Receiving a kidney transplant is receiving a second chance at life, or even a third or fourth. But that doesn’t mean the work is done. A common misconception is that a transplant is a cure or fix-all. The reality, however, is that a kidney transplant is just another treatment option. So, while the days of dialysis may be over, patients must remain vigilant as they learn their new daily regimen in order to maintain long-term success with their new gift.
Here are 10 tips for transplant recipients:
1 Mind the Meds: One of the most important responsibilities a patient will have after receiving a transplant is following the complex medication regimen prescribed. Taking immunosuppressant medications will be required for the rest of the patient’s life (or the life of the transplanted organ) and will reduce the chance of rejecting the transplanted organ. Medications must be taken at the same time each day to ensure a stable level of medication is maintained.
2 Don’t Skip Regular Labs: Another lifelong commitment will be routine lab work to assess how well the kidney is functioning, and to detect early indications of organ rejection. In addition to monitoring transplant health, routine labs help monitor medication levels to ensure they remain stable. COVID-19 has inspired transplant-specific in-home lab services like RemoTraC (http://caredx.com/remotrac) that make getting regular labs, including AlloSure surveillance testing, easier than ever.
3 Attend Scheduled Appointments: Routine clinic visits with the transplant team can help detect transplant complications. It’s important to bring an updated list of medications to each clinic visit, as well as to ask questions and clarify concerns. Many doctors now offer telemedicine visits that make regular check-ins easier than ever.
4 Keep It Clean: The immunosuppression medications that prevent rejection also lower the body’s ability to fight infection. Hand hygiene is the number one most important way to prevent infection. Fever, flu-like symptoms, difficulty urinating, foul smelling and cloudy urine, wounds that will not heal, and white pouches in the mouth are a few signs of infection and should be reported to the transplant team.
5 Drink: It is essential to stay well-hydrated following a successful kidney transplant. Ten to twelve cups of fluid is generally adequate, with half of that fluid as water. Be aware that some fluids can cause dehydration, such as caffeinated drinks.
6 Eat Well: Maintaining a healthy diet after transplant is beneficial. After a transplant, there are less dietary restrictions than while on dialysis and prior to transplant. Consuming a heart healthy diet is often recommended by transplant teams. A transplant dietitian is a helpful resource after transplant and can assist with individual nutritional requirements. Some foods may be restricted due to medication interactions.
7 Monitor Glucose: Hyperglycemia or high blood sugar can occur after a transplant due to the prescribed steroids and anti-rejection medications. Kidney transplant recipients are at risk for developing post-transplant diabetes mellitus which can increase the risk of infections, cardiovascular complications, and organ rejection. Glucose levels are monitored, and oral medications or insulin may be prescribed to maintain healthy glucose levels and prevent damage to the transplanted organ.
8 Screen for Cancer: People who have received an organ transplant are at an increased risk of developing cancer due to the immunosuppression medications taken to prevent rejection. Prostate and skin cancer screenings, colonoscopies, mammograms, and PAP smears should be completed as recommended based on age and medical history, to increase the likelihood of detecting cancer in the early stage. If a cancer diagnosis is confirmed, the transplant team should be notified immediately as medication adjustments may be necessary to prevent injury to the transplant.
9 Step Up Those Steps: Once a patient recovers from transplant surgery, regular exercise is highly recommended. Exercise improves physical health, strengthens the heart and cardiovascular system, lowers blood pressure, increases energy, improves sleep, and helps to maintain healthy weight. Low impact options include walking, bicycling, and swimming.
10 Health Apps: Staying on top of so many tasks may seem daunting. However, there are many tools that help keep track of critical health metrics which can be downloaded onto any smart phone. Health apps, such as AlloCare—a comprehensive free app designed for kidney transplant recipients—gives reminders to take medications on time, tracks fluids, steps, weight, blood pressure, and mood, and even helps with scheduling the next lab draw. Find more information at caredx.com/allocare, or simply download the app.
It can be easy to become complacent over time, but it is vital for transplant recipients to stay compliant with the daily medication regimen for the life of the transplant.
If you currently have a transplant, do not skip medication doses, do not stop taking the medications, and do not self-adjust the dosage. Maintain a good relationship with your transplant team and always attend scheduled lab and clinic appointments. Being aware of what you need to do to take care of your new kidney will cause it to thrive!
Ashley Pearce is a Registered Nurse who spent 7 years as a Transplant Coordinator in Oklahoma. She is currently a Customer Experience Manager at CareDx, a leading precision medicine company that is 100% focused on transplant care.
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