Right now, tens of thousands of people with kidney disease are considering or planning for a kidney transplant. If this is an option you’re starting to explore, you probably have lots of questions, and you may not even know where to start. We’re here to help.
Like any journey, getting a transplant begins with a few initial steps. Knowing what steps to take and when to take them is important, so we’ve outlined some of the information that you’ll need to get started.
If you or a loved one has kidney disease, it’s never too early to prepare for a kidney transplant. The sooner you start planning, the earlier you may be able to find a kidney. Getting a kidney transplant is a very personal experience, so you and your doctor should focus on making decisions and taking steps that are right for you and your health.
6 Steps to Starting Your Transplant Journey
Ready to get started? Below is a list of typical steps in the process of getting a kidney transplant. This information can help you figure out what to do now, as well as what to do (or expect) next.
- Discuss planning for kidney transplant with your doctor: Together you can decide if a kidney transplant is a good option—based on your health, wellbeing, and goals.
- Learn all you can about kidney transplants: The more you know, the better you’ll be able to decide what’s right for you and your health.
- Contact your local transplant center: Set up an appointment to learn about your next steps. If there’s more than one transplant center in your region, call each of them. The transplant center will order any necessary medical tests, which are a requirement before you can be added to the national kidney transplant waitlist.
- Start seeking a kidney donor: There are two basic ways to find a donor match.
through family, friends, or acquaintances.
- Register on the national kidney transplant waitlist for a donor kidney. The waitlist is managed by the United Network for Organ Sharing (UNOS).
Transplant Centers: Your Questions Answered
Organ transplants of all kinds are performed at specialty transplant centers. These centers are fully equipped for transplant surgery and staffed by expert care teams who are trained to educate both recipients and living donors on how to prepare for a kidney transplant. Most transplant centers are part of a hospital.
Should I register at more than one transplant center?
Yes. If there’s more than one transplant center near you, it’s recommended that you request referrals from your doctor and register at more than one center. This is called “multiple listing.” Since the travel distance between donor and recipient is a key consideration, having multiple listings may give you a better chance of getting a nearby kidney.
When should I be referred to a transplant center?
Discuss planning for kidney transplant as early as possible with your doctor. Referrals to a transplant center are typically made in stage 4 or stage 5 of chronic kidney disease (CKD). Getting accepted as a patient at the transplant center means you’ll be ready as soon as you find a kidney donor. If you are fortunate enough to get a transplant before your kidneys fail, you may be able to avoid dialysis.
How do I find a transplant center near me?
Ask your doctor for a referral to the nearest transplant center. To search all available kidney transplant centers in your region, visit the Organ Procurement and Transplantation Network (OPTN) and start by selecting “Transplant Centers by Organ.”
TIP: When choosing a transplant center, consider these factors:
- Coverage and cost under your insurance
- Whether the center performs living donations
- Location and ease of travel to and from the center
- If the center participates in a *paired kidney exchange program
*A paired kidney exchange program allows for a donor/recipient who may not be well matched to “swap” donors with another donor/recipient.
What do I need to know about insurance and the cost of a kidney transplant?
Insurance coverage for a kidney transplant varies by insurer and plan. It’s important to find out about all associated costs ahead of time, so you know what to expect.
Note: Private insurance and Medicare typically cover about 80 percent of initial surgery and medication costs. A transplant insurance coordinator may be available to help you better understand your coverage to avoid gaps and be better prepared for your transplant. Your transplant center will also have a financial coordinator and/or social worker who can help you understand your insurance coverage and answer any questions.
If you’re considering or planning for kidney transplant, you may have more questions than answers. Fortunately, there are many ways to educate yourself, and you can start today! We’ve provided several helpful steps to take as you learn how to prepare for a kidney transplant, and there are plenty of professionals and experts you can turn to along the way. As always, we recommend first talking with your doctor about big medical decisions such as this one.
If you’ve been diagnosed with chronic kidney disease (CKD), there’s a chance you’ll eventually need a kidney transplant, which means you would need to undergo major surgery. Just as with any surgery, there are some important steps to take before the procedure if you want the best chance at a smooth recovery. Here’s what to do while you await the day of your kidney transplant.
Important Things to Do Before a Kidney Transplant
Attend all doctor appointments
Your team of doctors will be in close contact with you leading up to the kidney transplant. Avoid having to delay appointments, or tests, as your doctors need to stay in touch to ensure you stay healthy before the day of your surgery. You’ll also have some medications to take before the kidney transplant, and seeing your doctors regularly will help you keep up with this routine.
