Answer: It is very important for transplant patients to be fully informed about all aspects of their transplants. Everyone is well aware of the impact of complete knowledge and information about the medications that they must take. Few, however, are aware of the impact of ignorance about your body after a transplant. One of these "body issues" relates to the question - should I be able to feel my transplant in my abdomen? And should I be concerned about protecting it? The answer is yes to both questions. The "devil", as they say, is in the details. The medical term we use for feel is "palpate." Initially, all abdominal organs such as the liver and the kidney and even the pancreas are readily palpable by the patient. Knowledge of how it feels is good for the patient and the physician to discuss at each meeting.

Due to excellent immunosuppression, which prevents and reverses rejection, it is rare for the enlargement or pain and tenderness in the organ to be a signal of a rejection episode. In the past - 10 to 20 years ago - that however was often the case. Nevertheless, just as with examination of the breasts in women and men, patients should examine and know their bodies. This becomes even more important in the bodies of organ transplant patients. Knowledge is power and patients should be aware of all changes in their bodies and their new organs. Patients should then have a dialogue about any changes with their physician as soon as possible.

Changes in your body that you should be aware of include new lumps or masses, bleeding from any source, skin color changes, fever, chills, new moles, changes in the size or color of moles, areas of tenderness or induration (hardening of a normally soft tissue), rashes of any kind, any new sensation such as pruritus (itching) or even changes in color or caliber (width) of bowel movements and urination. Should any of these changes occur you should consult your physician and have a dialogue concerning your body. After all, an inquisitive and informed patient is a healthy patient.

The second part of the question concerns the issue of now that the patient is aware of the relatively superficial transplant organ that they feel, how do they keep from damaging it? The answer is to avoid contact sports whenever possible including activities like motorcycle riding, wrestling, boxing and similar types of activities. Sexual activity, sports for fun such as baseball, basketball, jogging, track and field and other non-contact sports, when done in moderation are part of good health maintenance and should be encouraged. If you think it is dangerous and might hurt you, then avoid it! The expectation is that after receiving an organ transplant you will lead a healthy life and that this new life may be even superior to your life before you became ill. This can occur best when you are empowered with the information you need to keep you healthy. This along with a partnership with a healthcare professional who encourages dialogue will help you maintain your health.

Answer provided by Clive O. Callender, MD, FACS. Dr. Callender is Professor and Chairman of the Department of Surgery and Director at the Howard University Transplant Center and Principal Investigator of MOTTEP (National Minority Organ Tissue Transplant Education Program). He also serves as a member of the AAKP Medical Advisory Board.

The Dear Doctor column provides readers with an opportunity to submit renal related health questions to healthcare professionals who specialize in the area of concern. The answers are not to be construed as a diagnosis and therefore, altercations in current healthcare should not occur until the patient's physician is consulted.

This article originally appeared in the January 2002 issue of aakpRENALIFE, Vol. 17, No. 4.

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