Possible Complications
What can go wrong after a kidney transplant and how to catch it early — rejection, skin, dental care, new-onset diabetes, SGLT2 inhibitors, cancer screening, bones, eyes, and mood.
Key Points
- Rejection in the early stage is silent — the first sign is a rise in creatinine on a routine test, which is why you keep your follow-up appointments.
- See a dermatologist once a year for a full-body skin check — skin cancer is 65 to 100 times more common after a transplant, and early skin cancers are easy to cure when caught small.
- Wear SPF 50 sunscreen every day on the face and any uncovered skin, a wide-brimmed hat outdoors, and avoid the sun between 10 in the morning and 3 in the afternoon.
- You do not need antibiotics before every dental cleaning or filling — they are reserved for a prosthetic heart valve, a previous heart-valve infection, certain congenital heart conditions, or a heart transplant with a leaking abnormal heart valve.
- New-onset diabetes after a transplant affects about one in five recipients — screen with a fasting blood sugar and HbA1c at 3 months and then yearly, and treat with weight loss, walking, diet, and metformin first.
- SGLT2 medicines have uses beyond diabetes, including selected cases of proteinuric chronic kidney disease and heart failure. After kidney transplantation, their use and monitoring must be individualised by the transplant team because transplant-specific evidence is more limited.
- Keep up your normal cancer screening — yearly cervical smear, mammogram every 1 to 2 years from age 40 to 69, colon screening from age 50, anal screening if you have a history of HPV, and an annual lung scan from age 50 to 80 if you have a 20 pack-year history and still smoke or stopped within 15 years.
- Calcium and vitamin D are tailored to your blood tests; watch for hip pain that warrants an MRI, and see an eye doctor once a year from 5 years after the transplant for cataract.
- Low mood, anxiety, and a feeling of being overwhelmed are common after a transplant — tell the team early, because short treatment or counselling helps most patients.
Clinical review
Reviewed by Dr Osama Ashry Gheith, Consultant Transplant Nephrologist. Kuwait Center for Nephrology and Kidney Transplantation (KCNKT). Mansoura Urology and Nephrology Center, Egypt. Reviewed 1 August 2026.
About the Transplant Patient Portal
This chapter is part of ASNRT's bilingual (Arabic / English) transplant patient-education portal — 14 clinical chapters covering kidney transplantation from preparation through long-term follow-up, plus decision-aid tools for Ramadan fasting, drug-food interactions, and red-flag symptom triage.
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