KIDNEY
Post Transplant
Patients are notified by the transplant coordinator when a kidney is available for transplant and surgery is scheduled. In the case of a living donation, the coordinator will schedule the two surgeries. After being admitted to the hospital, the patient may undergo some additional pre-operative testing and dialysis.
The transplant operation usually lasts approximately four hours. An incision is made in the lower right or left side of the abdomen above the groin. The new kidney is connected to the bladder and surrounding blood vessels. The diseased kidney is normally not removed unless there are infection risks or increased size; if not removed the diseased kidney will naturally shrink over time. A tube (foley catheter) is placed in the bladder for post-operative urine drainage.
After surgery the patient is usually taken to the Intensive Care Unit (ICU) for 24 hours then transferred to the hospital transplant unit. Sitting is restricted for 72 hours to eliminate pressure on the incision. However, the patient can get out of bed and walk with assistance. Coughing and deep breathing exercises are performed to clear the lungs. Dialysis may be necessary temporarily if the new kidney does not immediately function.
The average hospital stay is six days but varies for each individual patient. While hospitalized, the multi-disciplinary team of transplant coordinators, dietitians, social workers and support staff provide post-transplant education and support services. The patient is instructed about diet and exercise. Classes are held to teach medication usage. Discharge arrangements are also planned and may include home care, resumption of daily activities, and scheduling of follow-up clinic visits.
Post Transplant
After discharge from the hospital, activity will be limited for six to eight weeks. Mild exercise, such as walking, is encouraged but driving and strenuous exercises are prohibited. The patient must keep a daily record of temperature, intake/output, and doses and times medication is taken. Patients usually return to work within two to three months.
Infection and rejection are the main risks associated with transplants. Each transplant patient is prescribed immunosuppressive or "anti-rejection" medications. These medications prevent the body's immune system from rejecting the new transplant, known as a "rejection episode." To maximize their effectiveness, immunosuppressive medications must be taken daily throughout the patient's life. For a period of time after the transplant, patients will require routine blood tests to determine if the medication needs adjustments to prevent rejection episodes. Therefore, post-transplant patients are required to have regular follow-up visits during the first two years.
Because post-transplant medications are designed to suppress the immune system to reduce the risk of rejection, they also increase the likelihood of infection. Immediately after discharge, it is imperative that patients avoid situations which would put them at risk for infection. This includes large crowds and contact with unhealthy individuals.
Immunosuppressive medications are vital for transplant success. However, a lifetime prescription can be financially challenging. Private insurance, Medicare, and Medicaid often cover a percentage of these costs. Our financial counselors can assist the patient with information and planning.
Our medical specialists at the Texas Transplant Institute always remain available to answer any questions and provide assistance following transplantation.