Kidney transplantation

The following tests and consultations are necessary before a kidney transplant:

Blood group determination
BMI calculation
Update on the physical examination
Renal and bladder ultrasound (before and after micturition) and urine culture
Abdominal ultrasound
Doppler diagnosis of flows in the iliac arteries
Laboratory results: HBsAg, anti-HBs, anti-HCV, HCV RNA, anti-HIV, morphology, cholesterol, triglycerides, total protein, albumin, AST, ALT, GGTP, bilirubin, PTH, prothrombin; PSA (men over 40)
Chest X-ray
ECG and ECHO of the heart
Gastroscopy
Diagnosis for fecal occult blood
Consultation with dentist, ENT and transplant surgeon

Women should additionally undergo a gynecological examination, including mammography or breast ultrasound. Additional examinations, such as MRI, CT scan, or cardiology or ophthalmology consultations, may also be required as needed. The decision to conduct these is made by the doctor involved in preparing the person for transplantation.

If you are registered on the National Transplant Waiting List (NLL) and have been waiting for a transplant for more than a year, you should update the results of the following tests every 12 months:

HIV, HCV, HBV, PTH, morphology, aminotransferases, total protein, albumin, bilirubin, coagulogram
Urine culture
ECG and ECHO of the heart
Test for occult blood in stool
Ultrasound of the kidneys and abdominal cavity
Chest X-ray
ENT and dental consultations
Doppler diagnosis of the iliac arteries
Gastroscopy (depending on indications)
PSA (men), cytology (women)

Women should also have a mammogram every two years. Keep in mind that kidney transplant surgery may carry a higher risk in overweight people, so it's a good idea to make sure your BMI does not exceed 30 kg/m². You may also need to undergo additional surgical procedures, such as removal of your own kidney or gallbladder.

Congratulations! You have successfully performed the surgery. In the period right after surgery, it is especially important that you take care of yourself. Here are some tips to keep in mind:

When you are discharged from the hospital, make sure you have all the pertinent information: contact numbers for members of the transplant team, dates and locations of scheduled follow-up appointments, and details of new medications, including immunosuppressants. Make sure all recommendations in your discharge card are clear. It is best to purchase medications from the nearest pharmacy.
Regular visits to the transplant clinic with your doctor are key - they should be at least every 3 months. Don't skip these visits or extend the intervals.
Keep a self-monitoring diary in which you record measurements of blood pressure, heart rate, body weight and information on daily urine collection. Do not change doses or discontinue medications without consulting your transplant doctor.
Avoid large gatherings for about 3 months, as your body is then more vulnerable to infection. After that time, the risk decreases, but it's still a good idea to exercise caution.
Consider returning to work or study 2-4 months after transplantation. This time may vary depending on your health and the type of work you do.
Annual flu vaccination is recommended for the first years after kidney transplantation.

After transplantation, you can return to most of your daily activities, but with more care and attention. If you are planning a pregnancy, discuss this with your transplant doctor to determine the optimal time and possibly change medications. You can return to sexual activity once your wound has fully healed, as transplantation does not affect the quality of your sex life.

The post-transplant diet becomes less restrictive than during dialysis therapy. Drink about two liters of fluids a day and limit salt unless otherwise directed by your doctor.

If you have pets, you can stay with them as before, making sure to practice proper hygiene and avoid contact with their feces. If you garden, do so with gloves and a surgical mask to minimize the risk of infection. Standard cleaning products will suffice for house cleaning.

After kidney transplant surgery

At the time of discharge, you will get the phone numbers of the transplant team doctors. Make sure you have them written down.

Follow-up visits are scheduled at the time of discharge. It is also a good idea to make sure you have a referral for this visit.

You will receive detailed information about the dosage of medications in your discharge. Make sure you understand these recommendations.

Yes, the drugs written on the prescription should be purchased at the nearest pharmacy.

It is recommended that you keep a diary in which you record measurements of blood pressure, heart rate, body weight and the results of your daily urine collection.

