for a baby.

Overall

Most people lead healthy, fulfilling lives after their kidney transplant. By taking good care of yourself as you recover, you give your body the best chance of healing well – so that, soon, you can get on with living your best life.

Summary

We have described top tips about kidney transplants. We hope it has been helpful.

Other resources

Renal transplantation (UHCW patient information)
Review article: Abramyan, 2023

Last Reviewed on 4 May 2024