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How Do I Stay Healthy After My Transplant?

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Getting a kidney transplant can feel like getting another chance at life. Just remember, getting a transplant is a treatment, not a cure. So, there are precautions you should take after your transplant to help you stay healthy. 

Taking your medicines

Taking your transplant medicines is one of the most important parts of keeping your new organ healthy. 

Even missing 1 dose of medicine can cause your body to reject your new kidney.

Make sure you:

  • Take your medicines every day as directed by your doctor
  • Never stop taking your medicines without talking to your doctor
  • Go to all of your doctor’s appointments after your transplant
  • Eat healthy
  • Follow the instructions of your transplant team

Water safety 

Follow water safety guidelines to lower your chance of infection from bacteria or parasites in water:

  • Treated water in the U.S. is generally safe to drink
  • Well water may not be checked frequently for bacteria and parasites. If you have well water, get the water checked to make sure it is safe to drink. 
    • Using a filter does not necessarily make well water safe to drink
  • Pay attention to “boil water” advisories from your local government
    • You can drink bottled water instead of boiling water

Food safety

Follow food safety guidelines to lower your chance of infection from bacteria in certain foods:

  • Avoid undercooked and raw meats, poultry, and fish
  • Avoid drinking unpasteurized milk
  • Avoid cheeses made with unpasteurized milk, such as brie, feta, and camembert
  • Avoid uncooked seafood, such as oysters, clams, and mussels
  • For fresh meat cold cuts that are cut by a meat slicer, only get enough cold cuts for a single serving that you will eat that day. Or get processed deli meat in a package, as it may be safer.

Sports and recreation safety 

  • In general, athletic activities are safe and encouraged for transplant recipients, but pay attention to what is considered safe and what is not safe:
    • Safer activities include:
      • Running
      • Basketball
      • Swimming (swimming in salt water is safer than swimming in fresh water, such as lakes or rivers)
      • Volleyball
      • Aerobics
      • Skating
      • Tennis
      • Cycling
      • Soccer
      • Golf
      • Canoeing
      • Weightlifting (low weight with high repetition)
    • Less safe activities have a higher chance of physical injury, such as:
      • Football
      • Karate and martial arts
      • Ice hockey
      • Trampolines
      • Boxing
      • Dodge ball
      • Gymnastics
      • ATV/snowmobiling
      • Downhill skiing or snowboarding
      • Sledding
      • Power lifting (high weight with low repetition)
      • Horseback riding 
  • For activities outside with a lot of sun exposure, it is important to protect your skin, because transplant recipients have a higher chance of skin cancer, such as:
    • Wear sunscreen of SPF30 or higher
    • Avoid the sun during peak hours from 10am - 4pm
    • Avoid tanning beds

Ask your transplant team when it’s safe to restart your pre-transplant activities. 

Animal contact and pet safety

Having pets is wonderful for our mental health. However, transplant recipients must be careful with pets, because they have a higher chance of getting infections from animals.

Here are some guidelines for certain animals:

  • In general, dogs and cats are safe, but they must be up-to-date with their own healthcare, such as their shots. 
  • If you have a cat, avoid changing the kitty litter. If that is not possible, change the litter daily and wear gloves and a mask. 
  • Avoid certain pets due to the higher chance of infection:
    • Rodents, such as guinea pigs or hamsters
    • Reptiles, such as lizards, snakes, or turtles
    • Amphibians, such as frogs or salamanders
    • Birds, such as parrots, parakeets, or finches

Here are some tips for animal safety:

  • Wash your hands carefully after handling pets
  • Do not let your pet lick your wounds or chew on your IV tubing 
  • Avoid handling pets with diarrhea
  • Avoid animal bites and scratches and do not pet stray animals
  • Ensure your home is free of raccoon latrines. These are areas where raccoons repeatedly go to the bathroom, which may include decks, patios, attics, or garages.

If you work with animals, such as a veterinarian, pet store employee, farmer, or slaughterhouse or laboratory worker, avoid work for 6 months after your transplant.

Gardening safety

Soil has many fungi and molds that can cause infections. You should avoid gardening for the first 6-12 months after your transplant. Ask your doctor when it’s safe to work in the soil again.

Here are a few tips to protect yourself when it’s safe for you to garden again:

  • Wear gloves
  • Cover your skin with clothing
  • Wear a mask
  • Use bug spray (and put it on last, after you’re dressed) 
  • Check yourself for ticks

Travel safety

Discuss your travel plans with your transplant team at least 2 months in advance so they have time to review your plans for safety. You may also want to meet with a travel specialist who works with transplant recipients. 

It is generally not recommended for transplant recipients to travel to:

  • Developing countries
  • Any place that requires vaccine for entrance

If you are traveling to the developing world:

  • Water is often not safe to drink, so use only bottled water even for brushing your teeth 
  • Do not use ice as it likely comes from the local water system
  • Follow the rule: “boil it, cook it, peel it, or forget it”
  • Never get the yellow fever vaccine because it is a live vaccine. Live vaccines contain a weakened version of the germ it is trying to protect you from. Because of this, there is a small chance the vaccine can cause an infection.

