What you should know about kidney transplant

Kidney transplantation is the best renal replacement therapy for end-stage renal failure. It is offered to all patients who do not have absolute contraindications for kidney transplantation. What to do to prepare for it, how to proceed after the transplant?

Basic check-up before kidney transplant

Before having a kidney transplant, you must go through the following tests and consultations:

  •    blood typing,

  •    BMI,

  •    an updated physical examination,

  •    ultrasound of the kidneys, bladder (before and after micturition), urine culture,

  •    abdominal cavity ultrasound,

  •    doppler diagnostics of flows in the iliac arteries,

  •    laboratory results: HBsAg, anti-HBs, anti-HCV, HCV RNA, anti-HIV, morphology, cholesterol, triglycerides, total protein, albumin, AST, ALT, GGTP,    bilirubin, PTH, prothrombin; PSA (men over 40),

  •    chest X-ray

  •    heart ECG, ECHO,

  •    gastroscopy,

  •    diagnostics for occult blood in the stool,

  •    a visit to dentist, ENT specialist, transplant surgeon.

Women should also undergo a gynaecological examination, including mammography or breast ultrasound. Additional tests are also often needed, such as magnetic resonance imaging, computed tomography, cardiology or ophthalmology consultation. Doctor preparing the patient for kidney transplantation decides whether to perform these additional tests.

When waiting for a transplant

If you are already active on the National List of Patients Waiting for Transplantation (KLO) and you have been waiting for a transplant for more than a year, you should update the results of the following tests every 12 months:

  •    HIV, HCV, HBV, PTH, morphology, transaminases, total protein, albumin,    bilirubin, coagulogram (blood clotting),

  •    urine culture,

  •    heart ECG, ECHO,

  •    faecal occult blood test

  •    ultrasound of kidneys and abdominal organs,

  •    chest X-ray

  •    ENT and dental examination,

  •    iliac artery Doppler,

  •    gastroscopy (as indicated),

  •    PSA (men), cytology (women).‏

Ladies should perform a mammogram every two years.

Please have in mind that kidney transplant surgery is associated with a higher risk in obese people. It is best that your BMI does not exceed 30 kg/m². It may also happen that an additional surgery will be needed before the transplant, e.g. removal of own kidney, gallbladder with deposits, or replacement of a heart valve.

After kidney transplant

You went through a successful surgery. Great! You should take better care of yourself, especially right after the procedure. Here's what to keep in mind:

  1. When you are discharged from the hospital, make sure you have: phone numbers of doctors from the transplant team, information on when and   where the follow-up visit is scheduled (you will need a referral), information about new drugs (including immunosuppressants) and at what times you should take them. Also, make sure that the recommendations on your discharge sheet are completely understood. It is best to buy the medications listed on the prescription at the nearest pharmacy.

  2.  Pay regular visits to your transplantologist at the transplantology clinic at least every 3 months. Don't skip them or extend the visit window.

  3.  Keep a self-check diary on a regular basis, where you record: blood pressure and pulse measurements, body weight in the morning and information on the daily urine collection. Do not stop taking prescribed medications or change doses without consulting your doctor first.

  4.  Avoid    crowded places for about 3 months. Your body is most susceptible to infection at this time. After 3 months, the risk of infection decreases, but it is still worth being careful and avoid direct contact with infected people.

  5.  2-4    months after transplantation, discuss with your doctor resuming work or study. This time frame will, of course, vary from person to person and will depend on your general health and the type of work you do.

  6.  Get the flu vaccine every year after your kidney transplant.

Everyday life after a successful kidney transplant

You can do virtually anything, only with greater caution and care. If you want to become a mother, talk to your transplant doctor about it and agree on the best time to seek pregnancy. Before that, some medications must be discontinued and replaced with others. In general, you can resume sexual activity as soon as the wound heals; kidney transplantation does not affect the quality of sexual life.

It is also worth knowing that after a kidney transplant, your daily diet becomes less restrictive than during dialysis. Drink about two litres of liquids per day and avoid salt unless your doctor tells you otherwise. Enjoy a larger palette of flavours!

If you have pets at home, you can play with them as you did before. Just keep them clean and avoid contact with their faeces. If you keep a garden, wear gloves and a surgical mask while working in it with gloves—that way you will minimise the risk of infection with soil bacteria. Use standard cleaning products to clean the house—they are perfectly enough.

And most importantly—enjoy your health!

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