How Should Home Care Be After a Kidney Transplant?

After a kidney transplant, a new lifestyle will begin for you at home with your loved ones and family. In order to maintain your new life healthily, it is extremely important to attend outpatient clinic check-ups on time, use your medications regularly, and pay attention to the rules you need to follow in your social life. The educational brochure we have prepared will guide you in this regard.

What Should Be Considered After a Kidney Transplant?

After being discharged following a kidney transplant, some monitoring needs to be done regularly at home as well. The most important of these are temperature measurement and blood pressure monitoring. You should be careful to perform these follow-ups on the days and times recommended by your doctor. If you have diabetes, your blood sugar measurements should be recorded in a notebook, and you should bring these recorded measurements with you when you come for an outpatient clinic check-up.
Outpatient clinic check-ups are very important for monitoring the function of your transplanted kidney, adjusting the dosage of your medications, and reviewing your general health status. The first six months after kidney transplant surgery are considered a critical period. After this period, the likelihood of rejection (the immune system's response aimed at eliminating organisms or substances perceived as foreign) begins to decrease. Rejection is also defined as the recipient organism's non-acceptance of transplanted tissues or organs.

What Problems May Occur After a Kidney Transplant?

If any of the situations listed below occur, you can apply to the organ transplant outpatient clinic during working hours, or to the emergency services near our hospital or your home outside of working hours.

• Fever of 38°C (100.4°F) or above
• Shortness of breath
• Cough, phlegm
• Decrease in urine output, burning sensation, and change in urine color
• Persistent pain, swelling, and redness in the surgical area
• Repeated vomiting, diarrhea
• If you have a dental problem and your dentist recommends antibiotic therapy
• Newly appearing rashes on the skin, itchy lesions
• In the event of any vaccination being administered or recommended

How Should Follow-ups Be After a Kidney Transplant?

Regular follow-ups at periodic intervals after a kidney transplant are extremely important both for maintaining general health and preventing possible complications. Therefore, especially within the first year, you must comply with the check-up dates specified by your doctor. After the transplant, you need to come for outpatient clinic check-ups at the periods specified below.

Post-kidney transplant follow-ups should be as follows:

• 2 days after discharge
• Once a week for the first three months after transplant
• After the 6th month following the transplant, once every 3 weeks depending on the patient's condition

What is the Risk of Infection After Kidney Surgery?

Since there is a risk of infection after a kidney transplant, the points to be considered to protect against these risks are as follows:

• It is extremely important to follow the rules below to protect against infections in general, especially during the first six months.
• Whenever you feel any change in your temperature, you must measure it, and if it is 38°C (100.4°F) or above, you must inform your doctor.
• In the early days when immunosuppressive drugs suppress immunity, you should pay particular attention to the surgical wound, keep the wound site clean, and definitely inform your doctor in case of swelling, increased heat, or redness on it.
• You should be careful to keep your hands clean during the day. You must wash your hands before and after using the toilet, and before and after meals.
• Oral and dental health is also very important after transplantation. If you are using aspirin or similar blood thinners, you must stop these medications approximately one week before dental treatment.
• You should not receive visitors at home, especially during the first six months.
• Within the first six months after transplant, you must wear a mask in crowded environments such as public transport vehicles and hospitals.
• You should consume raw vegetables and fruits only after washing them very well.
• If you use air conditioning at home, you should pay attention to cleaning the filters regularly.
• You should take care of the cleanliness of your home and try to stay in a well-ventilated and sunlit part.
• During the day, you should definitely not accept visitors who have a contagious disease, even if it's just a cold or flu, and you should also stay away from environments where such people are present.
• You should pay attention to your body hygiene and ensure that your personal items such as towels, combs, razors, and nail clippers are for your own use only. Male patients should shave their beards at home rather than at the barber.

How Should Nutrition Be After a Kidney Transplant?

The question "What should a person with a kidney transplant eat?" is one of the frequently asked questions by kidney transplant recipients. After transplantation, the dietary restrictions will decrease. However, cortisone, one of the medications used, not only leads to water and salt retention in the body but also increases appetite. Therefore, weight gain is common after transplantation. To prevent weight gain after kidney transplant, nutrition after kidney transplant should be as follows:

• Meals should be low in salt.
• Elaborate and lavish tables that will increase appetite should be avoided.
• Care should be taken to consume low-calorie vegetables at meals.
• Water should be drunk during the meal.

