We will be watching closely for signs of any complications so that we can treat them quickly. The most common complications are medication side effects, wound complications and infection. High blood pressure, renal (kidney) dysfunction, rejection and ureter complications can occur as well. Please remember that some of these complications are not common.
Rejection is a signal that your immune system has identified your new kidney as foreign tissue and is trying to get rid of it. Preventing rejection with immune-suppressive medications is the first priority. Only about 10 percent of patients may experience some signs of rejection during the first 6 to 12 weeks after the transplant operation. The most common symptoms of rejection are:
- Change in kidney function (an increase of creatinine)
- Tenderness over the kidney
- Decrease in urine output
- Weight gain
- Swollen ankles
If it appears that you are having a rejection episode, you may need a kidney biopsy and kidney ultrasound. If tests verify that your body is rejecting the transplanted kidney, we will increase your amount of anti-rejection medication or prescribe a different combination of anti-rejection medications. These types of rejection episodes are nearly always reversible and rarely lead to loss of the kidney so long as you continue to take your anti-rejection medications.
The anti-rejection medications that you take to prevent and treat rejection tell your immune system to accept your new kidney in your body. In doing so, they also can be telling your immune system to accept other things that it ordinarily would fight. In other words, the anti-rejection medications put you at greater risk for developing an infection. The most common infections after a kidney transplant are of the lungs, the surgical incision, and the bladder or urinary tract.
To check for infection, your caregivers may take sputum (the substance coughed up from your lungs), blood and urine samples, as well as samples from your catheter, wound and drain sites. Symptoms of infection may include fever, exhaustion, diarrhea or vomiting, redness or drainage around your incision, or a cough and sore throat. If you do develop an infection, we treat it with antibiotics, antivirus medications or antifungal medications. The infectious disease team at the medical center consults with the transplant team when necessary.
To help prevent infections, you will take antibacterial, antivirus and antifungal medications after your surgery. If an infection develops after you leave the hospital, we can usually treat it with outpatient antibiotics. However, sometimes people need to be readmitted for treatment with intravenous (IV) medications.
High Blood Pressure (Hypertension)
If you develop high blood pressure after your operation, your doctor will prescribe medication to regulate it. If you already take blood pressure medication, your doctor may change the dose or type of medication you take.
Renal (Kidney) Dysfunction
Sometimes deceased donor and even living donor kidneys do not work right away. You can think of the kidney as being "asleep" (called acute tubular necrosis, or ATN). ATN can last a few days or up to 2 to 3 weeks. You may still need dialysis after your operation until your kidney starts to function.
The new ureter the surgeon connected to your bladder may leak or become blocked after the operation. A sudden decrease in urine output and/or pain can be a sign that this is happening. An ultrasound usually will detect the problem. If the ureter becomes disconnected, leaks or is blocked, you will likely need an operation to fix it.
Even if you have never had diabetes, the anti-rejection medications you take to suppress your immune system may cause diabetes. If you had diabetes before your kidney transplant, controlling your blood sugar may be more difficult.
The anti-rejection medications you take may also increase your risk for certain types of cancer - sun-related skin cancer and a rare form of lymph node cancer.