Most Commonly Asked Questions about Kidney Transplant Surgery

A kidney transplant is a major and complex surgery, so it can affect almost all aspects of a patient’s personal/social life. Before undergoing this surgery, many people want to know what their life will be like afterwards. For example, if they can get married, work, and travel just like other people. They might also wonder whether they can have a kidney transplant while having serious health conditions, and how to prevent surgery’s complications. In this article, we have answered the most commonly asked questions about kidney transplant surgery. If you didn’t find your answer here, feel free to contact us.

When Can I Travel after a Kidney Transplant?

Patients can have land, air, and sea travel once they are fully recovered from the surgery. However, it is suggested to wait 6 to 12 months before going on long trips because the new kidney is prone to infection and needs frequent checkups for at least a year. Note that all patients should consult their doctor about necessary vaccinations and medications before travelling.

Is Catching a Cold Dangerous for the Transplanted Kidney?

Patients should take immunosuppressing medications for a long time after the surgery (maybe for the rest of their lives). So, even simple illnesses like a cold can jeopardize their health and life. That’s why they should consider the following tips to prevent viral and respiratory infections:

• Avoiding close contact with sick people
• Washing hands frequently, especially before eating
• Staying away from polluted or crowded places
• Wearing a mask when going out
• Maintaining hygiene and keeping the house clean
• Having a healthy lifestyle, getting enough sleep, and eating healthy (as advised by the doctor)

Can I Get Vaccinated after a Kidney Transplant?

Vaccination after a kidney transplant has multiple challenges and limitations, including:

• Vaccines that contain live, weakened viruses should not be used.
• Only the vaccines that are not made of live viruses are allowed.
• The patient should wait 3 to 6 months before getting vaccinated (unless the vaccine is urgent).
• The patient can get vaccines for hepatitis A and B, pneumococcal disease, and inactivated (non-live) influenza if the doctor allows.

Can You Have a Kidney Transplant at an Older Age?

The short answer is yes. People over the age of 65 can also undergo a kidney transplant. In fact, in some cases, the new organ helps them live longer and better compared to when they were on dialysis. However, the risk of death from infection and kidney failure is higher in them. That’s why the doctors are more cautious when choosing this treatment for the elderly and order various tests before making the final decision.

Can Patients with Lupus Undergo a Kidney Transplant?

People with autoimmune diseases, like lupus, can undergo a kidney transplant just like other patients. They can also get dialysis and take anti-rejection medications to prevent kidney failure. However, lupus can slightly reduce the lifespan of the transplanted kidney. In general, a kidney transplant is a better treatment for kidney failure in people with lupus because it increases their life expectancy.

Can You Get a Kidney Transplant When You Have Heart or Liver Disease?

Severe heart or liver diseases can increase the risks and side effects of kidney transplant surgery. Of course, the risks depend on the severity of the kidney diseases and the patient’s underlying conditions. Before the surgery, patients must take a stress test and an echocardiography. If the results are normal and acceptable, the surgery is done; however, if the tests show that the patient has severe conditions, like advanced heart failure, the transplant is either postponed or cancelled. In patients with serious liver disease, such as advanced cirrhosis, doctors may perform a liver and kidney transplant at once.

How Long Does a Transplanted Kidney Last?

If the kidney is retrieved from a living donor, it works for about 19 years, but if it is from a deceased donor, it lasts almost 10-12 years. Moreover, around 94% of kidneys donated by a living donor live for one year, while this number is 90% for kidneys from a deceased donor. However, many underlying health factors can affect how long the transplanted kidney continues to work. In most cases, good post-op care can even extend the graft’s lifespan.

How Can I Increase the Lifespan of a Transplanted Kidney?

Here are a few tips to increase the lifespan of a transplanted kidney:

• Taking care of the body during the recovery period.
• Taking medications as prescribed by the doctor.
• Having a healthy lifestyle, eating healthy, and avoiding a sedentary lifestyle.
• Taking immunosuppressing medications to prevent kidney rejection and reduce the risk of infections or cancer (happen due to the weak immune system).
• Getting medical checkups regularly to make sure the kidney works properly.
• Controlling diabetes, high blood pressure, high cholesterol, and protein in the urine.

Important note: You can prevent kidney failure and many other post-op complications just by following a balanced diet and being physically active.

Do You Get Osteoporosis after a Kidney Transplant?

Unfortunately, immunosuppressant medications can cause osteoporosis and increase the risk of bone fractures. However, the patients can manage bone loss if they take the right amounts of vitamin D and calcium daily, take regular blood and bone density tests, get joint replacement surgery when needed, lower steroid doses (if the doctor allows), and take medications that strengthen the bones (such as bisphosphonates).