If you smoke, it’s important to quit before the procedure, otherwise you increase your chance of facing life-threatening complications after surgery. Additionally, smoking can slow your recovery after a kidney transplant. If you’re having trouble quitting, talk to your doctor to get help.
One of the best ways to be healthy before a kidney transplant is to maintain an active lifestyle. Regular exercise can help regulate weight, which is important when you have CKD. Studies show that a sedentary lifestyle can lead to complications during, and after surgery, so it’s best to get at least an accumulative 150 minutes of moderate physical activity every week.
Follow a healthy diet
Another way to maintain your weight before the kidney transplant is to eat a balanced diet. In particular, your team of doctors might suggest a kidney-friendly diet to you, which involves limiting the levels of sodium, potassium, and phosphorus in your diet. Talk to your doctor to find out if you need this kind of diet before your kidney transplant.
Know what to expect from your kidney transplant
Your medical team should be keeping you informed on what to expect from surgery, and a transplant coordinator, or someone in a similar role, to guide you on how to prepare and recuperate.
Discuss with this person what to bring to the procedure, approximately how long it will take to heal, and what items you’ll need during recovery. Knowing this information should bring you peace of mind while you wait for a kidney transplant.
Get the Care You Deserve
Whether you have CKD and are not sure if you need a kidney transplant yet, or you’re already on the list to get a donor kidney, you deserve access to doctors with years of experience treating kidney problems. If you have questions about kidney transplants or chronic kidney disease, contact us today at Texas Kidney Institute to learn more!
It’s important to be as fit as possible before your transplant. Being on dialysis can make you feel very tired. Moderate exercise can help boost your energy levels and will lower stress. This could be walking, cycling, swimming, jogging or something else you prefer. Speak to your kidney care team about the right exercise plan for you.
Waiting for a transplant is an emotional time, and depression and anxiety are common. Staying busy can help. But you or your loved ones may wish to speak to a support group. Your kidney care team can put you in touch with local groups.
If you are on dialysis, you will have restrictions on what you can eat and drink. You will need to avoid certain foods, such bananas, which are high in potassium. You may also need to limit the amount of fluids you drink.
You will be given information on your diet and daily fluid allowance from your kidney care team. It’s very important to follow this advice.
If you’re overweight or obese, you will be encouraged to lose weight. Being a healthier weight can help to lower your chances of having problems with your transplant surgery and recovery. You should lose weight by increasing the amount of exercise you do and taking extra care with your diet. Speak to your kidney team for more advice on losing weight.
If you are a smoker you should stop as early as you can before your transplant. This will help you better prepare for the transplant and help to maintain your health afterwards. Speak to your kidney team or GP for help on quitting smoking.
If you wish to drink alcohol you may do so in moderation.
It’s important to take all your medicines. But please only take medicines that are prescribed for you by your kidney doctor and your GP.
If you are on dialysis, it is important that you don’t miss any dialysis sessions. Please talk to your kidney team if you have problems with dialysis.
You cannot receive a kidney transplant when you are pregnant. Please speak to your kidney team if you need advice on contraception or fertility when waiting for a kidney transplant.
Need help with any of the above?
If you need advice or have any concerns, please speak to your kidney care team.
A transplant is a treatment for kidney failure. Find out what's involved, who can have one, and how to prepare.
A transplant is a treatment for kidney failure, where the kidneys are no longer able to function. Most people go on dialysis first while they’re waiting for a suitable kidney to be available.
For people facing kidney failure, a transplant offers them the potentials to enjoy a longer, more active life, without having to continue with dialysis. Even if a transplant fails, many people are able to successfully have second and subsequent transplants.
Unfortunately, not everyone is a suitable candidate for a transplant.
To be eligible for a kidney transplant, you need to be reasonably healthy. Surgery and the medication used to prevent rejection can place a strain on your body and cause problems if you are not well. Discuss with your doctor if a transplant is a good solution for you, or whether another treatment option would be better.
Before a transplant can occur, there are certain medical tests used to assess your health. These can include:
- an appointment with the transplant assessment team, which includes discussions and a physical examination
- blood tests
- x-rays of the heart and lungs
- ultrasounds and other imaging of the heart to ensure it’s health
- a surgical review of your arteries, veins and bladder
- skin examination
- dental examination
- other specialised tests based on your personal health history
- periodic tests to make sure that you have not built up anti-bodies
In Australia, kidney transplants have a high success rate – currently, over 94% of transplants are working one year later.
Life expectancy for someone who has undergone a kidney transplant varies by each individual patient and their overall health. Currently, patient survival is at 91% for 5 years and 46% for 20 years for first transplants from deceased donors. The numbers for second and subsequent transplants are similar.