Generally available cleaning products are sufficient for regular cleaning of the premises.

For about 3 months, avoid places with lots of people. After this period, the risk decreases, but still exercise caution.

Most often, a return to work is possible after 2-4 months, depending on the state of health and the type of work performed.

Drink about 2 liters of fluids a day and avoid salt unless otherwise advised by your doctor.

Sexual activity usually returns to pre-sickness levels after the wound heals.

Yes, if your kidney function is stable for the first year, but consult your doctor about immunosuppressive treatment before becoming pregnant.

Yes, you can travel, but avoid regions with poor hygiene standards and remember to take enough medicine.

Keeping pets clean and avoiding contact with their feces is very important.

Diet after kidney transplantation

After a kidney transplant, proper diet plays a key role in maintaining the health of the new kidney. The following recommendations will help you take care of your body and reduce the risk of heart disease, diabetes, hypertension and osteoporosis.

If your transplanted kidney is functioning properly, you should drink plenty of fluids. Unless your doctor advises otherwise, you no longer need to limit your intake. Dehydration can be harmful to the new kidney, so it is recommended to consume 2-3 liters of fluids per day.

In the first two months after transplantation, the body needs more protein to support healing after surgery and to fight infections. Products rich in protein are:

Tofu and other soy products
Lean meats, poultry, fish
Low-fat or fat-free milk, yogurt, cheese
Eggs
Beans, peas, nuts

Some immunosuppressive drugs can cause elevated blood potassium levels. Depending on your test results, your doctor or nutritionist may recommend limiting potassium-rich foods, such as:

Salt substitutes (salt-free spices or dried herbs are recommended)
Fruits (e.g. melon, bananas, avocados, oranges)
Vegetables (e.g., potatoes, tomatoes, dark green leafy vegetables)
Chocolate
Beans, lentils, nuts, nut butters

To control fluid retention and blood pressure, limit your sodium intake to 2000-2500 mg per day. Avoid adding salt to foods and products with high sodium content, such as:

Fast food and eating in restaurants
Salt seasonings (e.g., garlic salt, soy sauce, teriyaki sauce)
Canned meats (e.g., ham, bacon, sausage)
Cured meats (e.g., salami, mortadella)
Frozen meals containing more than 600 mg of sodium per serving
Pickles and olives
Canned foods with added salt (e.g., canned vegetables, soups)

Immunosuppressive drugs increase the risk of foodborne infections. To prevent this, you should:

Avoid untreated well water and improperly processed bottled water.
Avoid raw and undercooked meats, seafood and eggs, as well as unpasteurized dairy products.
Always wash fresh fruits and vegetables thoroughly before eating.
Store cold products at a low temperature and hot products at a high temperature.

To protect your new kidney, follow your doctor's instructions regarding medication and diet:

Mycophenolate mofetil (MMF): Can cause diarrhea, constipation, nausea and vomiting. To relieve these symptoms, eat small, frequent meals or snacks. Taking the drug with a small amount of food (e.g., crackers, bread) may help.
Tacrolimus: Avoid all products containing grapefruit while taking this medication.

Choose lean meats, poultry and fish. Remove visible fat before cooking.
Consume low-fat or fat-free dairy products.
Include fiber-rich foods in your diet, such as whole grains, legumes, fresh fruits and vegetables.
Use small amounts of olive oil or canola oil. Avoid butter, cubed margarine and trans fats.
Bake, grill, boil or braise instead of frying.
Limit your intake of products with high sugar content.
Maintain a healthy body weight or lose weight if necessary.
Control your blood sugar and blood pressure to take care of your kidney.

Before you start physical activity, consult your transplant doctor. After transplantation, at least 30 minutes of exercise 5 times a week is recommended (if approved by your doctor). Regular physical activity will help with:

Weight control
Strengthening the heart
Improving energy levels
Maintaining bone health

Diet and physical activity are crucial to the long-term health and protection of the new kidney.