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Kidney Transplant Basics

Rejection is a frightening word, but it doesn’t always mean you’re going to lose your new kidney.

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Covid-19 cases are down, and hospitals are now returning to normal operations and so I figured now would be a good time to share with you some common questions most patients have in order to avoid any misconceptions about kidney transplantation.

When do I get to go home after my transplant?
Although most patients are sent home five to seven days after surgery, there’s really no set time frame. Transplant teams look at a number of factors before deciding on sending a patient home. These include your overall health and your ability to care for yourself before your transplant, your lab results, any chronic health problems, and the availability of caregivers and the level of support at home.

What medications will I need to take?
You’ll be prescribed a number of different medications, including medications called immunosuppressants which are
anti-rejection medications. Think of them as your way to “hide” your new kidney from your body’s immune system to protect it from being attacked and destroyed. You’ll be taking these as well as other medications that your doctor may prescribe. Always make sure to inform your transplant doctor about any new medications as some may interact with your transplant medications in a negative way. Also, although the science of transplantation is always changing and improving, expect to take your immunosuppressants for the lifetime of your kidney transplant.

Should I be worried about rejecting my new kidney?
Rejection is a frightening word, but it doesn’t always mean you’re going to lose your new kidney. Rejection is uncommon and your transplant team knows how to manage rejection with medications. Rejection is another reason why it’s so important to take your post-transplant medications as instructed. After treatment, most people will still lead relatively normal lives with their transplanted kidney.

When can I go back to work or school?
Most patients can go back to their jobs, school, or even start new careers weeks after their surgery. Normally, your transplant team is waiting for your kidney and your immune system to achieve a stable state. They do this through your regular visits and monitoring your lab results. You should ask your transplant physician about the number of weeks you can expect to return to work or school after the transplant as this may vary from patient to patient.

What kinds of food should I be eating?
After your kidney transplant, your diet will change. Unlike the time when you had chronic kidney disease or were on dialysis, you’ll now be able to eat more protein. You’ll be able to and may actually need to drink more water as well, something very different particularly for the patients who were on “water restriction” during the time that they were still on dialysis. A sensible diet is still best. And when in doubt, “if you can’t cook it, or you can’t peel it, you can’t eat it.”

How does this impact my loved ones?
While you were ill, family and friends may have had to manage many things for you or helped you with your care. After your transplant, you’ll be able to handle more of these issues on your own. Before your transplant, sexual activity may not have been possible. Now that you feel better, you may be ready to reconsider. Be sure to talk to your transplant team before resuming sexual activity.

When can I start exercising?
After a kidney transplant, people can respond differently. The amount of activity you can handle depends on your age and personal health. The goal is to get moving! For one person, “moving” may mean sitting up in a chair. For another, it may mean walking several times a day. If moving is challenging, your transplant team may prescribe physical rehabilitation to get you started in the safest way possible. Don’t be alarmed if you need rehabilitation support. Once you’ve found your “new normal,” keep exercising so that you can stay as fit as possible.

The key to maintaining a healthy kidney transplant is to have open and honest communication with your transplant team. As I always tell my patients, there are no silly questions. And I would rather they asked me first, instead of doing something they shouldn’t have done and potentially endangering not only their new kidney, but their health as a whole.

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