For transplants from live donors, survival rates are currently 96% at 5 years and 67% at 20 years, according to 2019 statistics from ANZSN.
There are two main types of transplant in Australia; those from a deceased donor and those from a living donor.
A kidney may be specifically given to you from a loved one, or in some rare cases, a kidney may be given to you by a stranger who altruistically donates one of their kidneys to the next suitable person on the waiting list.
Unless you have someone giving a kidney directly to you, you’ll need to be placed on the official waiting list. This will be assessed through your renal unit or nephrologist and team. In Australia, the average wait time for a kidney transplant is around 2.5 years, but it’s not uncommon for people to wait for up to 7 years.
Preparing for a kidney transplant can be overwhelming.
Before you head into surgery, make sure to talk to your doctor or health practitioner and ask them any questions you have. You will also need to speak to your carer, if you have one, and make plans with your school or workplace for initial changes to your daily life.
It’s important to be as fit and healthy as possible too. You want to make sure your body is ready for both the surgery and medication you’ll need to go on afterwards.
It’s also a good idea to have regular health and dental checks, and maintain your:
- recommended dietary and fluid restrictions
- dialysis schedule
- regular fitness or exercise plan
- ideal body weight for your age and size (being overweight increases the risk of problems during surgery).
During surgery, the new kidney is placed in position. Your existing kidneys are not usually removed. Sometimes, if you have large polycystic kidneys, one may be removed to make space for the transplant.
The operation usually takes 3 to 4 hours with variable hours of recovery. The new kidney is connected to your bladder so urine can flow, and a tube or catheter is placed in your bladder for up to 5 days (after which it’s removed). You may come out of the operation with tubes at the operation site (a drain) or a catheter in your bladder.
Some kidneys start to work straight away, but others may take a few days or weeks. You’ll be in hospital for about a week, depending on how quickly you recover from the surgery. The transplants kidney will be closely monitored with blood tests and scans. You may also be required to undergo a transplant biopsy where they take a small sample of the tissue.
You will need ongoing frequent monitoring of blood tests, blood pressure, drug levels and your health. Initially this will be very frequent (daily) and over time will become less frequent depending on your progress. Be prepared to come into the hospital daily after discharge.
You’ll take medications, for the life of the transplanted kidney, to stop your body from rejecting it. These medication can make you more prone to serious illnesses such as infections and cancers.
Sometimes a kidney stops working because people stop taking these medications, so it’s incredibly important that you take them regularly and a s prescribed. Along with general health and fitness, your kidney will last longer if you follow advice about caring for your kidney.
We welcome you to call our Kidney Helpline on 1800 454 363 for additional support.
Before you decide to have a transplant, it’s important to talk to your doctor and understand the risks. You might also find the resources below useful.
When you and your doctor agree it is time for you to be evaluated for a transplant, you undergo a series of tests to assess your options. You’ll be evaluated for potential issues like heart disease, obesity, and diabetes. A social worker or transplant coordinator will discuss the logistics with you as well; things like transportation, housing, financial and family support will all be considered.
There are several screening tests to determine your blood and tissue type which are needed to match you to a donor kidney. In addition to the tests below, other tests may be required depending on your age, medical history, etc. A mammogram, colonoscopy, or other tests may be required.
Blood type is the first test; it will tell you which of the four blood types — A, B, AB, or O — you are. You must have a blood type that is compatible with your donor for the transplant to be successful.
Compatible blood types:
- If your blood type is A, donor blood type must be A or O
- If your blood type is B, donor blood type must be B or O
- If your blood type is AB (universal recipient), donor blood type must be A, B, AB or O
- If your blood type is O (universal donor), donor blood type must be O
The Rh type (+ or -) is not a factor in donor matching.
Human leukocyte antigens (HLA)
Human leukocyte antigens (HLA) (also called tissue typing) is the second blood test you’ll undergo. The HLA are found mostly on white blood cells; they are markers that let your immune system know which cells belong to your body and which do not.
Crossmatch is another blood test you will undergo. This test tells you what antibodies you have in your body. Antibodies are produced by your immune system when it attacks foreign substances. You make antibodies when you have an infection, are pregnant, have a blood transfusion or undergo a kidney transplant. If you have antibodies to the donor kidney, your body will fight that kidney until it is destroyed. The crossmatch test is done by mixing your blood with cells from your donor. If the crossmatch is positive, you have antibodies against your donor and should not receive the kidney.
