BY: Terence Lee

Count your blessings if you need a kidney transplant and have received one, but be aware of possible complications.

Renal specialists say that about one in five kidney recipients and donors will encounter some form of difficulty. Donors should not expect zero risk, said Dr Pary Sivaraman, a renal specialist at Mount Elizabeth Hospital.

This is because donors will have only one kidney left and they need to take good care of it. Unhealthy food that may cause diabetes must also be avoided, said Professor A. Vathsala, director of the kidney transplant programme at the National University Hospital.

She advises donors to avoid strong pain relievers and traditional Chinese medication which can potentially damage the kidney.

For kidney recipients, a diligent regimen of immuno-suppressive medication is crucial. This will minimise the chance of the body rejecting the kidney.

Comprehensive follow-up is also important after a transplant to detect and minimise complications that may arise.

DONOR: POSSIBLE COMPLICATIONS

• Continuous pain from wound which usually fades after one month
• Tingling, prickling sensation or numbness of the skin which usually fades within six months
• Bleeding and blood clots which may result in the need for blood transfusions
• Infection of the wound
• Pneumonia
• Injuries to other organs
• Protrusion of tissue around the incision area
• Side effects associated with allergic reactions to anaesthesia and other medication used
• High blood pressure
• Kidney failure that requires dialysis or transplantation. This is extremely rare, occurring in only 0.3 per cent of donors
• Complications due to poor lifestyle, such as bad eating habits or lack of exercise
• Depression, especially if a recipient dies or the kidney is rejected

RECIPIENT: POSSIBLE COMPLICATIONS

• Failed kidney transplant which occurs in 3 to 5 per cent of patients
• Rejected kidney, which is less likely if the kidney is healthy and comes from a living donor
• Recurrent infections and problems with the blood vessel
• Transmission of infections from donor to recipient
• Use of immuno-suppressive medication can increase the risk of damage to the kidney Other types of problems include high blood pressure, diabetes, cataract, weight gain, bone problems and certain cancers
• Death during or after transplant, which occurs in 0.5 per cent to 5 per cent of patients, depending on health factors

This article was first published in Mind Your Body, The Straits Times on July 23, 2008.