Here are some tips for safe travel:

  • Bring an extra supply of your medicine
  • Keep all medicine in your carry-on bag
  • Bring a note from your doctor explaining what each medicine is for
  • Have a plan for leaving in case you get sick or have a medical emergency 
  • Have a plan in case you get diarrhea, because being dehydrated from diarrhea can affect the levels of your immunosuppressive drugs

Substances

After a kidney transplant:

  • Alcohol may be safe in moderation, but talk with your transplant center 
    • Not much is known about marijuana safety, but keep in mind:
    • It can cause mental impairment, dangerous drug interactions, kidney injury, abnormal heart rhythms, and infections from molds
    • It is safer to eat an edible baked at 300 degrees rather than smoked
    • It may affect your anti-rejection drug levels
    • Avoid smoking tobacco because it can lower blood flow to your kidneys and cause your kidneys to not work as well 

Keeping a healthy weight 

Keeping a healthy weight after your transplant can be hard because some of your medicines, such as steroids, can cause weight gain. Gaining weight can hurt your heart and bone health. 

Here are some tips for keeping a healthy weight:

  • Eat a healthy diet low in saturated fats and cholesterol, low in trans-fat, and high in fiber 
  • Limit alcohol. Alcohol has hidden calories and can make you hungry and eat more. 
  • Drink plenty of water (unless you are on a fluid restriction) 
  • Follow a low sodium diet
  • Avoid dietary supplements as they can cause dangerous drug interactions, liver and kidney damage, and probiotics can cause infections 

Safer sex practices

The best way to lower your chance of sexually transmitted infections (STIs) is to have fewer sexual partners or be in a long-term relationship with 1 person (monogamous).

Here are some ways to lower your chance of infection and STIs during sex:

  • Always use latex condoms during sexual contact outside of monogamous relationships
  • Consider latex condoms in monogamous relationships for the first 6 months after the transplant
  • Avoid exposure to feces during sexual activity 

Some medicines can affect sexual arousal and performance. Discuss these issues with your transplant physician if they happen. 

Having children

Many people have had children after a transplant. However, female transplant recipients do have a higher chance of problems during and after pregnancy. Always discuss plans for having children with your transplant team. All females who have a transplant should see a high-risk obstetrician. Doctors recommend:

  • Waiting at least 1 year after surgery to become pregnant, until the kidney is stable and without episodes of rejection
  • Using contraception early after transplant surgery
  • Using long-term contraceptives such as intrauterine device (IUD) and subdermal implants

If you become pregnant, you will need to tell your transplant and obstetrical team right away. Some medicines are not safe for the baby during pregnancy. Your doctors will need to closely monitor your health throughout your pregnancy and after delivery. 

Vaccines 

Vaccines are an important way to protect you and your family. Before your transplant, get any vaccines that need to be updated. Your vaccines will work better before your transplant. And make sure everyone in your household is also updated on their vaccines. 

Soon after your transplant, you may not be able to get some vaccines, except for your yearly flu shot and pneumococcal vaccines. 

Avoid live vaccines, which include MMR, varicella, rotavirus, yellow fever, and the intranasal flu vaccine. Live vaccines can sometimes carry infections. If you learn that someone you have been in close contact with recently got a live vaccine, contact your transplant team.

Whenever you are deciding to get a vaccine, remind your doctor or pharmacist that you are a transplant recipient.

Oral Health

Good dental health can help prevent infections, while sore and bleeding gums can cause infections.

Some of your medicines and a poor diet can cause swollen, sore gums and teeth sensitivity. 

Here are ways to keep your mouth and teeth healthy:

  • Examine your gums and teeth daily
  • Brush after each meal with a soft toothbrush and fluorinated toothpaste
  • Floss daily
  • Make sure any dentures have a proper fit 
  • Have your teeth cleaned and checked by a dentist every 6 months
  • Always tell your dentist that you are a transplant recipient before having any cleanings or procedures done 

Vision care

Some of your medicines, such as prednisone, can cause problems such as cataracts or dry eyes. Eye symptoms can be a sign of an infection starting. If you have any eye symptoms, let your transplant team know right away.

See an ophthalmologist (eye doctor) regularly for dilated, cataract, and glaucoma eye exams. 

Mental health 

Getting a transplant is a major life change and it is normal to have all kinds of feelings after a transplant. While some people may be overjoyed, some people may feel overwhelmed and stressed by the medicines and doctors’ visits. Some people may have health problems after their transplant, which can lead to depression. Other people may feel anxiety while trying to keep themselves healthy.

If you ever need emotional support, seek a professional to help you process your feelings and help you cope with your new normal. Your transplant care team may be able to recommend counselors, support groups, and other mental health and wellness resources that can help you. 

 

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This content was developed independently by AST and supported by a financial contribution from Sanofi