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A kidney transplant is surgery to place a healthy kidney into a person with kidney failure.
Renal transplant; Transplant - kidney
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 cool salt water (saline) that preserves the organ for up to 48 hours. This gives the health care providers time to perform tests that match the donor's and recipient's blood and tissue before the operation.
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. Usually, surgeons today can use small surgical cuts with laparoscopic techniques. See kidney removal for more information.
PROCEDURE FOR THE PERSON RECEIVING THE KIDNEY (RECIPIENT)
People receiving a kidney transplant are given general anesthesia before surgery. The surgeon makes a cut in the lower belly area.
Kidney transplant surgery takes about 3 hours. People with diabetes may also have a pancreas transplant done at the same time. This will usually add another 3 hours to the surgery.
See also: Pancreas transplant
Your doctor may recommend 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:
The risks for any anesthesia are:
The risks for any surgery are:
Other risks related to the procedure include:
Once your doctor refers you to a transplant center, you will be seen and evaluated by the transplant team. They will want to make sure that you are a good candidate for kidney transplant. You will have several visits over the course of several weeks or even 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.
Most, but not all patients waiting for a kidney transplant are on dialysis. While you are waiting for a kidney, follow these steps:
If you received a donated kidney, you will need to stay in the hospital for about 3 - 7 days. Afterwards, you will need close follow-up by a doctor and regular blood tests for 1 - 2 months.
The recovery period is about 6 months. Often, your transplant team will ask you to stay fairly 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.
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 usually 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.
Barry JM, Jordan ML, Conlin MJ. Renal transplantation. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 40.
Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9 Suppl 3:S1-155.