Your Kidney Transplant
The renal dietetic service:
A renal dietitian is a dietitian specialising in kidney conditions and can offer advice and help in:
- Protecting your kidney transplant
- Staying well
- Reduce the risk of developing complications
Following transplantation, a renal dietitian will see patients individually before going home. Once the new kidney is working well many of the food restrictions followed prior to transplantation can be reduced. The dietitian will discuss some of the complications which can arise from the transplant medications and how diet can help to reduce the risk of these occurring, for example:
- A weaker immune system will make individuals vulnerable to food poisoning and there are some foods which should be avoided. Good food hygiene when preparing, cooking and storing food will also help to prevent food poisoning occurring. Tips on staying well when eating out or travelling are also provided.
- A healthy diet and lifestyle will help prevent weight gain and control blood pressure, blood glucose and cholesterol levels. This will reduce the risk of developing conditions such as heart disease and diabetes.
- Bones can become thinner, which may lead to osteoporosis. A diet rich in calcium, as well as physical activity, will help to keep bones healthy.
If there is a need to see a dietitian after discharge from hospital, this can be arranged either at Plymouth, or your local renal unit.
Thanking the donor family
Donor families tell us that receiving a letter from their loved one’s recipient is a great comfort and makes them feel that their gift has been truly appreciated. NHS Blood and Transplant has produced a guide for thanking the donor family to explain further.
Questions and answers
Q: Am I too old for a transplant?
A: Age is not a restriction, but your health will be a factor in the assessment process.
Q: Is a transplant a cure for my renal failure?
A: Transplantation is not a cure but another form of treatment. However, if your transplant is working well, your quality of life will improve considerably and often patients can restart things they had to stop when their kidneys began to fail. The average life span for a deceased donor kidney is 10 years and for a live donor kidney it is 15 years. There is a wide range in these figures but when the kidney fails you will need to return to dialysis and/or have a further transplant.
Q: What are the differences between DBD and DCD kidneys?
A heart beating deceased donor (DBD) has been diagnosed with brain stem death and can donate multiple organs whilst still on the ventilator. A controlled non-heart beating donor (DCD) has died (the heart has stopped beating) and the kidneys, and sometimes other organs, can be donated a few minutes later.
The waiting list
Q: How long will I be on the waiting list before I have a transplant?
A: Unfortunately there are more people requiring a transplant than there are donors. The average for our unit is just over one year but this will vary considerably from a few days to much longer, depending on your matchability score – do we explain that? Could say “depending on your cell type and whether you have antibodies already”
Q: How long will I have to stay in hospital?
A: You can expect to be discharged from hospital within 7-10 days after your transplant, providing you are making a good recovery and your new kidney is working well, but you should be prepared for longer, as there can be early problems sometimes.
Q: How long will I be off work?
A: This is variable but most people should be back after about 8 weeks, depending on the type of work you do. Once you feel able to do so you will not be doing any harm as long as you can still attend for your all your follow-up clinic appointments.
After the transplant and beyond
Q: Am I more likely to pick up infections once I have had a transplant?
A: The anti-rejection medication that you will need to take suppresses your immune system to prevent your body rejecting your new kidney. This also means that you will be more likely to pick up infections.
Q: What is CMV?
A: Cytomegalovirus (CMV) is a virus that a large percentage of the general population has been exposed to and has passed off as having flu. The virus is kept dormant by your immune system. In transplant patients the CMV virus can be reactivated, as the immune system is suppressed by the anti-rejection medication. The virus can sometimes also be passed on to the recipient from the donor kidney if the donor had been exposed to CMV. All recipients who are at risk of CMV will be closely monitored by way of regular blood tests.
Q: What is the treatment for CMV?
A: Active CMV above a predetermined level will be treated with an anti-viral drug called Valganciclovir, which will be prescribed for a 3-week course. Repeat courses may sometimes be required.
Going on holiday
Q: Can I go on holiday after my transplant?
A: Yes you can, but we ask you to wait 12 months before going overseas.
Q: What SPF sun cream should I use?
A: We recommend you use a minimum of SPF 30 or higher year round, higher overseas.
Q: Should I use lip balm?
A: Yes we recommend a lip balm with a SPF 30 or higher.
Q: Why do I need to wear sun cream year round?
A: Due to the immunosuppression drugs used, transplant patients are at increased risk of developing skin cancers.
Q: How soon can I drive after a transplant?
A: You are safe to drive once you can make an emergency stop without pain. However you should contact your insurance company before starting to drive again as they may impose a set time limit.
Having a family
Q: Can we have children now that I have had a transplant?
A: Yes it may now be possible for you to have children. Men can become fertile again after transplantation and women can possibly become pregnant. We would recommend that you wait at least 12 months before trying to become pregnant and discuss the possibility with your Renal Consultant. It will probably be necessary to adjust your medication several weeks before you start trying for a baby (whether you are the mother or father) in order to minimise harm.