FAQ: Life After Transplant

Please do not hesitate to ask your questions—however trivial they may seem to you. Every step of the way, your Transplant Coordinator will be available by telephone to answer any questions—and there is no such thing as a "silly" or "dumb" question. Please feel free to ask any questions, at any time, for any reason. We are here to help you.

Your Transplant Coordinator is available if you have any questions or concerns, and you may, of course, contact any member of the Kidney Transplant Team at any time with your questions.

The staff at the Kidney Transplant Center will answer all calls between 9 a.m. and 4 p.m., Monday through Friday, except holidays. The Transplant Coordinators will return these calls at their earliest convenience, usually the same day that you call. The Transplant Office number is 610-619-8420. Leave your name and telephone number where you can be reached. Try to be as specific as possible when you leave your message. Your call will be returned during the next business day. If you need to speak to a Transplant Coordinator during weekends, holidays or after hours, ask the answering service to page the Coordinator, who will return your call. If you have call block, please remember to remove it when expecting a call from our staff.

In an emergency: Call 911 immediately.

In the event of a life-threatening emergency, such as chest pain, coma, breathing problems, or bleeding, call 911 and they will take you to the nearest hospital emergency room. You and your family should always ask the physicians in the emergency department to call the Crozer-Keystone Kidney Transplant Center, but DO NOT try to drive to Crozer-Keystone in an emergency. Call 911.

Am I cured now that I have a new kidney?

A very common question. While a kidney transplant may allow you to have a better quality of life, free of dialysis, it is not a cure. It is an ongoing treatment that requires a lifetime commitment full of medications, doctor visits and tests. It will, however, provide you with a better lifestyle, more energy and should provide you with a level of self-worth that you may not have had while on dialysis.

Do I need to stay close to the hospital post-transplant? If so, for how long?

After you leave the hospital, close monitoring is necessary for a few weeks. Your transplant team will develop a checkup schedule for you.

We will follow you closely for the first few weeks. You will receive an appointment for your next visit to the Kidney Transplant Center and for a procedure to remove a tube in your bladder. We will also give you instructions for lab work or other tests that you might need in order to monitor your progress and identify complications as soon as possible. You should bring your medications and this manual to all of your appointments.

For the first month after your transplant, you will have regularly scheduled follow-up appointments at the Kidney Transplant Center. These visits will be more frequent during the first year after surgery and will gradually decrease over the next few months. After three months or so, you will return to your regular doctor for follow up care. The appointments will involve routine check-ups and blood tests to monitor your progress and to be sure that your body does not reject the organ. Of course, you should always call the Kidney Transplant Team at any time if you are feeling sick or even if you just have questions.

During this time, if you do not live within an easy drive of Crozer-Keystone, you may need to make arrangements to stay close to the transplant center.

What follow-up examinations and tests will I undergo? How frequently?

Routine exams, blood work, laboratory testing and frequent clinical visits are necessary to a successful recovery. Prepare for at least two to three visits to the clinic each week to have blood drawn and participate in a thorough review of your recovery progress. These tests will determine whether or not your current medications are appropriate or need to be adjusted.

The main test used to monitor your new kidney is serum creatinine. A creatinine test reveals important information about your kidneys. Creatinine is a chemical waste product that's produced by your muscle metabolism and to a smaller extent by eating meat. Healthy kidneys filter creatinine and other waste products from your blood. The filtered waste products leave your body in your urine. If your kidneys aren't functioning properly, an increased level of creatinine may accumulate in your blood. A serum creatinine test ultimately measures the level of creatinine and gives you an estimate of how well your kidneys filter waste. Your doctor will provide a thorough review of the results for this tests and provide a direct course of action as necessary.

Beyond the standard blood and creatinine tests, monthly breast and testicular self-examinations are highly recommended, along with yearly PAP smears, breast exams, testicular exams, and skin cancer screenings. Studies have shown that taking immunosuppressive medications can increase your likelihood of developing certain types of cancers. It is imperative that you talk with your doctor to scheduled these examinations and to discuss any questions you may have regarding early detection of these types of cancers.

As you progress through your recovery, the need to visit the Kidney Transplant Center will be less frequent, and you’ll eventually be referred back to your primary care provider and/or nephrologist for long-term care.

What medications will I take after I leave the hospital?

You will take a complex regimen of medications when you leave the hospital and for the rest of your life. You may take many different drugs several times a day, including powerful immunosuppressants and steroids, which can have significant side effects. You will also take several drugs to alleviate these side effects. It is critical that you learn about your medications and develop a system to take them exactly as prescribed. Taking these medications is the single most important thing to do in order to prevent rejection and they must be taken as directed. Not taking the medications immediately or missing doses will cause damage to, and eventual loss of, your new kidney.

The medications fall into nine main categories:

  • Immunosuppressants (or “anti-rejection” medications): These medications are designed to suppress (or lower) your immune system and lessen the chance of kidney rejection.
  • Steroids (the first line of defense for rejection): These medications are also designed to lessen the chance of kidney rejection and will quickly be reduced to low doses.
  • Antivirals/antibacterials: These medications help your body prevent viral, bacterial and fungal infections.
  • Antihypertensive: These medications, although used to treat high blood pressure, will improve blood flow to your new kidney.
  • Cholesterol lowering agents: These medications are designed to lower and manage Cholesterol in your system.
  • Diuretics: Also known as “water pills,” these medications help control fluid buildup.
  • Various medications to help prevent stomach ulcers.
  • Various medications to counter side effects of the immunosuppressants.
  • Vitamins and minerals

Will the transplant center team advise my primary care providers of my care requirements?

Yes. Following your transplant, the team at Crozer-Keystone will work closely with your primary care physician and/or nephrologists regarding necessary post-op and follow-up care. Our policy is to keep them—and you—informed every step of the way.