All of these blood tests, along with the discussions mentioned above, are all required before you can be considered for a transplant. Once the results from all the tests are back, your transplant team will meet to discuss your results. They will discuss your medical and social history (history of drug or alcohol abuse, level of family and financial support, etc.) and make a decision. If they decide you should be listed for a transplant, you are then placed on the United Network for Organ Sharing (UNOS) waiting list.
The distance between you and your transplant center(s) is very important. Once you have been notified that a kidney is available, you will have a limited amount of time to get to the center. The less time the organ must be held outside the donor’s body will mean a better chance that the kidney will function when transplanted. There are three geographic levels to consider:
- Local: this is your local area and is served by the local organ procurement organization (OPO). There are 58 OPOs in the U.S.; they are typically state-wide but can be smaller or larger. Your transplant center will tell you what your local area and OPO is. An available organ will be offered within the OPO first.
- Region or zone: if the local OPO does not find a suitable match for an organ, they can be offered to patients at centers in a wider area. Kidneys are first offered within one of 11 regions of the U.S.
- Nationwide: if there are no local or regional matches, kidneys can be offered to anyone in the U.S. who is a potential match.
Most candidates are listed at a single transplant center, but some people choose to register at two or more transplant centers, called multiple listing, to potentially increase their chances of receiving a kidney. Unfortunately, there is no guarantee that multiple listing will shorten waiting time. Of the many factors affecting how long you will wait, location is only one. Multi-listing may offer more benefit to some patients than others and this should be discussed with your nephrologist or local transplant team.
Restrictions and considerations
The Organ Procurement and Transplantation Network (OPTN) has a policy to allow for multiple listing. That said, it is up to each individual transplant center to decide if they will accept you as a transplant candidate. Multiple listing in the same local area will probably not be of many benefits, even if you are listed at multiple hospitals. Some centers may have policy against accepting multiple-listed patients.
You must be considered and accepted as a transplant candidate at each center you want to be listed. This could include completing the full medical evaluation and agreeing to conditions set by the center. You will need to check with your insurance provider to understand how the cost of additional evaluations will be covered (they may only cover the cost of one evaluation). You’ll need to maintain current lab results and contact information for each center.
Waiting time is an important factor when waiting for a kidney transplant. The longest amount of time you have waited at any center is called your primary waiting time. If you are listed at multiple centers, your waiting time will start from the date each individual center listed you (unless you started dialysis before your first listing in which case they all date back to the dialysis start date). You can transfer your primary waiting time to another center (where you are listed) or switch time waited at different programs. All requests to transfer or switch waiting time must be approved by all involved centers.
Transfer of care
You may want to end your listing at one center and transfer it to another. You can do this as long as you coordinate with both programs. The new center will generally ask you to put your request in writing. It is very important to note that if you end your listing at one center before your new center formally accepts you, you may not be able to continue to accumulate waiting time.
Donating PKD affected kidneys for research
Researchers continue to make breakthroughs in PKD research, often with the help of donated cystic kidney tissue. Polycystic kidneys retrieved for research at the time of nephrectomy (surgical removal of non-functioning kidneys) provide an opportunity for scientists to study the cells and tissues that contain the genetic mutations responsible for cyst formation.
Our PKD tissue donation program provides patients with an avenue to contribute to the advancement of our understanding of PKD. We coordinate donations of discarded human PKD kidneys to research labs across the country. Click here for more information.
When you arrive at the transplant centre, you’ll be quickly assessed. Some of the tests you had at your initial assessment may be repeated to ensure no new medical conditions have developed. Tests will also be done to ensure the donor kidney is suitable for you.
The transplant procedure must be carried out as quickly as possible for the transplant to have the best chance of success. After the medical team has confirmed the kidney is in good condition and is suitable, you’ll be given the general anaesthetic and taken to the operating theatre.
The kidney transplant procedure involves 3 main stages:
- First, an incision (cut) is made in your lower abdomen (tummy), through which the donated kidney is put into place. Your own kidneys will usually be left where they are, unless they’re causing problems such as pain or infection.
- Second, nearby blood vessels are attached to the blood vessels of the donated kidney. This is to provide the donated kidney with the blood supply it needs to function properly.
- Finally, the ureter (the tube that carries urine from the kidney to the bladder) of the donated kidney is connected to your bladder.
A small plastic tube called a stent may be inserted into the ureter to help ensure a good flow of urine initially. This will usually be removed about 6 to 12 weeks later during a minor procedure called a cystoscopy.
When the kidney is properly in place, the incision in your abdomen will be closed with surgical staples, stitches or surgical glue.
