The Postoperative Course of both Living Donor and Deceased Donor operations is similar.
After you awake on the day after your kidney transplant operation, you will find that you have a number of intravenous lines in the hands and arms, a central venous catheter in the neck, potentially an arterial catheter in the wrist and a foley catheter the bladder. There will be a dressing on the incision in the pelvis. You will likely feel tired and sore and potentially nauseated while you get rid of all the anesthetic drugs from your body. Nursing staff will check on you with great regularity, taking your vital signs and monitoring your intake and outputs. This is postoperative day #1. You will then be scheduled for routine ultrasound testing of the kidney transplant on this day, to get a baseline exam as well as verify the kidney is functioning as it should. Get some rest today as you will encouraged to mobilize more the following days. You will also be offered some food in various forms; clear fluids or full fluids or regular food. Take what you can, don’t overeat, even if you feel hungry and make sure you take as much fluid in by mouth as you can to keep hydrated.
On postoperative day #2, you will start to see the routine nature of in-Hospital care, with the medical staff rounding on you twice a day, nursing staff performing checks every 4 hours, medication administration intervals, physiotherapy for mobilization appointments, and blood draws for testing. The same schedule will continue with decreasing intensity if all is well, until you are discharged from the Hospital in 5-7 days.
The central venous line and the foley catheter in the bladder are removed on postoperative day #4. The peripheral intravenous lines are removed as soon as you are able to eat and drink enough to support yourself. If is common for your bowels to take the longest to get back to normal and before they do, oftentimes there is a period of nausea and potentially vomitting, abdominal bloating with only intermittent passing of gas or stools, until things settle for good. This can take up to a week or more and doing lots of walking, minimizing narcotic pain medication use and eating small meals can all help this recover faster.
When the foley catheter comes out, it is common to have some urgency and burning with urination for a time, and this will also settle down. For those patients whom have not made any urine for a long time, your bladder may feel very full or urgent as it now has to accommodate a large volume of urine from the new transplant kidney. Your frequency and urgency will settle down eventually.
If there are any concerns regarding the kidney function from a technical standpoint either from clinical examination or from ultrasound interrogation, then there is a chance that you would have to go back to the operating room in order to re-explore the kidney and try to correct whatever is wrong with it.
Before you are discharged, a Transplant Clinic Nurse will come over and talk about followup schedules and requirements for bloodwork and testing and give you a tour of the Clinic. A Transplant Pharmacist will also discuss your medications, give you a printed schedule to refer to, and answer any questions you might have. An initial followup appointment will be made for you for the Transplant Clinic, and you will have an additional appointment with the Transplant Surgeon made to remove the stent which was left in place during the operation. This will be done in the office via telescope in the bladder (cystoscopy) and is a local procedure (you do not go to sleep for this small procedure).