Precautions for a transplanted kidney to last you your lifetime - CMCS Health.

Precautions for a transplanted kidney to last you your lifetime - CMCS Health.

Congratulations! 

You have a successful Kidney transplant. The newly grafted kidney is functioning well in your body. You do not require Hemodialysis anymore.

Many of the patients think that after a successful kidney transplant, they are perfectly healthy and can do anything they want to do as they were doing before they suffered CRF or ESRD.

True! You are no longer dependent on Hemo-Dialysis, But you must take adequate precautions to make the new grafted kidney last you your lifetime.

When you return home after a successful Kidney transplant, you want to drive yourself, pursue a sport you were enjoying before your kidney disease, go to a movie or market, or any other crowded place, want to entertain guests at home, want to restart your intimate life with your partner.

You can do many of these things, but in moderation and with proper guidance and following instructions from your kidney transplant doctor's team.

Your Medications:

Your Body has a God-gifted immune system to ward off infections and form a defense mechanism.

Since the newly grafted kidney is not your own body part, your body's defense mechanism will take the graft as a foreign material and will attack the new kidney as a natural attempt to protect you. This may lead to rejection of the new kidney by your body. To save the new kidney from being rejected by your body's immune system. Your transplant team doctors will prescribe certain medications called immune suppressant medications. These medications are your lifeline as they protect the newly grafted kidney. Remember these basics about your life-saving medications.

• Your Transplant team doctors will prescribe your medication depending on the lab. Tests are done to know the exact dosage required. Never ever increase or decrease the dosage of your anti-rejection medications on your own or without your KTP doctor's approval. Do not change the brand of medicines, you were prescribed by your doctor.
• The Medicines prescribed to you have a biological half-life, so to maintain the presence of your medicines in your blood all the time, you must strictly adhere to the dosing schedule prescribed by your doctor,i.e. exact prescribed dose at a particular time of the day, every day. Do not delay the medicine time or jump the dosing schedule. You can put an alarm on your mobile phone to keep you reminded about your medicine time.
• Always carry your medication with you, when traveling or going out of the house, so you do not miss your dosing schedule.
• Stock an adequate quantity of your medication, so you do not miss your dosing schedule if you run out of stock before your next supply.
• Always keep a list of your medications and dosing schedule prescribed by your KTP Doctors with you.
• Do not take any over-the-counter medicines, for any short-term medical condition without approval from your KTP doctors.
• Keep the medications in a place as recommended on the medicine box, do not expose them to overheated or damp places.
• Keep a regular check on the expiry date of your medications, to avoid consuming expired medications.
• Do not discontinue your anti-rejection medication no matter how great you feel, even if you think your transplanted kidney is working well. Stopping them may cause rejection to occur.
• Your KTP Doctors will recommend periodic testing of blood levels of your anti-rejection medications to ensure the right dosing, Keep on doing these recommended blood tests at told intervals and inform your KTP doctors without fail so they can tailor the dose as per your body's requirement. Many transplanted patients slacken in this routine once they feel perfectly healthy, which exposes them to the risk of graft rejection.
• If you are diabetic or hypertensive, You will be required to keep a regular check on your blood pressure and blood sugar and take the prescribed medicines accordingly, as uncontrolled high blood pressure and blood sugar are major reasons for your kidney going bad.

Precautions for warding off Infections: 

Since you are on Immunosuppression medication to avoid rejection of a newly transplanted kidney, you are prone to the dangers of acquiring viral and other infections easily. Following precautions need to be taken by a kidney transplant patient to keep on living a healthy disease-free life and save the kidney graft.

• Maintain good personal hygiene, like brushing off your teeth and cleaning your mouth after meals, wearing clean and sterilized clothing, and washing and sanitizing your hands frequently and before eating. Avoid getting shaved at parlors that use the same razors for many people. While getting haircuts tell your barber, to use proper precautions and use a new disposable blade.
• Avoid eating outside food or food cooked and served in unhygienic conditions, improperly or half-cooked foods. Fruits and vegetables must be properly washed and peeled off to avoid consuming pesticides or other impurities and disinfectants. Follow the diet plan prepared by your KTP team dietician. Avoid eating too much sugary, fatty, and fried foods. Ensure proper fluid intake as advised to you.
• When going to crowded places like cinema halls, airports, hospitals, buses or railway stations always cover your face with medical masks prepared for the purpose of warding off infections. Avoid shaking hands with many people.
• Avoid being around people who are suffering from contagious infections.
• .Tell the lab technician while at a pathology lab for blood tests to take adequate precautions.

Regular and proper Follow-up with your KTP doctors team as advised:

After a successful Life-saving Kidney transplant, your KTP team will give you proper guidelines and instructions for follow-up. You need to follow up on these instructions in totality.

You need to contact your KTP doctors team immediately if you have any of these abnormal symptoms:

• A fever higher than 100 Degrees Fahrenheit. Flu-like symptoms such as chills, aches, headaches, dizziness, nausea, or vomiting.
• Fluid retention ( Swelling or Edema )
• Sudden weight gain ( greater than 4 pounds and within 24 hours. 

• New pain or tenderness around the transplanted Kidney.

•  A significant decrease in urine output.

Maintaining a healthy lifestyle: 

Exercise regularly : 

The key is moderation and understanding your limits as a person, who has just undergone surgery. Your body is still weak and will take its own time to return back to full strength, so you should not push your body initially. Walking is the best exercise to start with. You can start with what time your body permits you without tiring it too much and gradually increase the time.

