Moving on after a kidney transplant

If you have just had a kidney transplant, are waiting for one, or are helping someone who has, you probably have more questions than anyone had time to answer in clinic. This guide is our attempt to put the ordinary ones in one place, in plain English, with the source of every fact named at the foot of the page.

A word first about who is writing. We are the editors of a small, independent publication. We are not a charity, a support group, a hospital or a company, and we offer no services, no helpline and no advice about your own case. That limit is deliberate. Your transplant team knows your kidney, your medicines and your history, and nothing on a web page can stand in for them. Practice also differs from one transplant centre to another, so where this guide and your team disagree, your team is right for you.

What we can do is read what public bodies publish, such as the NHS, NHS Blood and Transplant, Kidney Care UK, the UK Kidney Association, NIDDK, the National Kidney Foundation and the CDC, and set it out in a way that is easier to take in on a tired day. Where sources disagree, or where they stay silent, we say so.

* * *

Where to begin

If it is early days, start with the first months after a kidney transplant. It follows the road from the ward to the first weeks at home, and explains what the early appointments are for. The medicines come next in most people's minds, and for good reason: immunosuppressant medicines and living with them sets out what they do, what sources say about side effects and why a routine matters. And when the first months have passed, staying well long term covers infection, skin protection and the slow watching of kidney function.

Some of the questions are smaller but come up every week. What are the blood tests actually measuring, and what should you ask at clinic? That is in clinic follow-up and what the tests mean. Which symptoms should you never sit on? Signs of rejection and infection to report collects what the sources list. And what can you eat and drink? Diet and fluids after a kidney transplant keeps to what the public bodies say.

* * *

On getting your strength back

Recovery is rarely only about the new kidney. Months of illness, dialysis or surgery can leave the rest of you tired and weak, and rebuilding that takes time. Our pages on exercise after a kidney transplant and on physical therapy and regaining strength describe how sources approach gentle, graded activity, and why it matters to ask your team before you begin.

If you happen to be in New York City, one practice there describes its rehabilitation services on its own website, and we have set out what that page says below.

Contact a licensed physical therapist in NYC

If you are living in New York City and looking for a qualified physical therapist, then Paspa Physical Therapy is there to help. Their page describes one-to-one sessions in which a licensed physical therapist stays with you throughout, in a Manhattan facility with a full gym and private treatment rooms. It says each person is first evaluated, including posture, gait, balance, range of motion and strength, and that treatment includes hands-on manual therapy, a strengthening programme and a home exercise programme to build on between visits. It also says the practice treats both surgical and non-surgical patients, with an orthopaedic and sports medicine focus.

This is a pointer for readers who happen to be in New York, not a recommendation or an endorsement, and it does not replace the advice of your own transplant team, who should agree any new exercise programme first. Wherever you live, our page on physical therapy and regaining strength explains what to expect from rehabilitation in general terms.

* * *

The rest of life

Feeling low, anxious or simply flat is common enough that it has its own page: mental wellbeing and fatigue after transplant. Practical questions follow close behind, about returning to work, about travel and vaccines, and about pregnancy and fertility. For family and friends, and for anyone curious about the other side of the operation, there is also an outline of living kidney donation.

* * *

All the pages, in one list

For those who like to see everything at once, here are all the guides, in the order we would suggest reading them.

1. The first months after a kidney transplant: what to expectFrom the ward to the first weeks at home, and what the early appointments are for.
2. Immunosuppressant medicines after a kidney transplantWhat anti-rejection medicines do, what sources say about side effects and why routine matters.
3. Staying well long term after a kidney transplantInfection, skin protection and the slow watching of kidney function over the years.
4. Clinic follow-up after a kidney transplant and what the tests meanWhat the clinic visits and blood tests are for, and questions to take with you.
5. Signs of rejection and infection to report after a kidney transplantThe warning signs public sources list, and when they say to contact your team.
6. Diet and fluids after a kidney transplantFood safety, healthy eating and drinking, as public bodies describe them.
7. Exercise after a kidney transplant: pacing, limits and sportWhy gentle, graded activity matters and what sources say about starting.
8. Regaining strength after a kidney transplant with physical therapyHow rehabilitation helps rebuild strength after a long illness and surgery.
9. Mental wellbeing and fatigue after a kidney transplantTiredness, low mood and worry, and where public bodies point people for support.
10. Returning to work after a kidney transplantPhased returns, workplace rights and infection-aware workplaces.
11. Travel and vaccines after a kidney transplantPlanning a trip, carrying medicines and what sources say about vaccines.
12. Pregnancy and fertility after a kidney transplantPlanning ahead with your team, as public sources describe it.
13. Living kidney donors in outline: assessment, recovery and sharingA short outline of living kidney donation, for families and the curious.

With care,
The editors

P.S. If you find a mistake, a statement that has gone out of date or a source we should have used, please tell us. We would rather be corrected than wrong.