Kidney Transplant (cont.)

Outlook After Kidney Transplantation

Self-care at home

The period immediately following your transplant can be very stressful. You will not only be recovering from major surgery, you will also be anxious about organ rejection.

• You, your family, and the transplant coordinators must keep in contact and close follow-up with the transplant team.
  
  
• Before leaving the hospital, you will be given instructions on proper doses of and schedule for antirejection medication. Keeping track of these medications is extremely important, because they can actually harm your transplanted kidney if the doses are not appropriate.
  
  
• You will be taught how to measure your blood pressure, temperature, and urine output at home, and you should keep a log of these readings.
  
  
• Your social worker and dietitian will counsel you before you leave the hospital.

In the first few weeks after leaving the hospital, you will meet with members of your team frequently to monitor your recovery, review the logs, undergo blood tests, and adjust medication doses.

The outcome for kidney transplants continues to improve with advances in immune-suppressing medications.

• In the United States, the 3-year graft survival rate after transplantation is almost 80%.
  
  
• The earlier you can detect rejection, the better the chance it can be reversed and the new kidney's function preserved.

Complications

• Rejection
  
  
• Infection
  
  
• Cancer: Certain cancers, such as basal cell carcinoma, Kaposi sarcoma, carcinoma of the vulva and perineum, non-Hodgkin lymphoma, squamous cell carcinoma, hepatobiliary carcinoma, and carcinoma in situ of the uterine cervix, occur more frequently in people who have undergone kidney transplantation.
  
  
• Relapse: A small number of people who undergo transplantation for certain kidney disease experience a return of the original disease after the transplant.
  
  
• High blood cholesterol level
  
  
• Liver disease
  
  
• Weakening of the bones

Women who wish to become pregnant are usually told to wait for 2 years after the operation. Many women have taken their pregnancies to term after transplantation, but there is an increased risk of kidney rejection and fetal complications.

Signs of kidney rejection

One of your greatest concerns as a transplant recipient will be that your body's immune system will reject and attack the transplanted kidney. If not reversed, rejection will destroy the transplanted organ. For this reason, you and your family must keep aware of warning signs and symptoms of rejection. You must contact the transplant team immediately if any of these symptoms develop.

• Hypertension (high blood pressure) - An ominous sign that the kidney is not functioning properly
  
  
• Swelling or puffiness - A sign of fluid retention, usually in the arms, legs, or face
  
  
• Decreased urine output

If you are a kidney transplant recipient, any of the following symptoms warrant immediate care at a hospital emergency department, preferably the hospital where the transplant was done.

• Fever - A sign of infection
  
  
• Abdominal pain
  
  
• Tenderness, redness, or swelling at the surgical site
  
  
• Shortness of breath - A sign of fluid retention in the lungs