Due to cortisone-containing medications used after kidney transplant and the transplant surgery itself, protein breakdown in the body increases. Therefore, you should prefer a protein-rich diet. Also, you no longer need to restrict potassium and fluids. Although there is no special diet for the post-transplant period, your dietary routine should not be the same as it was in the pre-transplant period. Regarding nutrition, you should pay attention to the following points as much as possible:

• Prefer white meat over red meat.
• When preparing your meals, use liquid oil instead of margarine.
• Consume freshly squeezed fruit juice instead of carbonated drinks (except grapefruit and orange juice).
• EATING MUSHROOMS IS ABSOLUTELY FORBIDDEN.
• Prefer whole wheat bread instead of white bread.
• If you are taking a medication containing cyclosporine or tacrolimus, do not take these medications with citrus fruits such as oranges, lemons, and mandarins.
• Do not use large water jugs (demijohns) or water that has been left standing. Prefer small bottles that you can consume quickly.
• Consume pasteurized milk and dairy products. Never eat or drink products sold in the open.
• Pay attention that your daily fluid intake does not fall below 3 liters.
• For snacks, try to consume yogurt, milk, and fruit instead of heavy meals.

Does Blood Sugar Rise After a Kidney Transplant?

One of the side effects of the medications used after transplantation is an increase in blood sugar. This condition can be temporary or permanent. Therefore, patients with high blood sugar should be careful not to gain excessive weight for the rest of their lives and should pay attention to following a regular diet. Additionally, paying attention to the following points will also help prevent high blood sugar after a kidney transplant:

• Age, weight gain, and a family history of diabetes can raise blood sugar.
• Reducing cortisone and eating a regular diet can help control blood sugar.
• In case of high blood sugar, it may be necessary to use oral antidiabetics or insulin.
• Regular check-ups should be done at diabetes outpatient clinics.

How Should Exercise Be Done After a Kidney Transplant?

The question "Can people with a kidney transplant do sports?" is one of the frequently asked questions by transplant recipients. Exercising regularly after a kidney transplant can help you feel better and also help you return to your daily life more quickly. The point to consider here is that the exercises performed should not put a strain on the kidney. Walking is a good exercise method to start with. After 6 months, you can swim, play tennis, and ride a bike.

What Should a Person with a Kidney Transplant Pay Attention To?

The points to be considered in social environments after a kidney transplant are as follows:

• You should not go to public places for the first 6 months.
• You can start school or work life after 6 months.
• You should get a flu shot every year.
• You should wait for the first 6 months to pass before traveling.
• You should not carry weights over 5 kg.
• You should not use belts that tighten around the waist at the level of the kidney.
• You should not keep birds at home or grow flowers (as houseplants that involve soil).
• One year after transplantation, you may garden while wearing gloves.
• You can enter the sea after 6 months, but you should absolutely not enter a swimming pool for the first year.
• You should absolutely not smoke. Smoking can damage not only the heart and lungs but also your entire vascular structure. It shortens the lifespan of the transplanted kidney.
• You should absolutely not consume alcohol.
• You should not have laser hair removal for the first 6 months.
• You should not get tattoos or piercings after the transplant.
• You can drive a car 4-6 weeks after transplantation, provided you are careful.
• The medications used can affect your hair. While cyclosporine and cortisone cause body hair growth, the medication containing tacrolimus can lead to hair loss. The scalp and hair need to be washed to prevent oiliness. Also, you should not dye your hair for the first 6 months.

How Should Sexual Life Be After a Kidney Transplant?

The rules for sexual life after a kidney transplant are as follows:

• You should not have sexual intercourse for the first 6 weeks.
• The most suitable method of contraception is a condom, and it must be used.
• Both female and male patients can have children after transplantation.
• If you are planning a pregnancy, you must inform your doctor about this and plan accordingly.

How Should Medications Be Used After a Kidney Transplant?

After transplantation, your body realizes that the kidney tissue is foreign, and your immune system attacks this invader. Immunosuppressive drugs weaken your immune system's response, preventing the rejection of the transplanted kidney. However, immunosuppressive drugs also make you more susceptible to infections. Therefore, a balance is needed between the conflicting requirements of preventing rejection and maintaining adequate defense against infection. Fortunately, the amount of immunosuppressive medication needed to protect a transplanted organ decreases after the first few months following surgery. Still, immunosuppressive drugs are necessary for many years after the transplant. The medications, medication schedule, and usage methods will be explained to you in detail, and necessary informative documents will be provided. Medication use after a kidney transplant should proceed as follows:

• You should use the medications as recommended by your doctor, and you should make medication amount and dosage adjustments only as advised by your doctor.You should not change the dose or amount recommended by your doctor. If you are going somewhere, you must take spare supplies of your medications with you.
• You must absolutely not take your medications with alcohol, grapefruit juice, or orange juice. (Grapefruit and orange juice should not be consumed because they affect the level of immunosuppressive drugs in the blood.)
• You should not use any medication without your doctor's knowledge. If you vomit after taking medication, if vomiting occurs within 1 hour, you should take the same dose of the medication. If vomiting occurs later than 1 hour after taking the medication, you must call your doctor.