Organ donation and Transplantation – Part IX
Tips to protect a transplanted kidney
We have talked at length about maintaining your native kidney’s health. In this last installment of the current series, I will give you a few tips to protect the transplanted kidney since more than 20,000 kidney transplants are done each year in the U.S. and many in our community are living with a donated organ. Failure of the transplanted organ in the long term is an important limitation and the patient and his/her team of caregivers should do everything to prevent this complication. Here are a few points to keep in mind.
Always be compliant with the prescribed medications: Try not to miss even a single dose of the anti-rejection medications and stick to the schedule and timing as the doctor ordered. A pediatric nephrologist practicing in inner city New Orleans once told me that he sees transplant failure in children occasionally because the care giver forgets to give the child the necessary medications. That’s sad.
Watch out for infections: Being immunosuppressed means you are vulnerable to infections – anything from simple flu to serious ones like TB and hepatitis (currently an epidemic in Florida). Even a simple bronchitis can last for several days in a transplant patient and lead to complications if not treated properly. Strict personal hygiene coupled with a good dose of common sense can help protect your body from infections. Cleaning your hands, using disinfectants as needed, avoiding crowds, and keeping a safe distance from ‘possibly infected’ individuals will be helpful. Make sure you are up-to-date with your preventive vaccinations and immunization shots.
Know the early signs of rejection: These include fever, fatigue and weakness that were not present before, pain or tenderness over the area of the transplanted kidney, increasing blood pressure previously well controlled, decreasing urinary output and sudden weight gain with swelling of the hand and feet. Get in touch with your nephrologist if you note any of these signs.
Stay in touch with your health care team: Don’t miss any follow ups and don’t be shy to ask questions and discuss your concerns. Your health care team is vital for your welfare. Get your lab tests on a regular basis as recommended and discuss the results with your doctor. Blood levels of immunosuppressant drugs need to be measured periodically and the dose of the drugs adjusted accordingly.
Control your concomitant diseases well: Once the new organ is “well settled” in the body and kidney function is stable and you continue the proper maintenance, the next major concern is other diseases, especially heart disease, cancer, hypertension and Diabetes Mellitus. These are common in the general population and more so in transplant patients; they can take a toll on the longevity of your transplant too. Early detection and optimal control are of paramount importance.
Have a good support group: Apart from your immediate family, it is always good to have a few close friends who can give you a hand when needed. There are also kidney transplant support groups in most major cities. Some of them are on Facebook, and you can easily connect with them.
Update your knowledge constantly: Keeping abreast of new developments –
technology and drugs – in the field of transplantation is an ongoing job but you must be aware of the current advances to take advantage of them. Your transplant physician will, of course, do what is needed
Avoid accidents and trauma: As you well know, falls are dangerous, especially if you are on blood thinners because of the risk for internal and external bleeding. One patient I know who had a 5-year-old stable kidney transplant developed bleeding inside the skull (subdural hematoma) after a fall that required two surgeries back to back. This led to the failure of the transplanted kidney and he had to go on hemodialysis for a couple of years before he got his second transplant.
9. Embrace spirituality and practice meditation: Scientific proof now exists that spirituality, including prayers, yoga, pranayama and meditation go a long way in de-stressing your life, increasing productivity and improving overall health. Meditation keeps your mind steady, strong, relaxed and peaceful.
All that has been mentioned earlier to maintain your native kidney’s health like heart-healthy diet and regular exercises is applicable for the transplanted kidney too. Kidney transplantation has come a long way and our motto should be “Donate an organ and Save a life.”
* This concludes the series on organ donation and transplantation.
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading, “Second Chance - A Sister’s Act of Love” by Dr. Nathan from Outskirts Press, can be found at www.amazon.com