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The NKF Helpline is available Monday to Thursday 08:30am - 5:00pm Friday 08.30am – 12.30pm on 0800 169 09 36 or email [email protected].

Key Points

Many  people feel back to normal after a transplant, once the operation and frequent clinic visits of the first three months are over. However, if you have read the leaflet about drugs that you need to take and the possible complications of transplantation, you will realise that life never goes completely back to normal, though it can be very close to normal.

Work

It is usual to take three months off work after a transplant, although some people can go back sooner . Most types of work are suitable after transplantation. You should discuss with your local transplant doctors any work which involves a lot of exposure to people with infections, or heavy lifting that might put direct pressure on the transplant wound or directly on to the kidney.

Sport and fitness

Most 

Most activities and sports are possible after the first few months of transplantation. There is an annual transplant games in Britain, regular transplant athletics events and winter transplant games internationally. Exercise is recommended for people with transplants. However, every individual has slightly different problems with their health, so discuss first with your doctors exactly what you want to do.

Because the kidney transplant is close to the skin, sports which involve heavy contact are not advisable because of the risk of damage to the transplant. Examples include Rugby Union and Rugby League (and the American and Australian version of the game) and martial arts combat sports. It is hard to wear a guard that will protect the kidney against injury. If someone is a professional sportsperson, it is possible to adapt the transplant operation so the kidney is deeper inside the body but this makes it hard to perform a biopsy test for possible rejection so would not usually be recommended unless someone relies on the sport for their living.

Holidays

Travel is something most people on dialysis look forward to after a transplant, and is generally possible and very enjoyable! Travel away for more than a couple of days is not recommended in the first three months after a transplant. Vaccinations that are safe for more exotic travel are listed elsewhere.

Diet

Diet can be relaxed after a transplant, but not usually straight away! Keep checking your own blood results, because it is common to have high potassium levels for a few weeks after a transplant. It is therefore often not possible to go straight back to all those tomatoes and chocolate cakes with coffee.

Weight gain occurs in most transplant patients, as it is common to be underweight on dialysis. However, there is a major risk of becoming overweight, and it is important to watch what you eat right from the start. It is easier to avoid putting on weight than to lose it.

Fluid restriction

Fluid restrictions are common on dialysis, but are usually not needed after a transplant. Make sure you know what your fluid intake should be. Sometimes the transplanted kidney makes too much urine, so that drinking large amounts of fluid is needed. To take 4 litres every day can be quite hard if you have been used to less than 1 litre a day for several years.

How long does a kidney transplant last?

A kidney transplant does not last for ever. The average life-span of a transplanted kidney is twelve to fifteen years for a deceased donor kidney, and about fifteen to twenty years for a living related transplant. The average for a living unrelated transplant is somewhere between the two. So, the ‘best’ (longest lasting) kidney transplant is usually from a relative, then a friend or partner, then from a person who has died.

Another way of looking at how long a transplanted kidney is likely to last is to look at the percentage chance that the kidney will be working at set time points.

• an 90% chance (nine out of ten) of working one year after the operation
• a 70% chance (seven out of ten) of lasting five years

• a more than 50% chance (five out of ten) of lasting ten years or more

So, younger patients may need two or more transplants in their lives. If a transplant fails, the patient can restart dialysis and go back on the transplant waiting list.

Is it possible to have another transplant if the first one fails?

• Most people can have a second, or even third, transplant

• The wait for a second transplant is usually longer than for a first transplant

• The success of a second transplant is, on average, as good as for a first transplant

It is usually possible to have a second kidney if the first one fails. However, there are more ‘hurdles’ to get past before this is possible.

Why did the first kidney fail, and will failure happen the second time around?

Most causes of transplant failure will not repeat themselves in a second transplant. However, there are a few conditions which make doctors worry about early failure of a second transplant. Some types of kidney disease, which caused the original kidney failure, can come back in a transplant, and if they then cause transplant failure there may be some reluctance to try a second transplant.

If a transplant failed because of blood clots, tests to see if you have a tendency to blood clots may be needed. If the transplant failed because someone did not take their anti-rejection drugs properly, doctors will want to be sure that the reasons for not taking drugs are identified and there is an assurance this will not happen again. 

Is the body fit enough for another transplant?

Sometimes heart disease or other problems have developed since the first transplant operation, which would make a second transplant dangerous. People have to go back to square one in the assessment process for transplantation after transplant failure.

Can another transplant be found?

There can be a long wait for a second transplant. There are two reasons for this. First, the body may have a powerful memory for the tissue types in the first transplant. Most kidney units will not re-transplant someone with the same
tissue types as the first transplant. In other words, you may have to wait longer for a better matched kidney.

Secondly, the failed kidney may have caused the body to produce antibodies against the first kidney. These antibodies are directed against the tissue types of the original kidney, but also often react with a whole range of similar tissue types. That may mean that someone has antibodies which will react with 100% of other peoples kidneys, even if the tissue type match is nearly perfect. These antibodies will cause a positive cross-match test and make transplantation impossible. Doctors have tried to find ways of removing these antibodies, and if someone has someone interested in being a living kidney donor, they should talk to their transplant team about the options, which include looking for an ‘exchange’ transplant to avoid antibody barriers, or having an antibody incompatible tranpslant in a specialist centre. 

Success rate for second transplants

The good news is that the success rate for second transplants is almost as good as for first transplants, once a suitable kidney has been found. If a second transplant fails, then a third and even fourth, and maybe a fifth, transplant can be performed.

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Last reviewed March 2023
Next review March 2026

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

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