Kidney Transplant as an option is the best possible solution for chronic renal failure. The quality of
life is almost normal. However certain care and precautions as enumerated below will need to be
observed by transplant recipient and supporting family members.
Medications
The nephrologist will closely monitor the transplanted patient in respect of various parameters such
as Blood Urea, Creatinine, WBC, BP, etc., for first 2-3, months and thereafter he will give directions
for monitoring the various parameters periodically. He would also prescribe immune suppressant
and other drugs for managing the transplant kidney from time to time. Please ensure that these
instructions are followed meticulously without fail. Any side effects noticed must be brought to his
notice by the fastest means for further directions.
Diet and Nutrition
Eating properly is an important part of the recovery process & healthy life. A nutritionist can help in
developing an eating plan that provides a balanced diet to meet patient's needs. The number of
calories a patient requires will be based on whether he needs to gain, maintain, or lose weight and
on his level of activity.
Health Food - Diet should include a variety of foods such as:
Use of salt (sodium), sugar, and fat :-
Use of salt may be restricted to help limit fluid retention and to control blood pressure. Low fat, low-
sugar diet will help control weight and blood sugar. Consult a nutritionist regarding the use of salt,
sugar, and fat in a diet.
Food should be fresh, well cooked, hot, and hygienic. The fruits with the skin must be peeled
before consuming. Drink always boiled water.
Exercise
After transplant surgery, exercise is critical to mental health and physical well being. Physical
activity is also very important in helping decrease the effects of Prednisolone, which causes muscle
weakness. A daily exercise routine is essential to avoid muscle and total-body weakness that often
occurs after a long illness or period of confinement. The program should be a progressive one, in
which the patient builds or increases his levels of exercise. In this way, he will obtain the full benefits
of exercise without causing strain or serious injury to his body. Before starting on any exercise
program, he should remember to check with his nephrologist. He will give him advice regarding an
exercise routine that will best meet his needs.
WARNING: If a patient experiences any untoward symptoms or discomfort, he should stop exercise
until he consults his doctor
Avoidance of infection, Skin / Hair Care
Patients will not need any special skin care unless he develops acne or dry skin. Generally, he
should shower or bathe as often as necessary to keep his skin clean. Most soap is appropriate.
Acne
Prednisolone can cause acne on the face, chest, shoulders, or back. Cyclosporine can make the
skin more oily. If acne develops, the patient should wash the area three times per day with a mild
soap, scrubbing gently with a clean, wet washcloth. Rinse the soap completely from the skin to
leave the pores open and clean.
Ways to control acne:
WARNING:. If acne remains a problem, the patient may contact his nephrologist for further
directions.
Dry skin care - For problems with dry skin, use a mild soap and apply body lotion after bathing
Cuts and scratches - Wash minor cuts and scratches daily with soap and water. For treatment of
large cuts, contact your nephrologist immediately.
Skin growths - The nephrologist should be notified if the patient discovers any unusual skin
growths, rash, or discolouration.
Sun exposure - Transplant patients have an increased chance of developing skin and lip cancers.
Since the risk increases with time, the patient must always protect his skin from the ultraviolet rays
of the sun that cause skin cancers.
Dental Care
Precautions for dental care - Before the kidney transplant, the patient may have received a dental
consultation to ensure that all dental work would be completed before surgery. If the patient has
dental pain, he should consult his nephrologist who will direct him to an appropriate dentist
immediately. Before he has dental work done (including cleaning and polishing), he should check
with his nephrologist to see if he needs to take antibiotics.
Alcoholic Beverages
The liver breaks down Cyclosporine, Azathioprine, and Co-trimoxazole medications etc., and, if
combined with alcohol, could harm the liver and eventually lead to abnormal blood levels of these
medications. This can compromise the function of the kidney.
Pregnancy
There have been a number of successful pregnancies among women who have had kidney
transplants, although pregnancy may have special risks for both the transplant recipient and the
baby. Women should avoid pregnancy for two years following transplant surgery. Risks related to
childbirth & control should be discussed with the nephrologist and gynecologists. Thereafter, the
decision to have children must take a number of factors into account. This is a question that should
be discussed with the nephrologist.
