What happens after I wake from surgery?
When you wake up from surgery you will be in a recovery room called the Post Anesthesia Care Unit (PACU). You will have an oxygen mask covering your nose and mouth. This mask delivers a cool mist of oxygen, which helps eliminate the remaining anesthesia from your system and soothes your throat. Your throat may be sore from the breathing tube that was present during your surgery; this soreness usually subsides after 1 or 2 days.
Once you are more alert, the nurse in PACU will switch your oxygen delivery device to a nasal cannula, a small plastic tube that hooks over your ears and lies beneath your nose. Your nurse will frequently check your blood-oxygen level. Depending on the percentage of oxygen measured in your blood, you may need to keep the oxygen in place after you are transferred to your hospital room.
How will kidney donation surgery affect me?
The risks of kidney donation are the same as those of any surgery. There is the risk of bleeding, infection and/or breathing problems. You also may experience some side effects from the medications. However, long-term studies show that one kidney is enough to remove waste from the body and excess fluid from the blood to keep it healthy. As soon as your kidney is removed, your remaining kidney begins to take over the work that was previously done by two kidneys. It also will increase in size.
Will I be in pain after the transplant?
You will feel pain at your incision sites. However, the laparoscopic procedure hurts less than the open surgery. Your physician will prescribe appropriate medication to relieve your pain.
Some patients experience abdominal bloating and cramping after surgery. After 24 hours, your discomfort should gradually decrease and will continue to decrease over the next 2 to 4 weeks as you return to your regular activities.
Recovering from surgery in the hospital
Once you have recovered from the anesthesia, you will be transferred to your hospital room. After your surgery, the nurses will measure your "intake and output" — they will document all the fluids that enter your body and measure and collect any urine or fluids you produce, including those from tubes or drains placed during surgery.
A tube that was passed from a nostril into your stomach (a nasogastric tube) during surgery will be removed in the recovery room.
Diet
For the first 24 hours after your surgery, you will be limited to ice chips and/or clear liquids. Once you have passed gas (flatus) from the rectal area or have had a bowel movement, your diet will gradually be increased to solid food.
Activity
You will be encouraged to get out of bed starting the first day after surgery. The more you move, the less chance for complications such as pneumonia or blood clots in your legs.
Incentive spirometer
An incentive spirometer is a breathing aid you will use after surgery to help keep your lungs clear and active while you are recovering from surgery. A health care provider will teach you how to use the incentive spirometer. Once you are able to get out of bed, walk in the hallway and cough well, you may stop using the incentive spirometer, unless otherwise instructed by your health care provider.
What is the daily hospital routine?
You may be discharged from the hospital as soon as the day after surgery if you had a laparoscopic procedure. However, sometimes the hospital stay may be 2 to 3 days. Your hospital stay may be 3 to 5 days with open surgery. With either procedure, you will not be discharged from the hospital until you are recovering well.
Until then, you can expect:
- A visit from your surgeon and/or physician assistant
- A visit from your kidney transplant coordinator
- An intravenous (IV) line in your arm — This will be in place in your arm when you arrive at the nursing unit. The IV remains in place to deliver fluids and possibly medications. The IV will be removed before you leave the hospital.
- Small strips of tape (called steri-strips) covering the incisions — Your nurse will check to make sure the incisions remain clean and dry.
- Blood samples taken as determined by your doctor.
- A daily measurement of your urine output — Once the catheter is removed, make sure you collect your urine so the nurse can record the amount.
- A daily record of how much you drink — Your nurse will ask you what you drank so this information can be recorded.)
- PAS stockings on both of your legs — These stockings will deflate and inflate at intervals to promote adequate circulation. When you are walking on your own, these stockings will be removed.
What are the visiting hours?
The nursing unit does not enforce strict visiting hours. However, the staff recommends no more than two visitors at one time, since rest is an important part of your recovery. The nursing unit also requests that reasonable hours (from 9:00 a.m. to 8:00 p.m.) be observed. Children may visit if they are accompanied by an adult at all times. If you have any questions or concerns about visiting hours, please ask the nursing unit staff.
