After kidney transplant surgery, patients remain in the hospital for four to six days on average. After discharge from the hospital, patients will return for frequent follow-up visits. These will include:
Patients' primary care physicians will also be involved in follow-up care. Routine health maintenance is also important, including dental care with antibiotic prophylaxis, annual eye exams, and (for women) gynecologic care.
During the weeks or few months immediately after surgery, it is normal to feel tired and to need extra rest. The transplant team recommends that patients go out or visit with friends if they feel up to it, but not to overdo activity to the point of becoming exhausted. Depending on the medications patients are taking, they may be unable to drive for several weeks. Good nutrition and daily exercise are important for a successful recovery.
Most patients recover fully and are able to return to work or school within a few months. Life after kidney transplantation will involve many changes, however. These include:
Organ rejection is the most common and serious complication of kidney transplantation. After transplantation, patients therefore need to take immunosuppressant medications to prevent rejection of the donor kidney. Patients must be diligent about adhering to their medication regimens, as they are important to the long-term success of the transplant operation.
Drug regimens are tailored to the needs of each person, but usually patients take several medications to prevent rejection. These medications may make patients more susceptible to infection, particularly in the first few months when higher doses are needed. However, for the first several months to one year after transplantation, patients also take medications to prevent viral, bacterial, and fungal infections.
One type of anti-rejection medication, corticosteroids, are associated with unwanted side effects, so doctors at NewYork-Presbyterian have developed medication regimens that avoid the use of long-term steroid therapy.
NewYork-Presbyterian/Weill Cornell Medical Center researchers developed a urine test that is 85 percent accurate for detecting early signs of organ rejection in transplanted kidneys and identifying which patients may be at risk for rejection weeks or months before they develop any symptoms. The urine test is a "gene expression profile" that measures three genetic molecules in a sample of urine. A composite score calculated using the test is used to determine if changes need to be made to a patient's immunosuppressive therapy.
If the score starts to rise over time, the patient may be at risk for rejection and require more immunosuppressant therapy. If the score remains steady, the patient is not at risk for organ rejection and can stay on the same treatment plan. For the first time, this test gives doctors the opportunity to manage transplant patients in a more precise, individualized fashion.
Renal and Pancreatic Transplant Program
The Pancreas Center
Kidney and Pancreas Transplant Programs