You will receive detailed discharge instructions specific to you, from your nurse and physicians before leaving the hospital. We have included some general recommendations here.
Follow-up Visits
In a post-operative course we will schedule a re-visit in Transplant Surgery Clinic two weeks after your transplantation. We will also follow you in the Renal Clinic. For the first 3-4 months after the transplant you will be seen in clinic once or twice a week, and return to the lab for blood tests more frequently and possibly be temporarily readmitted (this can happen in up to 50% of patients in the first 6 months). It is your responsibility to ensure that you can get back and forth from the hospital when needed. Kidney transplant recipients report a much improved quality of life overall: a healthier body, increased freedom, more energy and fewer dietary restrictions. In Transplant Clinic we will do everything we can to ensure this happens for you too.
It is very important to let all of your other doctors and your dentist know that you have had a kidney transplant.
For a print friendly version of a letter you should take with you to your doctors and dentist, please use the following link.
Letter for Other Doctors and Dentist
You must have Adobe Reader® to view this file; click here to download the free version of the software
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Monitoring Your Kidney
It is important to check your blood pressure, and follow your fluid intake and urine output and weight.
We encourage kidney transplant recipients to take an active role in monitoring their kidney function.
For a print friendly version of the daily monitoring record, please use the following link.
Daily Monitoring Record
You must have Adobe Reader® to view this file; click here to download the free version of the software.
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Diet
It is important to make sure you drink enough fluids after you leave the hospital. 1.5 – 2 L per day is appropriate. It is normal to have a slightly decrease appetite after major surgery. Take it easy and eat what feels right. If your kidney function is normal, you have no dietary restrictions.
Use alcohol sparingly
Excessive alcohol drinking can lead to liver problems and dehydration that can hurt your transplanted kidney.
Do NOT smoke
Smoking can shorten your life and the life of your transplanted kidney. If you smoke, do EVERYTHING you can to try to quit. For more information call Quitworks Tobacco Treatment 1 -800 -879 -8983.
Weight gain is common after kidney transplantation. Please see section below for more information on weight gain.
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Weight Gain
Weight gain is common after kidney transplantation because, aside from the fact that you may feel better, and food will taste better, your anti-rejection drugs may increase your appetite.
Always ask to see a nutritionist if you are at all in doubt about how and what you should be eating.
The key to avoiding weight gain is watching what you eat, and exercising regularly. It is also important to adopt healthy eating habits, and avoid nibbling in front of the television, or eating out of habit.
Tips to Avoid Weight Gain
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Drink plenty of water
We often mistake thirst for hunger. Drink a full cup of water before meals. It makes you feel more full and is good for the kidney
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Eat 3 regular meals
Have a larger breakfast and smaller lunch and supper
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Eat slowly
To allow brain to register that you are full! Spend 20-30 minutes on each meal
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Choose a regular place to eat and sit down!
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Have 1-2 small snacks in the mid morning and afternoon
Examples of healthy snacks: Fruit ; Raw vegetables; Unsalted nuts ; Sugar free jello or pudding or popsicles ; Light yoghurt.
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If you eat the right food, you don’t have to feel hungry.
Unrefined carbohydrates come from plant foods in their natural form, for example, fruits, vegetables, grains, and beans. Whole grain (barley, brown rice, bulgur) and cereals are good sources of unrefined carbohydrates.
These foods are filling and take a longer time to digest. As a rule, fresh fruit and vegetables are very healthy. Eat at least 5 servings/day. It is better to eat fresh fruit than to drink juice, because it contains fiber.
Remember that potassium restriction is not required with a functioning kidney. You can now eat bananas! Numerous recipe books describe how to make delicious and healthy meals.
Eating sugary foods (sugar, candy, soft drinks, honey, jelly) and refined carbohydrates (pasta, white bread, white rice) makes your pancreas work hard to produce insulin. If you have a tendency to diabetes (all transplant patients do, because diabetes is a possible side effect of immunosuppressive medications), this could push your pancreas over the edge, and you could develop the need for insulin shots (diabetes).
Check any food you buy for fat content. Avoid those with cholesterol and high fat content (more than 6gm/serving). Microwave, broil, grill, or steam without adding butter; use nonstick sprays or cookware. Use less oil when baking. Fats which you can eat: small amounts of olive oil or canola oil are allowed. Small amounts of natural peanut butter may be allowed if your potassium level is OK. In fact, small amounts of these fats may help protect your heart and allow you to feel full for longer after meals. This will help you avoid craving for unhealthy snacks.
