After A Kidney Donation

Recuperation

Recuperation from a kidney donation, as from any surgery, is a gradual process.

The operation takes about three hours on average, and is followed by a further two to three hours in the recovery room. When the recovery room medical staff determine that the donor is in a satisfactory, stable condition, he is transferred to a regular ward.

Hospital stay

After surgery, the donor usually remains in hospital for two to four days, and is then discharged to continue recuperation at home. For the first day the donor is attached to a catheter, in order to monitor kidney function and the amount of urine passed. It is essential to drink a lot. While hospitalized, the donor needs no medical treatment other than painkillers and the supervision of the medical and nursing staff. He is required to get out of bed, walk around, stand, and sit, rather than resting all the time, so as to speed up the rate of recovery.

Recuperating at home

After being discharged, the donor must take it easy at home or in his immediate surroundings for a few days, depending on how he feels. Routine daily activities may well be painful or uncomfortable for the first few days, but ordinary painkillers, like those used to treat headaches, can deal satisfactorily with this level of pain.

About a week after surgery, the donor has a check-up at the transplant clinic, and if necessary, his stitches or staples are removed (usually, dissolvable stitches are used).

Back to work and physical activities

We recommend returning to work no earlier than two weeks after surgery; going back too early can be harmful to recovery. A donor is entitled to compensation from the Ministry of Health for 40 lost work days.

For six weeks after surgery the donor must not lift any heavy weights (of more than 5 kg) or engage in any strenuous activity, as explained to him by the hospital staff. Returning to sports and physical activities must be gradual. Anyone who engages in professional sport or extreme sport should ask for individual guidance from the hospital staff. It is important to consult the transplant department staff and receive individual guidance concerning all questions or dilemmas that may arise.

Follow up care for donors after the kidney donation

Before donating a kidney, a person undergoes a long process of thorough testing to ensure that he will enjoy a long, healthy life, God willing, after his donation. Nevertheless, the donor is left with only one kidney, and he must do his utmost to safeguard it by maintaining a healthy lifestyle.

There are several rules that a donor should follow carefully. He should also do periodic tests to identify any abnormalities which may occur, so that they can be treated in a timely manner.

With the help of prominent specialists in the field, we have compiled the following list of recommendations and tests.

There are two types of periodic tests: tests to be carried out immediately following the kidney donation, and tests for long term follow-up.

We have attached a form for your doctor in the community, which contains a list of tests the donor must undergo. Print the form and hand it to your family doctor.

General recommendations

  • Maintain a healthy weight.
  • Do not smoke.
  • Do not fast during the first year after donating a kidney (you should drink), and avoid extreme dehydration throughout your life.
  • Avoid very high levels of protein consumption (protein drinks or protein-rich diets).
  • Avoid medication that is harmful to the kidneys (non-steroid anti-inflammatories [NSAIDs], such as Naprosyn, Advil, Ibufen, Naxyn, Voltaren, Abitren).

Periodic tests

Stage 1: Initial period after the kidney donation

Ten to fourteen days after the operation the donor must have a post-surgical check-up at the medical center where the surgery was performed. The surgeon examines how the incision is healing, and the body’s recovery as a whole.

Three months later a surgeon must examine the donor again. Blood and urine tests must be carried out before the check-up (see attached form). The test results are taken to the appointment, and if any abnormality is found, the donor is referred to a nephrologist.

Stage 2: Long-term follow up

From one year after surgery, the following tests should be performed annually at your local clinic, and the results taken to a nephrologist.

  • Blood count
  • Full biochemical check-up, including kidney and liver function, electrolytes, and lipid profile
  • Urinalysis
  • Urine albumin/creatinine ratio
  • Urine protein/creatinine ratio

Limitations on fast days

Kidney donors and fasting

Following a kidney donation, the donor’s remaining kidney undergoes a process of development and growth, in order to ‘compensate’ the body for the absence of the kidney that was removed. During this period, dehydration must be avoided, so that the body can regain its strength. For this reason, doctors recommend that donors do not fast for the initial period following the kidney donation.

Medical opinion is divided as to how long this initial period lasts, but the consensus is that the donor can fast as usual from one year after surgery.

After consulting medical specialists and senior rabbinic authorities (poskim), our recommendations are as follows:

Yom Kippur

A year or more after a kidney donation, the donor can fast as usual. However, since he must avoid dehydration, he must stay out of the sun and refrain from physical exertion. It is advisable to stay in air-conditioned surroundings.

If less than a year has passed since the donation, the donor must drink one and a half liters of fluids in the halachically-defined manner (i.e. le’shiurim).

For more detailed instructions (formulated by Rav Heber) for donors and recipients, press here.

Tisha B’Av

According to medical specialists in Israel and senior rabbinical authorities, a person who has donated a kidney within the last year must not fast on Tisha b’Av. From a year onward, he can fast as usual (unless he has any special problems). Kidney donors must be careful not to dehydrate, so they must refrain from physical exertion and exposure to heat, and try to stay in air-conditioned surroundings.