You’ve successfully received a new kidney and it’s functioning properly.
It is now your job to guard your precious treasure so you should take care to follow these rules: Keep the area of the surgery clean at all times by washing with soap. If you notice any redness, swelling, or secretion from the incision, notify your doctor at once.
Personal Hygiene
Minimize the risk of infection by showering daily, preferably with antiseptic soap. Wash your hands with soap after using the bathroom and before meals to protect against infection.
Brush your teeth with a soft toothbrush to prevent mouth infections and gum damage. We recommend brushing after each meal and using an antiseptic mouthwash.
Visit your dentist every six months for a routine checkup. Take antibiotics (Augmentin, etc.) before any dental procedure.
Hair and Skin Care
The medication you take can cause pimples on your face, back, or shoulders. If pimples appear, wash the area thoroughly with soap, rinse the bar of soap and dry carefully. If there is any secretion from the pimples, avoid applying make-up. If the problem persists, consult a dermatologist or the transplantation staff. Steroids frequently also cause brittle hair or hair loss.
Transplant patients are especially at risk from skin cancers because their immune systems protect them less from ultra-violet rays. Avoid exposure to the sun between ten in the morning and four in the afternoon, especially in spring and summer. Spread good-quality sun-block on exposed areas during the summer and wear a hat and long sleeves when out in the summer sun.
Any mole which changes color or whose edges become irregular or which secretes liquid should be checked by a dermatologist. Benign moles sometimes become malignant.
Proper Diet and Nutrition
A central factor in keeping healthy after transplantation is proper nutrition. Medications, especially steroids, increase one’s appetite and frequently lead to weight gain. They can also lead to increased levels of sugars and fats (cholesterol and triglycerides) in the blood and accelerate the process of osteoporosis. We suggest consulting with a nutritionist for a personalized diet plan and long-term supervision.
The following guidelines should be complied with:
- Avoid foods high in cholesterol and saturated fats such as organ meats, fatty meat and poultry, ground meat products, yellow cheeses, high-fat salty cheeses, sour cream, whipped cream, butter, margarine, margarine-rich dough, chocolate, ice cream and cake.
- Reduce intake of sugar, honey, jellies and other foods with high sugar concentration.
- Reduce consumption of salt and salt-rich foods such as soup powders, pickles and smoked foods.
- Avoid fried food if possible. Choose cooking, steaming or baking instead.
- Avoid sugary soft drinks.
- Eat fiber-rich food such as whole-wheat bread, whole rice, and fiber-enriched grains.
- Eat high-calcium foods such as dairy products with at least 5% calcium and fish whose bones are also eaten, such as sardines.
- Be sure to eat food which has been prepared under sanitary conditions. Wash fruits and vegetables thoroughly. Don’t frequent restaurants and avoid rare or uncooked food. There is a real danger from under-cooked foods which may be full of bacteria.
- Weigh yourself frequently. Any significant weight gain is undesirable and should be dealt with.
- It is very important to drink at least two liters of water daily (for adults). On hot days, drink even more.
- At the beach or the swimming pool, avoid exposure to the sun and drink plenty of fluids.
- Due to the medications, grapefruit and grapefruit juice are prohibited.
- If you must restrict potassium consumption, eat fewer fruits, vegetables, legumes, and potatoes.
Visiting Friends
There is no restriction at all on visiting healthy friends. One should avoid contact with people who have contagious disease such as flu, sore throat, etc. and children’s diseases.
Physical Exercise
It is important to gradually resume normal physical activity. Strenuous exercise can be resumed three months after surgery.
Vaccinations
All transplant patients should be vaccinated against the flu every year and against pneumonia (pneumovax) every five years. Anyone coming into frequent contact with transplant patients should avoid being vaccinated against polio and smallpox.
What to Look Out For
There are a number of conditions which may develop months and even years after receiving a kidney:
Chronic Rejection
Among a large percentage of patients there occurs a very gradual deterioration in the functioning of the transplanted kidney. This process is almost unavoidable and takes place over a period of many years, but can be slowed somewhat by the proper control of blood pressure and by minimizing the dosage of anti-rejection medications (Cyclosporine and Prograf) as much as possible. Of course, there are situations where large doses much be used to prevent immediate rejection. You should always follow your doctor’s orders.
Return of the Original Disease
Some of the same diseases which affected the original kidney are liable to return and attack the transplant.
Elevated Fats in the Blood
An elevated fat level in the blood is typical after transplants due to the effects of taking steroids, Cyclosporine, Prograf, and Rapamycin. Reducing these levels by proper diet and by medications which reduce the “bad” cholesterol (LDL) (statins) is vital in preventing heart disease. Latest medical advice recommends reducing the cholesterol level even further, especially for diabetes sufferers.
Hypertension
Hypertension is common after transplantation, mainly due to the effects of steroids, Cyclosporine and Prograf. It is very important to reduce your blood pressure to around 135/85 to prevent heart disease and preserve kidney function.
Diabetes
Diabetes sometime results from taking steroids, Cyclosporine and Prograf after a transplant. Controlling your sugar levels is critical to preventing heart disease and other complications of diabetes, including damage to your transplanted kidney.
Growths
There is an increase in growths after transplantation – mainly skin growths. It is important to follow the rules against exposure mentioned earlier as well as to monitor the situation and bring any changes to the attention of your doctor.
The occurrence of malignant growths among transplant patients is no greater than that of the general population. In any event you should undergo tests for early detection – mammography for women, colonoscopy for men and women over 50 and PSA blood test for men to detect prostate cancer.
The information in this page is based partially on an article by Prof. Eitan Mor, Director of the Transplantation Department of Beilinson Hospital in Petah Tikva