Eat meat products in moderation, and make vegetable dishes (artichoke, asparagus, eggplant, mushroom, onions, potatoes, spinach, squash, zucchini, salads) beans dishes (chick-peas, kidney beans, lentils, peas) and grains dishes (corn, brown rice, wheat, barley, koshi) the main part of your meal, and keep animal product portions small. Trim all fat from meat and remove skin from poultry. However, we do encourage you to have 1-2 servings of fish per week including salmon, mackerel, blue, sword, tuna.
Try decreasing your salt intake if you have high blood pressure or fluid retention (swollen ankles)
Speak with the renal dietitian to discuss your individual nutritional needs after transplant. Refer to the booklet “Nutrition After Transplant” which the dietitian will give to you
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Activities and Physical Exercise
Patients and families often have questions about the activities they can do when they leave the hospital. After a few days in hospital, most people feel more tired than they expect to when they get home. Many times, whether or not your are up to a particular activity will depend upon whether or not you are back to a regular well balanced diet and good sleep pattern.
Once you are at home, start out by doing just those activities you know you could do while in hospital. Think about adding one new activity at a time and make sure you are well rested when you begin. Plan on taking pain medicine, if needed, half an hour before trying a new activity. Avoid doing exercises that strain your abdominal incision (eg. Crunches, heavy lifting) until checking with your surgeon.
Start by spending 10-15 minutes on the new activity to see how you feel. Begin slowly and pace yourself. If you feel tired, you can slow down or stop and plan to try a little later. Doing a little at a time will help you to build your strength and endurance. Frequent rest periods will help you to stay active during recovery from any illness. If you feel short of breath or have chest pain, you should check with your doctor immediately.
The following includes common daily activities listed by how much work or energy they require. Activities at the top take the least energy. These recommendations are based on our general collective experience and common sense. We encourage you to discuss each item below with your nurses and doctors to get the most appropriate information specific for you.
| Activity |
When to Resume…. |
| Walking/Exercising |
Check with your doctor before doing strenuous exercise like jogging, aerobics, weightlifting and tennis.
Avoid exercise if you experience pain in your joints, have chest pain, have a fever or you are a diabetic and your glucose is over 300 or less than 70 mg/dL. Talk to your doctor about these things.
Drink plenty of fluids when exercising.
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Travel
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After discussion with your doctors.
Before you travel, check with your transplant team – certain destinations will require special precautions such as: vaccinations or antibiotics.
Locate the nearest transplant center at your destination, BEFORE you travel.
Take along enough of your medications for your entire trip (include extra doses just in case) and keep them with you at all times (NOT in checked baggage).
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| Back to Work |
After discussion with your doctors.
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| Taking a Shower |
Immediately, but allow the water to run over your incision. Avoid having the water hit it directly. Dry the incision completely by gently patting instead of rubbing.
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| Taking a Tub Bath |
If you have an incision on your abdomen it is best not to bathe for two weeks to prevent infection and allow for complete healing.
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| Sexual Activity |
When you feel comfortable or as instructed by your doctor. There is no reason why you should refrain from sexual activity unless you or your partner is sick or has a vaginal infection. If either you or your partner has an infection, both of you should seek treatment prior to intercourse.
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| Driving |
Not until you have stopped taking pain medication.
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| Lifting |
With an abdominal incision, avoid lifting more than 15 lb (about the weight of a bag of groceries) for 6 weeks to allow your inner tissues and muscles time to regain their usual strength.
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If you experience any of the following symptoms when you go home, please call the transplant clinic nurses or the renal transplant fellow on call:
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Temperature >100.5F
- Chest pain, shortness of breath, rapid heart beat
- Signs of infection (redness, swelling, increase pain, pus)
- Nausea and vomiting and unable to keep medicines down
- Draining wound
- Easy Bruising
- Increased pain despite pain medications
- Blood in your stool or urine
- Rapid weight loss or gain
- Black tarry stools
- Leg or calf swelling, tenderness or redness
- Sudden weakness or numbness on one side of the body or the face.
- Sudden change in vision
- Difficulty talking
- Sudden severe headache
Please use this list to help you think about the things you will need before you leave the hospital. We will do everything we can to help you prepare for your discharge, BUT it is also your responsibility to make sure you have all your questions answered before you leave.
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Disclaimer:
This site is not an attempt to practice medicine or provide specific medical advice, and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Nor should users rely upon the BWH web site if they might need emergency medical treatment. We strongly encourage users to consult with a qualified health care professional for answers to personal questions.
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