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Kidney transplant

Renal transplant; Transplant - kidney

A kidney transplant is surgery to place a healthy kidney into a person with kidney failure.

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Kidney anatomy
Kidney - blood and urine flow
Kidneys

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Kidney transplant - series

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Description

Kidney transplants are one of the most common transplant operations in the United States.

One donated kidney is needed to replace the work previously done by your kidneys.

The donated kidney may be from:

The healthy kidney is transported in a special solution that preserves the organ for up to 48 hours. This gives the health care providers time to perform tests to ensure that the donor's and recipient's blood and tissue match.

PROCEDURE FOR A LIVING KIDNEY DONOR

If you are donating a kidney, you will be placed under general anesthesia before surgery. This means you will be asleep and pain-free. Surgeons today can often use small surgical cuts with laparoscopic techniques to remove the kidney.

PROCEDURE FOR THE PERSON RECEIVING THE KIDNEY (RECIPIENT)

People receiving a kidney transplant are given general anesthesia before surgery.

Kidney transplant surgery takes about 3 hours. People with diabetes may also have a pancreas transplant done at the same time. This can add another 3 hours to the surgery.

Why the Procedure Is Performed

You may need a kidney transplant if you have end-stage kidney disease. The most common cause of end-stage kidney disease in the U.S. is diabetes. However, there are many other causes.

A kidney transplant may NOT be done if you have:

Risks

Specific risks related to this procedure include:

Before the Procedure

You will be evaluated by a team at the transplant center. They will want to make sure that you are a good candidate for a kidney transplant. You will have several visits over a period of several weeks or months. You will need to have blood drawn and x-rays taken.

Tests done before the procedure include:

You will also want to consider one or more transplant centers to determine which is best for you.

If the transplant team believes you are a good candidate for a kidney transplant, you will be put on a national waiting list.

Your place on a waiting list is based on a number of factors. Key factors include the type of kidney problems you have, how severe your heart disease is, and the likelihood that a transplant will be successful.

For adults, the amount of time you spend on a waiting list is not the most important or main factor in how soon you get a kidney. Most people waiting for a kidney transplant are on dialysis. While you are waiting for a kidney:

After the Procedure

If you have received a donated kidney, you will need to stay in the hospital for about 3 to 7 days. You will need close follow-up by a doctor and regular blood tests for 1 to 2 months.

The recovery period is about 6 months. Often, your transplant team will ask you to stay close to the hospital for the first 3 months. You will need to have regular check-ups with blood tests and x-rays for many years.

Outlook (Prognosis)

Almost everyone feels that they have a better quality of life after the transplant. Those who receive a kidney from a living related donor do better than those who receive a kidney from a donor who has died. If you donate a kidney, you can most often live safely without complications with your one remaining kidney.

People who receive a transplanted kidney may reject the new organ. This means that their immune system sees the new kidney as a foreign substance and tries to destroy it.

In order to avoid rejection, almost all kidney transplant recipients must take medicines that suppress their immune response for the rest of their life. This is called immunosuppressive therapy. Although the treatment helps prevent organ rejection, it also puts patients at a higher risk for infection and cancer. If you take this medicine, you need to be screened for cancer. The medicines may also cause high blood pressure and high cholesterol and increase the risk for diabetes.

A successful kidney transplant requires close follow-up with your doctor and you must always take your medicine as directed.

Related Information

Acute kidney failure
Corneal transplant
High blood pressure - adults
Diabetes
Glomerulonephritis
Liver disease
Pulmonary tuberculosis
Osteomyelitis
Kidney removal - discharge

References

Barlow AD, Nicholson ML. Kidney transplantation surgery. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 103.

Becker Y, Witkowski P. Kidney and pancreas transplantation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 26.

Gritsch HA, Blumberg JM. Renal transplantation. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 47.

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Review Date: 4/2/2019  

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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