Your care plan and treatments will change after your transplant. Some things will change a lot from the treatment you had on dialysis. To keep your new kidney working, the medicines you take will change. Tests will be done regularly to check how well your new kidney is working.
Your first year after transplant will be the busiest. There will be a lot of blood tests and many visits with the transplant team. Blood tests are done for many reasons but one of the most important after a kidney transplant is to check the levels of the immunosuppressant medicines in your blood.
Immunosuppressant medicines purposely weaken your immune system so that your body doesn’t fight against your new kidney. These medicines need to be kept at certain levels to protect your kidney and prevent rejection.
You’ll have fewer blood tests and visit the clinic less often as time passes and as you feel better. Kidney ultrasounds, scans, and biopsies will be done to know how well the new kidney is working. Your medicines will be changed as you feel better and as your body heals. It’s very important that you take all your medicines exactly as prescribed (right dose, right time).
Immunosuppressant medicines may have side effects, so you’ll be watched closely by the transplant team. The transplant team will adjust the dose of your medicines to help you get the right amount of medicine or if you have side effects.
If you live outside of the greater Edmonton or greater Calgary areas, you’ll need to stay in the city where you had your transplant surgery for
up to 12 weeks after surgery. Before your transplant, talk to your social worker if you need help finding a place to stay in the city after your transplant. Staying close to where you had your transplant makes it easier to see how you’re recovering and helps when you need extra tests that you can only get in larger centres. These tests can be arranged more quickly if you’re closer.
You won’t be able to drive for about 4 weeks after your surgery and you leave the hospital.
You may be readmitted to the hospital in the first year after your transplant. This may happen more than once and is quite normal. Your transplant team will need to watch you closely as your body adjusts to the new kidney.
After your transplant, you’ll need to drink lots of water every day. This will keep you and your new kidney well hydrated. You’ll feel better and it helps your new kidney work well. This will make you pee (empty your bladder or pass urine) often at first. Before your transplant, when your kidneys didn’t work well, your bladder got smaller so it can’t hold as much urine as it used to.
It’s important to stay in contact with the transplant team to protect your kidney. Together you and your team can prevent rejection. You’ll work together to find ways to manage problems with your medicines or side effects as you go through your new treatment plan. Support is available for you and your family. If you’re feeling unwell, please contact your transplant team as soon as possible.
Dialysis after transplant
You may need dialysis for a short time after the transplant until your new kidney is working well. Sometimes it takes time for your new kidney to work well. This may be related to your overall health or if something happened to the donor kidney before or during the transplant surgery. If the kidney doesn’t start working well right after the transplant it’s called delayed graft function.
If you do need dialysis after a transplant, it
doesn’t mean that the transplant has failed.
It may take hours, days, or weeks for the new kidney to work as it should. The transplant team will talk to you about short-term dialysis if it’s needed during this time. They’ll also work with you to plan your treatments.
Statistics from the kidney transplant programs in Alberta show that more than 95% of transplanted kidneys are working 1 year after the transplant.
Caring for your new kidney
You’ll need to make some changes now that you have a kidney transplant. Some will be easier than others to adjust to but overall, you’ll likely feel better and have more energy.
Some of these changes include:
- lifelong immunosuppressive medications
- closely watching for signs of kidney transplant rejection
- regular blood work
- staying in contact with the transplant program
- regular visits with your family doctor and dentist
- cancer prevention – sun safety, using sunblock, protective clothing, avoiding smoking and alcohol
- preventing infections – using good hand washing and staying away from people who are sick
- drinking lots of water each day (2½ to 3 litres each day)
After a transplant, many people can go back to work, and go back to doing the same activities and routines they did before their kidney disease. But it’s important to remember that you need to take very good care of the transplanted kidney for as long as you have it. This means working with the transplant team and taking good care of yourself.
Take your immunosuppressant medicines every day as prescribed.
During your initial recovery period, all blood tests must be done at the hospital where you had your transplant. Once the transplant team lets you know it’s OK you can have your blood tests done closer to where you live.
You’ll have regular follow-up appointments with the transplant team. Extra blood tests, other tests, or hospital stays may be planned to help keep you and your new kidney healthy.
It may be a year before your blood tests are done less often. It may go down to every 1 to 4 months. Blood tests will be done more often if there’s a change in your health or if your kidney isn’t working well. Having regular blood tests is an important part of your transplant care.
Caring for yourself after transplant
Tracking your health and wellness is an important part of your care after a kidney transplant. After you leave the hospital, you’ll be asked to keep track of your:
- temperature
- blood pressure
- pulse
- weight
- blood glucose (sugar)
This information helps to find possible side effects of some of your new medicines. You’ll also be asked to keep track of how much fluid you drink and how much you pee out. Give your transplant team a report of your readings at your transplant clinic appointments.