Discharge Instructions for Kidney Donors

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1 Your Health Matters Discharge Instructions for Kidney Donors Congratulations and thank you! You have given the gift of life. Your courage and generosity will make the life of your recipient much better. You have had an operation called donor nephrectomy, which means that one of your kidneys has been removed. This pamphlet describes what to expect at home during your recovery, and how to keep your remaining kidney healthy. Early Recovery 1) Physical Activity You will likely feel very tired once you get home and may find yourself taking naps during the day. This feeling is quite normal, and should gradually improve. Your incision will take a few months to fully heal. For the first six weeks after surgery, you should not do anything that places significant stress on your abdomen. In other words, avoid activities that require a strong contraction of your abdominal (stomach) muscles. As a guideline, avoid lifting or carrying more than 10 pounds. After six weeks you may gradually increase your activity level. Please listen to your body and do not do anything that causes severe pain. After 3 months you should have few limitations to your activity level. Pay attention to what your body is telling you. Sexual activity should be avoided until your body is comfortable with the physical movement, usually 2 to 3 weeks after the operation. Contact sports carry a low, but real risk of kidney injury. We recommend using good judgment in participation of these activities. 2) Pain SDSUR0345 Revised 9/13 The donor nephrectomy operation results in a variable amount of pain, which sometimes is severe. The severe pain will disappear within one to two weeks, but some level of discomfort and a pulling sensation with activity can last up to several months after the operation. You may wean yourself off of the narcotic pain medications depending on your progress. Acetaminophen (Tylenol ) can be used once the pain level begins to subside. If you experience a sudden and severe increase in pain, which is not relieved by your pain medicines, contact the Kidney Transplant Service using the number listed below. A physician or nurse is available 24 hours a day. If you cannot get in touch with the Kidney Transplant Service, or if you need emergent care, go to your Emergency Department. If you do go the Emergency Department, please contact us or have the emergency physician contact us. Find a Doctor: (888) Patient Education Library:

2 3) Diet and Bowel Function You may eat whatever you wish, but you may not have a normal appetite for the first few weeks. This is normal. You may prefer to drink liquids and eat light meals during this period. Constipation is normal in the first few weeks after the operation due to narcotic pain medicines like Norco and Percocet. Be sure to take the Colace (docusate sodium) pills twice a day to keep your stool soft as long as you are taking the narcotic pain pills. Stop Colace if you are having loose stools. Drinking six to eight full glasses of water or fluids a day and eating a fiber-rich diet will help to keep your bowel movements regular. Metamucil or a similar fiber-containing laxative can be taken with water to treat constipation. If you have not had a bowel movement for 2 to 3 days and you are feel bloated, try these over the counter items: Warm prune juice Dulcolax (Biscodyl) suppository Fleets enema If these treatments do not work, please call the Post Kidney Transplant Clinic and speak with a nurse during clinic business hours (Monday to Friday 8:00 AM to 4:30 PM) or make an appointment. If you are experiencing severe discomfort from constipation or feel that you need more urgent advice, you may call us at any time to speak with a physician. If you experience diarrhea for more than one or two days, call the Post Kidney Transplant Clinic. 4) Care of the Incision Your incision has internal stitches, which will dissolve over time. No stitches need to be removed. Surgical glue has been placed over the incision to reinforce the skin closure. The surgical glue will come off in the shower or it will peel off easily after a couple of weeks. Generally you do not need to place dressings over the incision. A small amount (a few drops) of clear yellow or blood-tinged drainage from the wound is normal. If this occurs, you may cover the incision with gauze to prevent staining your clothing. Do not wear tight fitting clothing over the incision for the first several weeks after the operation. If the drainage persists more than 3-4 days, contact the Post Kidney Transplant Clinic for advice. You may shower normally, without covering the incision. For the first month after surgery, avoid swimming, hot tubs, baths and other activities in water. Call the Post Kidney Transplant Clinic if you experience increasing redness of the wound and surrounding area, or large amounts of drainage from the wound (more than a few drops). Fever may also signal a wound infection. Keeping the incisions out of the sun for at least six months will prevent darkening of the scar and make it less noticeable.

3 5) Fever Low grade fever in the first few days after the operation is normal. However, a fever higher than F or 38.5 C may signal an infection. If this happens, please call the Post Kidney Transplant Clinic and ask to speak with a nurse or the physician. For an urgent issue, go to your Emergency Department. 6) Urine You should make normal amounts of urine with one kidney. If you experience pain or burning with urination or have cloudy urine, you may have a urinary infection. Contact the Post Kidney Transplant Clinic or transplant physician if this happens within the first 6 weeks after surgery. After this time period, contact your doctor immediately and/or seek immediate medical attention. Please remind them that you have only one kidney. 7) Driving We advise that you do not drive for at least 1 week after your operation. After this period you may resume driving if you are no longer taking narcotic pain medicines (Norco, Tylenol with Codeine, Percocet, etc.) and when you feel that your discomfort level will allow you to make emergency road maneuvers without hesitation. 8) Return to Work If you brought your disability papers with you to the hospital, the donor advocate will assist you with filling out the form. Please ask for her help while you are in the hospital. The form will be completed by a medical provider and returned to you at your follow up appointment. The standard time off from work is 6 weeks. If you have an office job, you may return earlier if you are stable. You will receive further advice during your clinic follow-up. If you have a job, which requires significant physical activity, you may find that you need additional time off from work. If possible, please discuss your work situation with your team prior to discharge.

4 FOLLOW-UP Your follow-up appointment with the Post Kidney Transplant Clinic will be within two weeks after discharge. The in-patient staff will schedule this appointment and give you the time and date when you are discharged. If you do not live locally, the Post Kidney Transplant Clinic will advise you when it is safe to go home. At your last visit with the clinic you will be advised of when you should make a follow-up appointment with your local physician. Additional instructions will also include how often you will need laboratory work or see your primary care provider. Female donors: DO NOT plan a pregnancy for at least 1 year. Please inform your primary care provider or gynecologist that you have only one kidney when discussing the possibility of getting pregnant. Medicines In general, you should use Acetaminophen (Tylenol or generics) for pain. Narcotic pain medications are OK if prescribed by a doctor. You may use medicines that contain Non-Steroidal Anti-Inflammatory drugs (NSAIDs) occasionally (once in a while). NSAIDs have harmful effects on your kidney if used frequently. Common examples of NSAIDs are: Aspirin Ibuprofen Naprosyn Indocin Ketorolac Advil Aleve Toradol Motrin Anaprox Nuprin Naproxen Generic Beware of common cold remedies that contain NSAIDs. Make sure to read the label or ask the pharmacist for help. If you need to take medicines other than Acetaminophen (Tylenol or generics) for pain, consult your doctor or pharmacist and advise them that you only have one kidney. Other medicines may potentially affect your kidney. When you see your doctor, remind them that you only have one kidney.

5 PHONE NUMBERS If this is a life-threatening emergency, please call 911. Post Kidney Transplant Clinic: Monday to Friday 8:00 AM to 4:30 PM and after hours and weekends (415) or and follow the prompts Thanks again this transplant happened because of you!!! We are committed to you, our donors. No matter how long it has been since the donation, if you have a question or problem that you think is related to your kidney donation, please feel free to contact

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