Smoking
Transplanted patients are advised not to smoke and avoid consuming tobacco/other narcotics
products, as this will compromise the functioning of kidney.
Vacations and Travel
Travelling within the country can be undertaken after 2 months of transplant, however all
precautions and medications including food should be followed as stated above. If planning a trip to
a foreign country that requires immunization for smallpox, measles, or any other vaccine containing
a live virus, the patient should request his Nephrologist to send a letter to concerned authorities
stating that he cannot receive these vaccines. Travel to these countries may not be safe being not
immunized.
General summary instructions for transplant patients and donor
Transplanted patient:
1. Take medications as per nephrologist's directions. Avoid self-medications.
2. Monitor various health and blood parameters as advised by nephrologist.
3. In case of any side problems, get in touch with your nephrologist by the fastest means.
4. Avoid getting infections from others.
5. Eat well cooked hot foods.
6. Drink boiled water.
7. Eat fruits after peeling the skin.
8. Wear sun glasses to prevent cataract.
Donor:
1. Rest for one month after transplant.
2. Not to lift weights, not to do strenuous work till three months.
3. To check blood pressure quarterly- life long.
4. To report to the Nephrologist once in a year.
References
1. Madras Institute Of Nephrology, Chennai, India
2. www.kidneytransplant.org
life is almost normal. However certain care and precautions as enumerated below will need to be
observed by transplant recipient and supporting family members.
Medications
The nephrologist will closely monitor the transplanted patient in respect of various parameters such
as Blood Urea, Creatinine, WBC, BP, etc., for first 2-3, months and thereafter he will give directions
for monitoring the various parameters periodically. He would also prescribe immune suppressant
and other drugs for managing the transplant kidney from time to time. Please ensure that these
instructions are followed meticulously without fail. Any side effects noticed must be brought to his
notice by the fastest means for further directions.
Diet and Nutrition
Eating properly is an important part of the recovery process & healthy life. A nutritionist can help in
developing an eating plan that provides a balanced diet to meet patient's needs. The number of
calories a patient requires will be based on whether he needs to gain, maintain, or lose weight and
on his level of activity.
Health Food - Diet should include a variety of foods such as:
- Fruits
- Vegetables
- Whole-grain cereals and breads
- Low-fat meal and dairy products or other sources of calcium
- Lean meats, fish, and poultry or other sources of protein such as dal,legumes etc
Use of salt (sodium), sugar, and fat :-
Use of salt may be restricted to help limit fluid retention and to control blood pressure. Low fat, low-
sugar diet will help control weight and blood sugar. Consult a nutritionist regarding the use of salt,
sugar, and fat in a diet.
Food should be fresh, well cooked, hot, and hygienic. The fruits with the skin must be peeled
before consuming. Drink always boiled water.
Exercise
After transplant surgery, exercise is critical to mental health and physical well being. Physical
activity is also very important in helping decrease the effects of Prednisolone, which causes muscle
weakness. A daily exercise routine is essential to avoid muscle and total-body weakness that often
occurs after a long illness or period of confinement. The program should be a progressive one, in
which the patient builds or increases his levels of exercise. In this way, he will obtain the full benefits
of exercise without causing strain or serious injury to his body. Before starting on any exercise
program, he should remember to check with his nephrologist. He will give him advice regarding an
exercise routine that will best meet his needs.
WARNING: If a patient experiences any untoward symptoms or discomfort, he should stop exercise
until he consults his doctor
Avoidance of infection, Skin / Hair Care
Patients will not need any special skin care unless he develops acne or dry skin. Generally, he
should shower or bathe as often as necessary to keep his skin clean. Most soap is appropriate.
Acne
Prednisolone can cause acne on the face, chest, shoulders, or back. Cyclosporine can make the
skin more oily. If acne develops, the patient should wash the area three times per day with a mild
soap, scrubbing gently with a clean, wet washcloth. Rinse the soap completely from the skin to
leave the pores open and clean.