Your recovery at home
Each donor’s recovery is unique, but you can expect to return to your normal routine about 2 to 4 weeks after laparoscopic surgery, and longer if you had open surgery.
Activity
For 2 to 4 weeks after surgery do not lift or push anything over 10 pounds. Avoid activities that increase abdominal pressure, especially sit-ups.
After that, you are encouraged to gradually increase your activity level.
Walking is great exercise! Walking will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots and helping your lungs remain clear.
Diet
Your diet gradually will be increased to solid food (within 3 to 4 days after surgery), as tolerated.
Return to work
Generally, upon physician approval, you should be able to return to work in 2 to 4 weeks if you have laparoscopic surgery, and 6 to 10 weeks if you have open surgery.
Incision care
- The steri-strips, or small pieces of tape covering your incisions, will gradually fall off on their own. If the strips do not fall off on their own, your health care provider will remove them at your follow-up appointment.
- Keep the wound dry and covered for 24 hours. After 24 hours, remove the bandage or Band-Aid.
- Dip a cotton-tipped swab in hydrogen peroxide and gently roll the swab over the incisions.
- Allow the area to air dry or roll a dry cotton-tipped swab gently over the incisions.
- Apply a thin film of antibiotic ointment, as prescribed by your physician.
- After 24 hours, leave the incisions open to the air. Cover with a bandage only if the areas will get dirty or clothing and/or bed linens will rub against and irritate the incisions. You may bathe or shower the following day unless otherwise specified by your doctor.
- Do not take any aspirin, Advil, Motrin, aspirin-containing products, vitamin E, garlic pills, nor smoke or drink alcohol for 3 days after surgery. You may take Tylenol (acetaminophen) for pain.
- After open surgery, the staples will be removed in 2 weeks by the doctor or nurse, unless you have been informed otherwise. This does not apply to patients who have had laparoscopic surgery.
Signs of infection
You may notice some minor swelling around the incisions; this is normal. However, call your health care provider if you experience any of the following:
- An increase in redness, tenderness or swelling of the incisions
- A marked or sudden increase in pain not relieved by the pain medication
- Trouble urinating: pain or burning, constant urge or frequent urination
- Bloody, cloudy or foul smelling urine
- Your physician may instruct you to use an antibiotic ointment. Discontinue use of this ointment if white pimples or blisters appear at or around the incision lines.
- A persistent elevation of body temperature greater than 100.5 degrees Fahrenheit. (You should take your temperature daily, at the same time each day)
- Sweats or chills
- Skin rash
- Persistent sore throat, scratchy throat or pain when swallowing
- Persistent sinus drainage, nasal congestion, headaches or tenderness along the upper cheekbones
- Persistent dry or moist cough that lasts more than 2 days
- White patches in your mouth or on your tongue
- Nausea, vomiting or diarrhea
Follow-up appointment
A follow-up appointment will be scheduled two weeks after your surgery. Your surgeon will assess the incision sites and your recovery, and will provide further guidelines about your activity and diet at this time.
Long-term follow-up
By the time you leave the hospital, you should be well on your way to recovery from your surgery. The plan of care at this time is to help you maintain healthy kidney function and a full and productive life.
You should have yearly blood pressure checks, an urinalysis and blood tests to measure kidney function and to determine levels of such substances as urea nitrogen and creatinine.
These substances are normally found in the blood, but decreased levels may indicate inadequate protein in the diet or liver disease.
Increased levels could be a sign of kidney disease.
Tests can be performed by your local physician or at The Cleveland Clinic.
Are there any long-term risks?
Historically, kidney donors are not at any greater risk for developing future health problems — including kidney disease — than people with both of their kidneys. Living donation does not change life expectancy, and after recovery, donors can continue to lead normal lives.
Also, kidney donation has been shown to have no effect on a donor’s ability to father a child or become pregnant.
As with any surgical procedure, a small minority of donors have negative or mixed feelings after surgery. However, it is natural for donors to have concerns about their health. Sharing your experiences with your family or a counselor may help you cope with any emotional stress you experience before or after surgery.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/22/2004
