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Niertransplantatie: Wat te verwachten na de operatie?

Hospitalization continues immediately after the transplant in order to control the new kidney’s function and the intake of new immunosuppressants drugs must start immediately. These are drugs that are designed to prevent the patient's defense system from expelling the new kidney (the defense system is the one that fights every foreign body - micro-organism - microbe during our lives).

Is it possible to undergo dialysis after transplant?
There is a chance that the patient will perform dialysis sessions until the new kidney begins to function properly, but this does not prejudge anything.

Can I stop taking immunosuppressive medications?
NO! Because then your body will eliminate the new kidney, which will stop working without being able to recover. Thhe medication must be continued lifelong.

What do I need to know about my immunosuppressive treatment?

  • You should be familiar with your medications, their names and their content and have a list of them with you constantly. You will probably also take cortisone and you should not abruptly stop taking cortisone for any reason.
  • Some drugs (that seem apparently "innocent", e.g. antibiotics such as erythromycin) can affect the dose and / or levels of immunosuppressive drugs. Check with your nephrologist first before taking any new medication.
  • If you travel, you must always have more medicine with you than your planned.
  • Avoid grapefruit juice since it is responsible for increasing the levels of some immunosuppressive drugs.

What are the most common complications of kidney transplantation?
Along with the usual complications of any surgery, the complications of kidney transplantation are the following:

  • Delay in the function of the new kidney. Sometimes, the newly-transplanted kidney delays starting functioning. Most likely, it will soon start functioning normally. Until then, you may need dialysis.
  • Loss of urine from the implanted ureter of the transplanted kidney.
  • Any infection that can be treated, since the immune system reduces its effect by suppression. They may be urinary tract infections, viral infections or fungi.
  • Acute rejection, a complication that has been greatly reduced with all new medications.

What is discarding and how many types are there?
Discarding means your body is trying to get rid of something strange, something that does not belong to it - including your new kidney. Acute rejection occurs within the first year of the transplantation and is very often treated successfully. Chronic rejection is a slow process, with not fully perceived mechanisms and difficult to deal with.

What are the contraindications?
Contraindications for kidney transplant associated with the recipient are the following:

Severe cardiomyopathy or coronary heart disease, cancer, active systemic infection, liver cirrhosis, substance dependence, refusal to take medication after transplantation.

When can I work again?
With kidney transplant, one can turn to his normal routine, including his work. If the patient is an office clerk, then he can return after a period of 6 weeks to 2 months. If his work requires physical effort, a reasonable limit is a trimester. In any case, the patient may return to work after having consulted his nephrologist.

Do I need to be on a special diet after transplant?
If there is no kidney failure after the transplant, then there are no diet restrictions. However, much attention should be paid in case of a possible increase in body weight after transplant. Weight gain may have a negative effect on transplantation, that is why a healthy diet after transplantation is especially important.

Can I travel after my kidney transplant?
The advice of most transplant centers is to avoid traveling abroad in the first year of the transplant, due to a high risk of infection.

How will you be sure if the transplanted organ is healthy and works well?
With regular medical follow-up and laboratory testing that will be evaluated by the nephrologist. Visits are initially frequent and become less common over time and if the new kidney works well. In addition, it is necessary to measure and monitor levels of immunosuppressive drugs quite often as the therapeutic range is narrow.

Mesogeios Dialysis Centers Scientific Team 

1. Kasiske BL et al. The evaluation of renal transplant candidates: Clinical practice guidelines. J Am Transplant 2001;1
2. Neprol Dial Transplant 2000;15(suppl 7):3-38.
3. Marra G, Dalmasso E, Angello M, Munegato S, Bosio A, Sedigh O, Biancone L,Gontero P. Prostate Cancer Treatment in Renal Transplant Recipients: A Systematic Review. BJU Int. 2017 Sep 18. doi: 10.1111/bju.14018. [Epub ahead of print]
4. Zuber J, Sykes M. Mechanisms of Mixed Chimerism-Based Transplant Tolerance. Trends Immunol. 2017 Nov;38(11):829-843. doi: 10.1016/j.it.2017.07.008. Epub 2017 Aug 18. Review.
5. Lentine KL, Kasiske BL, Levey AS, Adams PL, Alberú J, Bakr MA, Gallon L, Garvey CA, Guleria S, Li PK, Segev DL, Taler SJ, Tanabe K, Wright L, Zeier MG, Cheung M, Garg AX. Summary of Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017 Aug;101(8):1783-1792.
6. Piccoli GB, Moio MR, Fois A, Sofronie A, Gendrot L, Cabiddu G, D'Alessandro C, Cupisti A. The Diet and Haemodialysis Dyad: Three Eras, Four Open Questions and Four Paradoxes. A Narrative Review, Towards a Personalized, Patient-Centered Approach. Nutrients. 2017 Apr 10;9(4). pii: E372. doi: 10.3390/nu9040372. Review.