What is a Kidney Transplant with Stem Cells?

Clinical studies show that stem cells can increase the success rate of kidney transplants and lower the risk of organ rejection. Stem cells taken from bone marrow, fat tissue, the placenta, or the umbilical cord have anti-inflammatory effects. They adjust the immune system’s response and reduce the need for strong immunosuppressant meds.

Can You Get a Kidney and Pancreas Transplant at Once?

If a patient suffers from kidney failure and type 1 diabetes, a kidney and pancreas transplant can be done at the same time. The goal is to control blood sugar and help the kidneys work normally. In some cases, a patient may choose to only undergo the kidney transplant and have the pancreas transplant later. However, transplanting both of them at the same time reduces the risks and side effects, especially those related to post-op medications.

What Is a Preemptive Kidney Transplant?

In short, a preemptive kidney transplant means receiving a new kidney before getting dialysis. When a patient is diagnosed with kidney failure, the surgeons sometimes do a kidney transplant before dialysis even begins. It not only avoids the complications of dialysis but also reduces the risk of organ rejection and the patient’s death.

Is Artificial Kidney Used in Iran?

No. An artificial or lab-engineered kidney is not used in Iran. All kidney transplants are done using kidneys donated by living or deceased donors. Even developed countries do not use artificial kidneys yet because they are still in their preclinical stages.

What Is a HLA Test?

Before a kidney transplant, the doctors order a Human Leukocyte Antigen (HLA) test to compare immune system markers (A, B, DR) of the recipient and donor. These antigens (proteins) help the immune system recognize what belongs to the body and what does not. If the HLA types do not match, the body is more likely to reject the transplanted kidney.

The HLA test prevents the immune system from attacking the new kidney immediately. A good HLA match increases the success rate of this operation. In other words, the better the match, the higher the chances that the transplanted kidney will survive.

What Tests Should I Take before a Kidney Transplant?

The most important tests that you should take before a kidney transplant are:

• Blood test to check blood type compatibility between the donor and recipient
• HLA test to compare the immune system markers and reduce rejection risk
• A crossmatch test to make sure the recipient does not have harmful antibodies
• DSA test to make sure there are no antibodies related to HLA
• Blood tests to measure the level of creatinine and electrolytes, and check whether the blood clots normally or not
• Tests for detecting infections that can be transmitted through blood
• Heart and lung examinations
• Tests to find the underlying conditions, such as heart disease, diabetes, high blood pressure, or cancer
• A full review of medical history and lifestyle factors that may affect transplant success
• Mental health assessment

What Are the Indications and Contraindications?

Indication means the doctors approve that a transplant is the best treatment option for the patient. Contraindication refers to situations in which a kidney transplant is too risky to perform because the patient has a certain health issue (like allergies, untreated illnesses, or a risky pregnancy).

What Are Tissue Typing and Antibody Panel Tests?

Tissue typing is another word for the HLA test. This test identifies the types of antigens found on the surface of the donor’s and recipient’s cells. On the other hand, the antibody panel test checks whether the patient’s blood contains antibodies against the donor’s HLA antigens. In the picture below, you can see the difference between tissue typing and antibody panel tests:

Can You Get Married after a Kidney Transplant?

Yes, people who have had a kidney transplant can get married and, after recovering, have intercourse. In most cases, they can also conceive normally and have healthy children. However, these patients face more challenges during their pregnancy, so they should plan it carefully and get regular checkups throughout the 38-40 weeks. Fortunately, many patients who used to be on dialysis say that they are healthier and have a better sexual/married life after having a kidney transplant.

Can You Have a Kidney Transplant if You Have Kidney Stones?

People who have kidney stones face certain limitations when donating or receiving a kidney, but the stones don’t necessarily prevent the surgery. In many cases, kidney stones are treated with medication months before the operation. If the donor’s stones are small, the surgeon first takes them out and then proceeds with the transplantation.

Abdominal Swelling after a Kidney Transplant?

Abdominal swelling after a kidney transplant is normal and happens to many patients. The belly swells for several reasons, including:

• Fluid buildup
• Increased pressure inside the abdomen
• Medication side effects
• Constipation
• Heart or liver problems like heart failure or portal hypertension (very rare)

This swelling usually resolves on its own within about two to four weeks after surgery. However, if it comes with other symptoms like pain, shortness of breath, a noticeable change in urination, rapid weight gain, or increased creatinine levels, it should be checked by a doctor right away.

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