The biggest advantage of having a kidney transplant is that your quality of life is much improved compared to dialysis. For one thing, you no longer need dialysis if it has been started. For another, you're likely to be able to resume your regular life activities, even becoming pregnant if you're female. (I explain the precautions for women with T1DM to take when they're trying to conceive in Chapter 16.)
The success rate of a kidney transplant is quite high, too. Ninety percent of transplanted kidneys are working well after one year, 80 percent after four years, and 50 percent after ten years. Some transplants have lasted as long as 40 years. Now that's something to cheer about!
When you have a transplant, however, you have to take drugs to prevent rejection. This is the biggest disadvantage because drugs to prevent rejection may
^ Make you more susceptible to infection ^ Slowly damage the transplanted kidney ^ Cause osteoporosis or soft bones
It's important to continue to monitor your kidney function after the transplant to make sure that your body isn't rejecting the kidney. The best test for this is the creatinine. If it starts to rise, you have to temporarily increase the dosage of your immunosuppressive drugs. (See the later section "Following up and treating your diabetes" for more information.) Post-transplant, your doctor also continues to monitor your bones for osteoporosis and your skin for skin cancers that are more common after a kidney transplant. He or she does this with blood tests and observation of your skin.
Occasionally, the transplanted kidney fails and another transplant is necessary. The same evaluation and precautions apply to this new kidney.
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