Ways to control acne:
- Keep hands away from the face and avoid rubbing the affected area. To avoid infections,
do not prick or touch the acne. - Do not use cosmetics.
- Avoid the use of medicated hypoallergenic cosmetics intended to cover acne. Wearing
makeup will prevent acne from going away. - Do not rub or scrub the skin vigorously. This can irritate the skin.
- Avoid soaps that contain creams and oils, because they will aggravate acne.
- Do not use lotions for dry skin.
- If the skin becomes very dry, stop washing those areas temporarily so that the skin can
recover its natural moistness.
WARNING:. If acne remains a problem, the patient may contact his nephrologist for further
directions.
Dry skin care - For problems with dry skin, use a mild soap and apply body lotion after bathing
Cuts and scratches - Wash minor cuts and scratches daily with soap and water. For treatment of
large cuts, contact your nephrologist immediately.
Skin growths - The nephrologist should be notified if the patient discovers any unusual skin
growths, rash, or discolouration.
Sun exposure - Transplant patients have an increased chance of developing skin and lip cancers.
Since the risk increases with time, the patient must always protect his skin from the ultraviolet rays
of the sun that cause skin cancers.
- Avoid direct midday sun, when ultraviolet rays are strongest.
- Wear a cap, long sleeves, and slacks when outdoors unless using a sunscreen.
- Wear sun glasses to prevent cataract
Dental Care
Precautions for dental care - Before the kidney transplant, the patient may have received a dental
consultation to ensure that all dental work would be completed before surgery. If the patient has
dental pain, he should consult his nephrologist who will direct him to an appropriate dentist
immediately. Before he has dental work done (including cleaning and polishing), he should check
with his nephrologist to see if he needs to take antibiotics.
Alcoholic Beverages
The liver breaks down Cyclosporine, Azathioprine, and Co-trimoxazole medications etc., and, if
combined with alcohol, could harm the liver and eventually lead to abnormal blood levels of these
medications. This can compromise the function of the kidney.
Pregnancy
There have been a number of successful pregnancies among women who have had kidney
transplants, although pregnancy may have special risks for both the transplant recipient and the
baby. Women should avoid pregnancy for two years following transplant surgery. Risks related to
childbirth & control should be discussed with the nephrologist and gynecologists. Thereafter, the
decision to have children must take a number of factors into account. This is a question that should
be discussed with the nephrologist.
Smoking
Transplanted patients are advised not to smoke and avoid consuming tobacco/other narcotics
products, as this will compromise the functioning of kidney.
Vacations and Travel
Travelling within the country can be undertaken after 2 months of transplant, however all
precautions and medications including food should be followed as stated above. If planning a trip to
a foreign country that requires immunization for smallpox, measles, or any other vaccine containing
a live virus, the patient should request his Nephrologist to send a letter to concerned authorities
stating that he cannot receive these vaccines. Travel to these countries may not be safe being not
immunized.
General summary instructions for transplant patients and donor
Transplanted patient:
1. Take medications as per nephrologist's directions. Avoid self-medications.
2. Monitor various health and blood parameters as advised by nephrologist.
3. In case of any side problems, get in touch with your nephrologist by the fastest means.
4. Avoid getting infections from others.
5. Eat well cooked hot foods.
6. Drink boiled water.
7. Eat fruits after peeling the skin.
8. Wear sun glasses to prevent cataract.
Donor:
1. Rest for one month after transplant.
2. Not to lift weights, not to do strenuous work till three months.
3. To check blood pressure quarterly- life long.
4. To report to the Nephrologist once in a year.
References
1. Madras Institute Of Nephrology, Chennai, India
2. www.kidneytransplant.org
Life after Transplant
Balaji Medical and Educational Trust
| Chronic Kidney Failure is one of the Deadliest disease. Yet, it is least understood. |
| Dr.Rajan Ravichandran MD,MNAMS,FRCP(Edin),FACP(USA) Nephrologist |
 |
|