Living with kidney transplant living

Overview

A kidney transplant is an operation that places a healthy kidney from a donor into your body to take over the work of your own failed kidneys. Living with a kidney transplant means taking care of the new kidney — and yourself — so it can keep working well for a long time.

Kidney transplant is the most common type of organ transplant. Around the world, thousands of people receive one every year.

It affects people of all ages who have kidney failure, including children, younger adults, and older adults. You might be offered a transplant if your kidneys no longer work well enough to keep you healthy, and you are well enough to have the operation.

Symptoms

Common symptoms

• Low fever
• Pain, swelling, or tenderness over the kidney transplant area
• Passing less urine than usual
• Swollen ankles, legs, or puffiness around the eyes
• Feeling more tired than usual
• Flu-like symptoms, such as aches and chills
• Blood in the urine

Symptoms in children

• Fever
• Vomiting or feeling sick
• Being more irritable or fussy than usual
• Less energy and not wanting to play
• Reduced urine output or wetting less often
• Swelling in the face or tummy

Symptoms in older adults

• Confusion or memory changes
• Unusual tiredness
• Swelling in the legs or ankles
• Low or high temperature
• Less urine output
• Changes in appetite or feeling generally unwell

Causes

Main causes

• Diabetes, which can damage the kidneys over time
• High blood pressure, which can harm the small blood vessels in the kidneys
• Glomerulonephritis, a family of conditions that inflame the kidney’s filtering units
• Polycystic kidney disease, a genetic condition where fluid-filled cysts grow in the kidneys
• Other causes, such as autoimmune diseases, infections, or severe kidney injury

Risk factors

• Having a family history of kidney disease
• Having diabetes or high blood pressure
• Being of Black African, Black Caribbean, South Asian, or other minority ethnic background (in the UK, kidney disease is more common in these groups)
• Using tobacco or drinking too much alcohol
• Not taking anti-rejection medicines exactly as prescribed after a transplant

When to see a doctor

See a doctor urgently if:

• Contact your transplant team the same day if you have a fever, pain over the transplant, less urine, swelling, or any of the symptoms listed above under 'urgent.'
• If you have severe symptoms, such as trouble breathing or very severe pain, call your local emergency number immediately.

Book a routine appointment if:

• Attend all scheduled follow-up appointments with your transplant clinic.
• Have your blood pressure checked regularly, and bring your readings to appointments if asked.
• Ask your doctor how often you should have blood and urine tests to keep track of your transplant.

Diagnosis

The health of a transplanted kidney is monitored with regular blood and urine tests that measure how well the kidney is filtering waste. If tests suggest a problem, your doctor may recommend pictures of the kidney (imaging) or a tiny sample of kidney tissue (a biopsy).

Tests that may be done

• Blood tests to check kidney function, such as a creatinine level, and to screen for side effects of medicines
• Urine tests to check for protein or blood, which can signal damage
• Ultrasound or other imaging to look at the size, blood flow, and structure of the transplanted kidney
• Kidney biopsy, where a very small needle sample is taken to look for rejection or damage

What to expect at your appointment

You will be seen often in the transplant clinic at first, and then less often as your kidney stays stable. Appointments usually include a quick check-up, blood tests, and a chance to talk about any symptoms or worries. If a biopsy is needed, you may be asked to stay in hospital for a few hours or overnight.

Treatment

After a kidney transplant, your main treatment is anti-rejection medication, which you take every day, usually for life. These medicines calm your immune system so it is less likely to attack the new kidney. Your transplant team will also help you manage blood pressure, cholesterol, and other health conditions to protect the kidney.

Self-care at home

• Take all medicines exactly as prescribed, even when you feel well.
• Never stop or change your medicines without talking to your transplant team.
• Check your blood pressure at home if your doctor advises, and keep a record.
• Contact your transplant team right away if you have signs of infection or rejection.
• Avoid people who are sick, and wash your hands often.
• Ask your pharmacist before taking any over-the-counter medicines or herbal remedies, as some may harm your transplant.

Medical treatments

You may need a combination of medicines to keep your immune system from rejecting the new kidney. These are usually taken as oral tablets. Your doctor will choose the right combination for you and adjust the doses based on your blood tests. You may also need medicines to control high blood pressure, diabetes, or other health problems. If you have an infection, you may be treated with antibiotics or antiviral medicines.

When is surgery considered?

Most people will not need another surgery after a transplant. Sometimes, a small operation may be needed to fix a problem such as a blocked blood vessel or urine tube, or if the transplant kidney needs to be removed because of severe rejection or infection.

Living with this condition

Your day-to-day life will include a new routine of medicines, regular check-ups, and monitoring your health. Many people learn to fit this into their normal life and return to work, study, and family activities. It helps to build a routine and keep a list of your medicines, appointments, and blood pressure readings.

Lifestyle tips

• Stay active in a way you enjoy, but check with your transplant team before starting intense exercise.
• Protect your skin from the sun, as anti-rejection medicines can make your skin more sensitive.
• Limit alcohol and do not smoke, as these can affect blood pressure and kidney health.
• Try to get enough sleep and manage stress with activities like walking, reading, or meditation.
• Travel is possible, but ask your team about vaccines, insurance, and where to get help if you are away.

Diet and exercise

You can usually eat a normal, healthy diet after a transplant, but some foods can interact with your medicines. For example, grapefruit and pomegranate can affect anti-rejection medicine levels. You may also need to limit salt to help control blood pressure. A kidney-friendly diet is often low in salt and processed foods, with plenty of vegetables and fruit. Ask your transplant team for a referral to a dietitian who can personalise advice. Gentle regular activity, such as walking, swimming, or cycling, is great for your heart and mood.

Mental health and emotional wellbeing

Having a transplant is a major life event, and it is common to feel anxious, low, or overwhelmed at times. You might worry about rejection, the future, or the burden on your family. These feelings are normal, and asking for help is a sign of strength. Speak to your doctor or nurse, and consider seeing a counsellor or psychologist. You can also reach out to your local mental health crisis service if you feel unable to cope.

Prevention

You cannot always prevent kidney failure, but you can do a lot to protect the health of your transplanted kidney. Keeping your medicines on time, monitoring your blood pressure, and attending check-ups are the best ways to prevent rejection and other problems.

Vaccines

Keep your vaccinations up to date as recommended by your doctor. Because anti-rejection medicines weaken the immune system, some live vaccines (like measles, mumps, rubella) should be avoided. Always ask your transplant team, pharmacist, or primary care doctor before having any vaccination.

Screening programmes

You will have regular screening through blood tests, urine tests, and blood pressure checks. These checks help detect early signs of rejection, infection, or side effects from medicines, so they can be treated quickly.

Complications

If left untreated

• If signs of rejection are ignored, the immune system can attack and permanently damage the transplanted kidney, causing it to fail.
• Untreated infections can become serious and affect the whole body, or increase the risk of rejection.
• High blood pressure, diabetes, or high cholesterol, if not managed, can slowly damage the transplant kidney and blood vessels.

Long-term outlook

The outlook after a kidney transplant is generally very good. Many people keep a transplant working for 10, 15, or even 20 years or more, especially with careful follow-up and healthy habits. If a transplant ever stops working well, there are still options such as dialysis or another transplant. You are not alone, and your healthcare team will support you at every stage.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.