After your child comes home from the hospital, he will need frequent visits to the transplant clinic. Because the first year is the time in which rejection and other problems are most likely to occur, it's very important that the transplant team closely monitor your child.
A typical schedule of outpatient clinic visits might be:
For long-term care, it will be at the discretion of the Renal Transplant Team to offer monthly visits with an alternate month schedule of local lab work and the every other month visits at Children's Hospital.
For the first six weeks we recommend that your child rests, avoids lifting anything heavy and avoids large crowds (eg, crowded restaurants, movies, music concerts, etc.). Therefore, during this time your child should not attend school. Our social work department will make arrangements so that your child can continue his studies at home.
When your child is able to return to school, with consent, your school can be informed of his condition and be asked to alert parents or guardians of illnesses, such as chicken pox, measles or the flu. If this occurs, please contact the transplant program to determine if there are any precautions necessary.
Please use good judgment when it comes to situations that may cause your child to be exposed to possible infections. Try to avoid close contact with people who are ill. The common cold is not a threat; however, if the cold does not go away after about three weeks, you should visit your primary doctor.
Swimming in chlorinated pools or even the ocean is acceptable; however, many lakes, streams and ponds can harbor bacteria that may make you extremely ill. Hot tubs and jacuzzis also may harbor bacteria. Use common sense and if in doubt, please ask.
Some of the medications your child will be taking will make her more sensitive to sun exposure. We recommend that sun protection lotions with SPF 15 or greater be used for any sun exposure.
Now that your child has had a kidney transplant, it is also necessary that each time he visits the dentist for dental work of any kind, he must take an antibiotic before the visit. Your dentist, your primary physician or our office may prescribe this.
After a kidney transplant, some patients may require a low sodium diet. Others may be prone to gain weight and should avoid high calorie foods and concentrated sweets such as sugary drinks or candy. Everyone should work towards a low fat, low cholesterol diet. It is recommended that you speak with our nutritionist if you have any specific questions or concerns.
After the first six weeks, your child may resume or begin an exercise program. Talk to the transplant team or your primary doctor about what is right for your child.
There are certain activities that should be avoided. Your child should not participate in high contact sports of any kind. Some examples of these activities are sports such as karate, boxing or football where there is a chance of injuring the new kidney. Please talk with us about specific sports in which your child wishes to participate.
We ask that you call before your child takes any medication not prescribed by us, as they may interact with the transplant medications that are prescribed. Also, while you may have Tylenol, you should not give your child any Ibuprofen or Advil products as it may injure his transplanted kidney.
We understand that there is quite a lot to learn and take care of when your child has received a transplant. Please let us know if you need to talk to someone. A social worker or counselor is always available.
Please notify the transplant team with any of the following:
During the normal business day (8:00 a.m. to 5:00 p.m.), call the Nephrology office at 215-590-2449. If necessary, they will page one of the transplant coordinators. If you have a general question, please leave a message on the voicemail and someone will get back to you by the end of the day under normal circumstances.
After normal business hours or weekends or holidays, page the Renal Doctor on call. In emergency situations, there is always a Renal Transplant Coordinator on-call, who can also be reached through the hospital operator at 215-590-1000 if you are unable to reach the physician on-call.
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Reviewed by: Bernard S. Kaplan, MB, BCh, FAAP Date: July 2005