Will I need to return to the transplant center if I have complications?

Perhaps. It depends upon the nature of the complication. Throughout your post-transplant recovery, your Transplant Coordinator will be available by telephone to answer any questions—and there is no such thing as a "silly" or "dumb" question. Many important phone numbers are listed in your Discharge Guide. Feel free to call them at any time.

When can I return to work/school?

Patients usually return to work within 60 to 90 days. But it is extremely important to alert your employer to the potential conflicts that post-operative testing could produce in the workplace. For example, patients may need to be treated for unforeseen rejection or other problem, resulting in additional time off work. It may be best to initially resume your work on a part-time basis or with a flexible schedule until you have a better understanding of how well your recovery process is going.

Ultimately, the decision of when to return to work or school is entirely up to you. If you have questions or any doubts about whether or not you are ready, sit down with your employer and/or family and develop a return strategy.

When can I begin driving again?

Kidney transplant patients, on average, cannot drive for up to four weeks following the surgery. Post-operative medications generally cause drowsiness, weakness, blurred vision and hand tremors and could make handling a motor vehicle very difficult. Please do not attempt to drive a vehicle without the consent and clearance of the transplant team.

Is it okay to smoke cigarettes or use other tobacco-related products?

Beyond the obvious health benefits, we strongly recommend that you either do not begin to smoke or that you quit immediately. Smoking diminishes your red blood cells' ability to carry oxygen, so less oxygen reaches all of your tissues and this decreases your ability to heal. Smoking also narrows your blood vessels, especially those in your legs, arms, and heart. It also increases the acid in your stomach and can delay or prevent the healing of any ulcers you may develop. All of these problems are even more serious in individuals taking immunosuppressive medications. Finally, smoking can damage the lungs and put you at a much greater risk of developing lung infections, such as bronchitis, emphysema, and pneumonia, and cancer, a leading cause of death among transplant patients.

When can I resume sexual activity? Is it safe to have children after transplant?

Following kidney transplantation, men will typically have far fewer problems with impotence and women may resume their normal menstrual cycle, with chances for pregnancy being far greater than it was before surgery. It is important to note, however, that post-operative surgery medications, such as some blood pressure and anti-rejection medications, could still affect your normal sexual functions. Impotence, menstrual irregularities, increased acne, bruising and body hair could all affect the patient either physically or psychologically.

Urinary tract infections (UTI) are another common problem relating to sexual intercourse. Women who are on immunosuppressant medication tend to develop infections much easier since this medication affects the immune system’s ability to fight off infection. To avoid them, be sure to urinate before and after intercourse and drink plenty of fluids (water). If you think you may be suffering from UTI symptoms or have questions about sexual intercourse after transplant, contact your doctor’s office for more information.

Many transplant patients interested in children want to know if it is safe and possible to continue with their plans following the surgery. While childbirth is not recommended within the first year following the transplant, it is important to know that it is possible and you should take all of the necessary precautions to prevent it until your doctor has cleared you for childbirth. Many patients also want to know if having only one kidney will affect a baby born after the transplant surgery. It has been well documented that many healthy babies have been born to both men and women who have received the transplant surgery. However, studies have shown that there is a greater chance to women who have had the procedure that they might lose the baby prior to full-term or their baby will be born smaller. Also, the chances of birth defects do not appear to be any higher or lower than that of the general population at this time.

Your doctor is always the best source of information about these issues. It’s important to discuss and be under the care of one who has the necessary knowledge and experience to assure the best chance of having a normal pregnancy and a healthy baby.

When can I travel again?

The Kidney Transplant Team at Crozer-Keystone highly recommends that patients do not travel until they are stable and their kidney is functioning properly. Your doctor can help you make a decision on when the right time for travel is. Once your doctor has deemed travel appropriate, the transplant coordinator can provide the names, addresses, and phone numbers of transplant programs in the areas you are going to in case any problems arise. Be sure to carry a list of medications and a medical summary of your procedure and current progress with you when you travel.

We do not recommend travel to under-developed countries, as their availability of high-quality, clean facilities is typically very low. In addition, high-quality food and drinking water may also not be available in these areas, which could lead to risk of serious infection or disease.

Almost any place in the western world and developed areas such as Europe, Australia, Japan, etc. will have the medications and medical expertise to help you in the event that a problem occurs. However, preparedness is the key to travel. Talk with your doctor before you travel to be sure you have everything you need and are properly educated about what to do in the event of an emergency.

What is proper diet and exercise now that I have a new kidney?

Immediately after surgery, your surgical incision will require approximately four to six weeks to heal. Once your doctor has cleared you to begin a non-strenuous exercise program, it’s time to get active. The type and level of exercise you’ll be able to do is strictly dependent on your age, how fit you were prior to surgery, and whether or not you have any underlying medical conditions that may prohibit you from doing certain things. Gentle walks are a great way to get back to doing the things you love again. Take it slow and easy in the beginning. As your condition improves, you’ll be able to walk farther and faster.

Proper diet is important both to the recovery from the transplant operation and to the long-term success of the transplant. Diabetics should continue their typical diet while all other transplant patients should follow a well-balanced diet. Post-op weight gain is always a concern with kidney transplant patients. Expect a significant increase in appetite following the surgery and be sure to watch what you eat and your daily caloric intake.

While each patient is somewhat different, a well-balanced diet containing 1,500 to 2.000 calories a day is generally enough depending on your level of activity and exercise routine.

Many transplant recipients take part in sports in a highly competitive way. The U.S. Transplant Games, sponsored by the National Kidney Foundation, are a testimony to the excellent rehabilitation that results from the combination of a successful transplant and the motivation to get in shape. View additional information about the U.S. Transplant Games.

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