Although kidney transplantation is a very successful treatment for kidney failure, complications can occur. Your transplant team will do their best to reduce your chance of having any complications and to treat any arising problems straight away.

You can minimise the risk of complications by following instructions carefully and keeping your transplant team informed of any problems that occur.

Possible complications after having a kidney transplant may include:

Problems associated with the kidney transplant operation: 

About 5 in 100 patients experience a urine leak where the donor ureter joins your bladder. This usually requires a return to theatre for an operation to have the leak repaired.

About 5 in 100 patients experience internal bleeding which may require a blood transfusion and possibly a further operation to stop the bleeding or remove any clots that have collected.

About 2 in 100 patients have a blood clot form in the vein or the artery of the new kidney. This means the blood supply to the kidney will stop. If this happens you will have to go back to theatre and, unfortunately, it usually results in the kidney having to be removed. 

There is a small chance that you could develop a lymphocoele (a collection of lymph (tissue) fluid). The fluid usually collects in a small pocket next to the transplant kidney and can block the flow of blood to the kidney or the flow of urine from the kidney. If this happens it will need draining.

Following all surgery there is a risk of Deep Vein Thrombosis (DVT) clots forming in the veins of the leg. To prevent this happening you will be given injections of a blood thinning drug whilst you are in hospital. You will also wear surgical stockings to encourage the blood flow in your legs whilst you are less mobile.

Problems associated with the medication taken after transplantation:

There is a small chance that you could develop diabetes (raised blood sugar) as a side effect of your anti-rejection (immunosuppression) drugs. It is usually treated with a change in diet and/or tablets. Sometimes there is a need for insulin injections.

High blood pressure is very common following a kidney transplant, particularly during the early months. Many people after a kidney transplant require blood pressure lowering drugs. It is vital to control high blood pressure as, if left untreated, you could be at risk of heart disease or a stroke and it can damage the transplant kidney.

The anti-rejection drugs will make you more likely to develop infections. The risk is greater in the early stages after your transplant because the doses of anti-rejection drugs are higher. It is important to inform your transplant team if you think you have an infection. If you know family or friends who have a serious infection it is a good idea if you avoid visiting them while they are unwell.

About 1 or 2 in 100 patients will develop cancer as a result of the anti-rejection drugs you will take after your kidney transplant. In particular you will be more prone to developing skin cancers.  For this reason we encourage you protect yourself from the sun by using powerful sun screens and avoiding direct exposure to the sun.

Problems associated with organ transplantation:

About half of all transplanted kidneys will experience delayed graft function.  It may take several days for your new kidney to start working and you may need haemodialysis during this time.  If your kidney takes more than a few days to start working properly or temporarily stops your doctors may take a tissue sample of the new kidney to see if you have rejection.

Roughly 30 in 100 patients will experience acute rejection within the first 6 months of their transplant. Your body will recognise that your kidney is ‘foreign’ and the natural response is to attack and reject it. You will be given anti-rejection medication to reduce the chance of this happening; these medications will need to be taken for the life of your kidney transplant. Rejection is treated by changing the dose of anti-rejection drugs and / or by prescribing a new drug in addition. As rejection can be detected following one of your regular blood tests it is critical that you attend your clinic appointments regularly.

Some patients will experience anxiety and mood swings. The transplant operation can put a lot of stress on you and your family. It is very common for patients or relatives to have anxieties. There are counselling services to help you adjust to life at home. Please ask your transplant team for more information about these services.

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