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Staying Healthy
Besides taking anti-rejection medications, there are a number of positive steps you can take to help keep you and your new organ healthy.
Eat a Low-Cholesterol Diet
High cholesterol is common after transplantation. One-quarter to one-half of transplant recipients will develop high cholesterol. If cholesterol levels get too high, blood vessels may become partially clogged, slowing or blocking the flow of blood. This increases the risk of heart disease and stroke. In fact, heart disease is the leading cause of death in transplant recipients with a working kidney transplant. Therefore, it is important for you and your doctor to work hard to minimize risk factors for heart disease, including controlling cholesterol.
| LDL Cholesterol Levels |
| Optimal |
Less than 100 mg/dL |
| Near Optimal |
100 to 129 mg/dL |
| Borderline High |
130 to 159 mg/dL |
| High |
160 to 189 mg/dL |
| Very High |
190 mg/dL and above |
Source: www.americanheart.org
People with high cholesterol should take several steps to lower their cholesterol levels. These include:
- A low-fat, high-fiber diet
- Increased physical activity
- Careful weight management
- Cholesterol-lowering drugs
Talk to your doctor or a nutritionist for a diet and medication plan that may improve your heart health.
Minimize Risks for High Blood Pressure
Hypertension, or high blood pressure, is a major cause of kidney failure leading to transplantation and often continues to remain a problem after transplantation. High blood pressure can also lead to heart damage (heart attack, heart failure) and stroke (brain vessel bleeding or clotting).
Some transplant recipients develop hypertension because of their immunosuppressive medications. People with post-transplant hypertension usually find that their blood pressure can be effectively managed.
Regardless of the cause of your high blood pressure, you should maintain a healthy lifestyle. There are a number of ways to increase your cardiovascular health and lower your blood pressure. These include:
- Stop smoking
- Eat a low-salt, low-fat, high-fiber diet
- Exercise
- Manage your weight
- Take blood pressure-lowering medications
Consult with your transplant team before undertaking any lifestyle changes. Your doctor may prescribe medicines to help you lower your blood pressure. Many times, blood pressure cannot be controlled with one drug, and others will need to be added.
Be Aware of the Signs of Diabetes
Some anti-rejection medicines can cause high blood sugar. Steroids, cyclosporine, and Prograf have all been associated with the development of new-onset diabetes. African American and Hispanic transplant recipients appear to be at higher risk for developing diabetes, as are overweight recipients or those with a family history of adult-onset diabetes. Reducing the dose of anti-rejection drugs, especially steroids, or changing medications may help blood sugar levels return to normal. Never change your dosing or medication on your own. Talk to your doctor, who will decide what is right for you.
Call your transplant team right away if you are often very thirsty, have to urinate more often than usual, have blurred vision, or feel confused; these may be signs of high blood sugar. Early treatment can help prevent complications. Blood sugar levels can sometimes be reduced through weight loss, careful diet, and exercise. An oral drug or insulin shot may be necessary.
You may want to consult a blood glucose chart like this. [link to previous spawned blood glucose chart]
Prograf® (tacrolimus capsules and injection) is approved for the prevention of rejection in patients who have received a liver or kidney transplant. Only physicians and facilities specializing in transplantation should manage patients taking Prograf. Anti-rejection medications may result in an increased possibility of developing an infection or lymphoma, a type of cancer.
In clinical studies, up to 20% of patients taking Prograf developed insulin dependent diabetes after transplant, but in some patients, after two years, insulin was no longer required. African American and Hispanic kidney transplant patients were at an increased risk.
Prograf has been associated with toxicity to the kidneys and nervous system. Common side effects are tremor, headache, high blood pressure, diarrhea, nausea and changes in kidney function.
Prograf should not be used in patients allergic to tacrolimus. Prograf injection should not be used in patients allergic to castor oil.
Seek Help When You Need It
The periods before and after a transplant can be very stressful. It is normal for people in this situation to be nervous or depressed to some degree. Your loved ones may be having similar feelings. Ask your transplant team about counseling services that can help you, your family, and your friends get through this period.
After your transplant, the steroids you receive to protect your new organ may also affect your mood. Talk to your doctor about ways you can minimize steroid use.
Prograf Prescribing Information 
Prograf Patient Information
Prograf Safety Information
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