Kidney Transplant

A kidney transplant is a surgical procedure to place a kidney from a live or deceased donor into a person whose kidneys no longer function properly.
Your kidneys remove excess fluid and waste from your blood. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body a condition known as kidney failure or end-stage kidney disease. A kidney transplant is often the best treatment for kidney failure.
Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option. If a compatible living donor isn’t available for a kidney transplant, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor.

Why it is done

A kidney transplant is used to treat kidney failure (end-stage kidney disease), a condition in which your kidneys can function at only a fraction of normal capacity. People with end-stage kidney disease need either to have waste removed from their bloodstream (dialysis) or a kidney transplant to stay alive.
Common causes of end-stage kidney disease include:

Diabetes
Chronic, uncontrolled high blood pressure
Chronic glomerulonephritis an inflammation and eventual scarring of the tiny filters within your kidneys (glomeruli)
Polycystic kidney disease

Sometimes kidney disease can be managed with diet, medication and treatment for the underlying cause. If despite these steps your kidneys still can’t filter your blood adequately, you might be a candidate for a kidney transplant.

Risks

Complications of the procedure

Kidney transplant surgery carries a risk of significant complications, including:
Blood clots
Bleeding
Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
Infection
Failure of the donated kidney
Rejection of the donated kidney
An infection or cancer that can be transmitted with the donated kidney
Death, heart attack and stroke

Anti-rejection medication side effects
After a kidney transplant, you’ll take medications to help prevent your body from rejecting the donor kidney. These medications can cause a variety of side effects, including:

Acne
Bone thinning (osteoporosis) and bone damage (osteonecrosis)
Diabetes
Excessive hair growth or hair loss
High blood pressure
High cholesterol
Increased risk of cancer, particularly skin cancer and lymphoma
Infection
Puffiness (edema)
Weight gain

How you prepare

Finding a donor
A kidney donor can be living or deceased, related or unrelated to you. Your health care team will consider several factors, such as blood and tissue types, when evaluating whether a living donor will be a good match for you. Family members are often the most likely to be compatible kidney donors. But many people undergo successful transplants with kidneys donated from people who are not related to them.
If a compatible living donor isn’t available, your name will be placed on a waiting list for a deceased-donor kidney. Because there are fewer available kidneys than there are people waiting for a transplant, the waiting list continues to grow. The waiting time for a deceased-donor kidney is usually a few years.
Paired kidney donation may be an option if you’ve found someone willing to donate a kidney, but the donor’s blood and tissue aren’t compatible with yours. Rather than donating a kidney directly to you, your donor may give a kidney to a person whose blood and tissue is compatible with the donor’s kidney, and you receive a kidney from another transplantee’s donor.

Staying healthy
Whether you’re waiting for a donated kidney or your transplant surgery is already scheduled, work to stay healthy. Being healthy and as active as you’re able can make it more likely you’ll be ready for the transplant surgery when the time comes. It may also help speed your recovery from surgery. Work to:

Take your medications as prescribed
Follow your diet and exercise guidelines
Keep all appointments with your health care team
Stay involved in healthy activities, including relaxing and spending time with family and friends

Stay in touch with your transplant team and let them know of any significant changes in your health. If you’re waiting for a donated kidney, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag handy, and make arrangements for transportation to the transplant center in advance.

What you can expect

During a kidney transplant
Kidney transplants are performed with general anesthesia, so you’re not aware during the procedure. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the procedure.
During the surgery:

The surgeon makes an incision and places the new kidney in your lower abdomen. Unless your own kidneys are causing complications such as high blood pressure, kidney stones, pain or infection, they are left in place.
The blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen, just above one of your legs.
The new kidney’s ureter — the tube that links the kidney to the bladder is connected to your bladder.

Kidney transplant surgery usually lasts about three to four hours.

After a kidney transplant
Spend several days to a week in the hospital.
Doctors and nurses monitor your condition in the hospital’s transplant recovery area to watch for signs of complications. Your new kidney will make urine like your own kidneys did when they were healthy. Often this starts immediately. In other cases it takes several days. Expect soreness or pain around the incision site while you’re healing.
Have frequent checkups as you continue recovering.
After you leave the hospital, close monitoring is necessary for a few weeks. Your transplant team will develop a checkup schedule for you. During this time, if you live in another town, you may need to make arrangements to stay near the transplant center.
Take medications the rest of your life.
You’ll take a number of medications after your kidney transplant. Drugs called immunosuppressants help keep your immune system from attacking your new kidney. Additional drugs help reduce the risk of other complications, such as infection, after your transplant.

Results

After a successful kidney transplant, your new kidney will filter your blood, so you will no longer need dialysis.
To prevent your body from rejecting your donor kidney, you’ll require medications to suppress your immune system. You’ll likely take these drugs for the rest of your life. Because medications to suppress your immune system make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications.
After transplant, skin checkups with a dermatologist to screen for skin cancer and keeping your other cancer screening up to date is strongly advised.