Recovery at the transplant centre

After a kidney transplant operation, it is expected that you will have some discomfort, particularly around your wound as you recover.

There are lots of ways the transplant team can support you to make sure this is as manageable as possible. Some patients may feel sick during the first few days and anti-sickness medication can be given to help with this if needed.

Managing your pain

Good pain control is important and will help you to recover more quickly. It is important you can cough, take deep breaths, and move around. This all helps to reduce the risk of complications such as blood clots in the legs and lungs, and to reduce the risks of chest infections. If you’re finding this difficult because of discomfort, it suggests that your pain is not well controlled, and this can slow your recovery.

Let the transplant team know if you are having difficulty. There are lots of different things they can use to help with your pain. There are also specialist pain teams that can help, if needed.

Painkillers (particularly opiates) can have side effects, including sickness, itching, drowsiness and constipation. Your transplant team will help you to manage your pain and minimise these side effects as much as possible. Early and regular mobilisation helps with this.

The nurses and doctors looking after you will keep a close eye on your pulse, blood pressure, temperature and urine output. You will need regular blood tests, as least once daily and sometimes more often.

When you wake up from the operation, you will usually have fluids through a drip (intravenously into the tube/cannula in your vein). It is important for you and the transplant kidney to have enough fluid, but too much can also be harmful. You will usually be encouraged to start drinking as soon as you wake up after the operation.

Your transplant team will try to stop the drip as soon as possible and will guide you with how much you should try to drink each day. Some patients can find this difficult if they have been on a fluid restriction before the transplant. Talk to your transplant team if you are finding this difficult. Daily weights are also a useful tool to monitor your fluids and you may be asked to measure your weight each morning.

Start to eat a light diet as soon as you feel able, with small amounts often, then increase as you can over the first day or two. Starting to eat can help to encourage your normal bowel habits to return and help prevent constipation.

Getting up and moving again as early as possible after an operation is very important. This helps to reduce the risk of blood clots in your legs and lungs as well as chest infections. It can also help to speed up your recovery, reduce muscle wastage and help prevent constipation.

Usually within 6 to 12 hours of the operation, you will be helped to sit out in your chair and encouraged to start some walks. The nurses and physiotherapists will help you. If you have mobility difficulties, don't worry, your needs will be supported. Your transplant team may offer you daily targets to try to achieve, such as a certain number of short walks or time spent out of bed. They can also give you simple exercises that are safe to do and give you advice around carrying on your recovery at home.

You may feel bloated after your operation and sometimes your bowels may not work properly for the first few days. The sooner you get out of bed and start moving around, the sooner your bowels will start working. Eating and drinking as soon as you are able after the operation will also help with this.

If you are constipated, you may need tablets (laxatives) or other medications to help. Let your team know if you are having problems.

Extra plastic can be a source of infection in the body. Your transplant team will try to remove any plastic tubes as soon as they can, usually within the first 1 to 3 days.

The timing can vary depending on your needs and the details of your transplant operation. Ask your transplant team about this each day.

The transplant team will monitor the amount of urine you are making and your blood results. This will help them to understand when the kidney transplant is starting to work.

The time it takes for a transplanted kidney to start working can vary from immediately after the operation to months afterwards. Most kidney transplants start working within a week or so of the operation. There are lots of factors that effect this and everyone's circumstances are different. The transplant team will explain the details of your kidneys progress to you. If the information is not clear or you have questions, ask your team.

Some patients may need to go to the intensive care or high dependency unit after a kidney transplant. This is not always possible to predict, but if your transplant team think this is likely it will be discussed with you before the operation.

Many medicines might be prescribed after a kidney transplant, for example to prevent rejection or infection, or to manage pain.

All patients that have a kidney transplant will need immunosuppressants. These lower your immune system and reduce the chance of your body rejecting your new kidney.

Each transplant centre unit uses slightly different medication doses and types. Before you leave the transplant centre, you will be given detailed information about your new medicines and how to take them. You’ll also be told what other medicines to avoid.

It’s very important that you take all your new medicines as directed.

Learn more about transplant medicines

Please talk to your GP or transplant team before you start taking any over-the-counter medicines or herbal medications. This is because some non-prescription medicines and herbal medications can affect your immunosuppressant medications.

As your transplanted kidney settles, you should be able to eat more foods and follow a much less restrictive diet than on dialysis. However, you may need to avoid some foods. Your transplant team will tell you what you can and can’t eat.

When you do leave hospital, remember that support is still there for you. Your transplant team will make sure that you know who to contact with any questions or concerns, day or night. Leaving the hospital is the start of a long journey of recovery, often with some challenges along the way. Having a transplant can be an emotional experience and the transplant medications can also affect your mood.

There are support services available, offering a range of practical, social, and emotional support including from local and national kidney charities. Ask the transplant team about what is available near you.

An appointment will be made for you in the kidney transplant clinic, and you’ll be told the date, time, and location of this visit. To start with, most patients will be seen at least once or twice a week in the transplant clinic after their operation. Hospital transport can be arranged, if needed.

Over the following weeks and months after your operation, it is likely that your kidney function will be more stable, and that you will need to come to the transplant clinic less often. After a year, if you do not have any serious problems, most patients only have to attend the centre once every 3 to 4 months.

A tube (stent) is often inserted between the transplant kidney ureter and your bladder.

This will be removed as soon as it is safe to do so. Sometimes this will be during your stay in hospital but may be days or weeks after you go home. Your transplant team will explain when and where this will be for you.

If you have a dialysis tube (catheter) in your neck or groin veins, or a dialysis tube in your abdomen (tummy), these will need to be removed. The timing of this removal depends on how well the transplanted kidney is functioning.

Dialysis lines and tubes are sometimes removed during your stay in hospital, but this may need to be delayed until days or weeks after you leave hospital. Your transplant team will explain when this will be for you.