All Transplant Recipients remain in the SICU (Surgical Intensive Care Unit) the first night after surgery for monitoring of vital signs, urine output and fluid status. When you awaken in the SICU, you will notice an IV in either your arm or neck. You will have a tube going into your bladder that drains your urine into a collection bag. This tube is called a Foley catheter and it will stay in for three days. You will have oxygen tubing in your nose to help you breathe easier. There will be a dressing over your incision on your abdomen. You will have a button to push to give yourself pain medication when you need it.
The nurses and doctors on this unit will be monitoring you very closely. They will be checking your vital signs (temperature, blood pressure and pulse) and your urine output every hour. To prevent pneumonia you will be instructed to take deep breaths and cough frequently. The nurses will also show you how to use a machine called an incentive spirometer. Proper use helps keep your lungs expanded.
Usually 24 hours after surgery you will be transferred to either 8 West or 8 East, the transplant floors. This is where you will stay until you are discharged from the hospital. The staff on the 8th floor has special expertise in the care of transplant patients. They are knowledgeable about the transplant medications and will help you thoroughly learn them. They will educate you on the signs and symptoms of infection and rejection and provide you with follow-up instructions.
You will be encouraged to get out of bed as soon as your team feels this is safe, usually within 24 hours of transplant. Walking will help prevent post-op complications like blood clots and pneumonia. Once you are able to pass gas, you will be allowed to drink and eat. The nurses will be closely monitoring the amount of fluid you drink and the amount of urine you produce. Many factors influence when a new kidney begins to work. Do not be alarmed or disappointed if the new kidney does make urine immediately. Sometimes a new kidney needs a few days or weeks to regain complete function. We call this delay in regaining the kidney function “Delayed Graft Function”.
Every morning while you are in the hospital you will have blood drawn and you will be weighed. These things help the transplant team understand how well the new kidney is working. You will begin taking new medications for anti-rejection. Your Post-Transplant Coordinator will give you a black binder with checklists to keep track of your medications once you are home. You and your caregiver will work with members of the Transplant Team while you are in the hospital to learn your medication regimen, and the do’s and don’ts of life after transplant. We are always available to answer any questions you may have.
You will leave the hospital with the Black Transplant Binder which includes a list of your medications and doses on a Medication Card, a vital signs log to record your vital signs at home, and your Discharge Education information, which, includes all the contact information for the members of your Transplant Team. Your Binder, Medication Card, and vital signs log should be with you at all clinic visits to allow us to review your medications and make any necessary changes and to allow us to review your weight and blood pressure results and to look for subtle changes that may need attention. You can expect to stay in the hospital for 4-5 days after your surgery.