Do not start doing strenuous exercises and lifting weights initially as is not advised in any stomach surgery for at least three months.

Regular exercise post-kidney transplant helps a kidney-transplanted plant gain overall improved health as it improves blood circulation, and helps in controlling blood cholesterol, blood sugar, and body weight. Regular exercise increases endurance and improves muscle tone and the functioning of the lungs and heart. 

Driving:

Driving is not advised for the initial 2 to 4 weeks post-kidney transplant as your body may suffer from tremors, weakness, and blurred vision till the time you get used to your post-transplant medicines. These effects of medicines may last for a few months. Once your body gets used to your medications, with your KTP doctor's permission, you can resume driving.

Sexual Activity and Fertility:

The most frequently asked question by a transplanted patient. A person's sexuality is affected when they suffer from CRF or ESRD. Men may suffer from impotence and loss of sex drive while women's menstrual cycle may become irregular or stop completely. Post kidney transplantation some of the aspects affecting the sexuality of a CRF or ESRD patient will definitely improve. Chronic fatigue experienced by a kidney patient diminishes post-transplantation and improved health makes sexual life more enjoyable. Men will have fewer problems in gaining and maintaining an erection while women will resume normal menstrual cycles and overcome lack of vaginal lubrication during coitus.
Sexual activity was not very important before the transplant but with improved health post-transplant, it comes higher on your agenda.
It is common for transplanted patients to resume living a normal life as they recover, and active sexual life is no exception.
For women, it is important to maintain good hygiene before, during, and after as they are more prone to urinary tract infections because of being on immunosuppression medications. Urinating before and after coitus and drinking more water reduces the chances of acquiring a UTI.
In case you get infected with UTI, consult your KTP doctor for the same.

Managing Diabetes:

Corticosteroid like prednisolone (Wyesolon) increases the blood sugar level but after two months when the dosage is reduced, it will start becoming normal. You may require your diabetes medicines or insulins to keep your blood sugar levels in check as advised by your doctors. Your doctors may advise a controlled carbohydrate diet and regular exercise to keep your blood sugar in check.

Managing Blood pressure:

The targeted blood pressure for a kidney transplanted patient is less than 130/80. You will require your blood pressure medicines to continue post-transplant under the supervision of your doctor. Doctors will advise you blood pressure medication, and keep your weight in check by advising exercise and a low-salt diet.

Maintaining a normal Lipid Profile:

Many kidney transplanted patients may have higher blood cholesterol and lipid profiles due to side effects of medication, gaining weight, poor diet, lack of exercise, a family history, and proteinuria in certain cases. Your KTP doctors will suggest a heart-healthy diet, regular exercises, and lipid-lowering medication for keeping a check on your lipid profile.

Controlling Obesity:

Weight gain is common after a successful transplant. However, being overweight may make you prone to heart disease and New-Onset diabetes post-transplant. To avoid being obese a kidney transplant patient should take a healthy, balanced diet and exercise regularly to burn extra calories. 

Bone Disease:

Bone diseases in a transplanted patient are called chronic kidney disease-related mineral and bone disorders. (CKD-MBD ). It may cause your bones to be brittle and prone to easy fractures. Your KTP team may recommend routine blood tests for calcium, phosphorus, parathyroid hormone (PTH), and vitamin D.

Gout:

Due to side effects of your kidney transplant medication like cyclosporine, your body may find it difficult to excrete excessive uric acid from the bloodstream. High blood uric acid results in the deposition of uric acid crystals in joints causing swelling and pain termed as Gout. Certain dietary control may be advised by your doctors like cutting down on red meat, seafood, sugared soft drinks, and alcoholic beverages, especially beer. 

Travel:

Traveling should be avoided in the first two months after the transplant to cut down the chances of infection. If traveling to another continent, you may require certain vaccinations to protect you from any epidemic disease prevailing. You must also carry a sufficient quantity of your post-transplant medications with you.

Vaccination:

Live vaccines like Varicella Zoster, BCG, smallpox, intranasal influenzas, Live oral typhoid Ty21a, measles, mumps, rubella, oral polio, yellow fever, and live Japanese B encephalitis vaccines must be avoided.

Vaccines that can be taken after consulting your KTP doctors team are DPT, Haemophilus Influenza B, Hepatitis B ( Before transplant), Hepatitis A, Pneumovax, Inactivated polio, Influenza types A & B, Meningococcus ( In high-risk cases), and Typhoid.

Skin Care:

Corticosteroids like Prednisolone (wyesolon) may cause acne on your face, shoulders, chest, or back. Cyclosporine may cause these areas to be oily. Wash this area thoroughly with water at least three times a day every day. Avoid vigorous rubbing or scrubbing, instead use a wet washcloth and mild soap to remove accumulating oils, dead skin, and bacteria. Avoid using soaps that contain oils or cream-based.

Eye care:

Kidney transplant patients are advised to have annual periodic eye check-ups with an ophthalmologist. Prednisolone (Wyesolone) can cause cataracts and changes in vision.

Dental Care:

You should brush your teeth at least once or twice every day, Use mouth rinse after meals to avoid accumulation of bacteria.

Quitting smoking:

Kidney transplant patients must quit smoking after the transplant to avoid complications and chest infections.

Pregnancy:

Pregnancy may occur after a successful kidney transplant. Your KTP team will advise you to avoid pregnancy in the first year of the transplant. Proper monitoring by your KTP team and Gynecologist is needed for the safety of both mother and baby and dose adjustment of your medication may be needed.

Click on the following Useful Links to Learn More About Kidney Transplant in India.

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With Love from India.