Although the procedure may sound relatively straightforward, it’s very demanding and complex surgery that usually takes around 3 hours to complete.
After the operation
Once you’ve recovered from the effects of the anaesthetic, it’s likely you will feel some pain at the site of the incision. Painkillers will be provided, if necessary.
After the operation, you’ll immediately begin treatment with medication designed to prevent your immune system from rejecting your new kidney. See living with a kidney transplant for more information on this.
Most transplanted kidneys will start working immediately, particularly if they come from a living donor, although sometimes they may take a few days or weeks to work properly. If this is the case, you’ll need to have dialysis during this time.
Most people can leave hospital in about a week, but you’ll need to attend frequent appointments at the transplant centre, so your kidney function can be assessed and tests can be carried out to check how well your medications are working.
For the first month after surgery, you may need to have 2 to 3 appointments a week. However, over time, your appointments will become less frequent. After a year, as long as you do not have any serious problems, you should only have to attend the centre once every 3 to 6 months.
After kidney surgery, you should be able to return to work and normal activities within a few months, provided you make good progress.
Living Donor Kidney Transplantation
Waiting on the transplant waitlist is not the only option available to kidney failure patients. A living donor can give one of their healthy kidneys to a transplant patient and end their long wait for treatment.
How to Prepare for Kidney Transplant Surgery
We help patients going through the kidney transplant process every day. Although everyone’s experience is different, we are experts in each step of the process and are dedicated to helping you through your unique journey.
The Day of Your Kidney Transplant
Arrive early at the hospital. You may need to undergo some additional tests and evaluations before surgery.
Most transplant patients stay in the hospital four to 10 days. Living donation transplants are usually discharged sooner, after two to three days. Before going home, kidney transplant patients receive extensive education about the medicines they will need to take and other self-care habits they will need to adopt.
What to Expect After Your Kidney Transplant Surgery
Regular Post-Transplant Clinic Appointments
We need to keep a close watch on you for a full year to make sure your kidney is doing well. For the first few months after your kidney transplant, you will probably need to come back to the clinic a few days a week. You will need to have various labs done to make sure your body is accepting your new kidney. As your condition stabilizes, your clinic visits will decrease.
You will need to take anti-rejection medicines for the life of your transplanted kidney. Your regular health care provider will help you manage your medications and lifestyle changes.
healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.
A kidney transplant is an operation to place a healthy donor kidney in a person whose two kidneys are no longer working properly. A transplant is considered a long-term alternative to kidney dialysis. This article contains general information about kidney transplants.
Considering a kidney transplant
If you have serious (end-stage) kidney failure, a kidney transplant may be an option. A transplant may offer you both a longer, dialysis-free life, and a better quality of life.
Your healthcare team will assess whether you are medically suitable for a kidney transplant.
To decide whether you want a transplant, it is important to understand your condition and the potential benefits and risks of the procedure. You also need to be willing to undertake the self-care that will be required — for the rest of your life — after the operation. Read more about the questions to ask your healthcare team.
Who can donate a kidney?
People can choose to donate their kidneys when they die (deceased donor) or they can donate one kidney while they are still alive (live donor).
If you donate a kidney, you can usually live safely with your one remaining kidney without complications. Living donors are usually relatives, partners or close friends. To read more about organ or tissue donation after death or to register as a donor, visit www.donatelife.org.au.
The waiting list for a transplant
If you are suitable for a kidney transplant and you wish to have one, your name will be put on a waiting list. This is because there are usually not enough donor kidneys for the number of people who need a transplant at any one time. The average wait for a deceased donor kidney is about 3 years.
When a deceased donor kidney becomes available, a recipient is chosen based on the best blood and tissue match. You need to be contactable in case a suitable donor kidney becomes available.
To be ready for a kidney transplant and to help with your recovery, it is a good idea to be as healthy and fit as possible. In particular, you should:
- maintain recommended dietary and fluid restrictions
- keep to your dialysis schedule
- get enough physical activity
- try to lose weight if you are overweight
What happens during a kidney transplant?
A kidney transplant usually takes 2 to 3 hours, with a couple of hours in recovery. The surgeon will make a cut in the lower part of your body and place the new kidney in position.
The new kidney will be connected to the bladder by a transplanted ureter. It will also need to be connected to your blood supply.
Your old (diseased) kidneys are not usually removed unless they are causing a medical problem.
You will usually have a temporary tube to drain your urine (known as a catheter) for a few days.
If your new kidney does not work right away, you may need dialysis for a short while until it does.
Your medical team will check if your kidney works and find any early signs of rejection by your body.
After the surgery, you will probably need to stay in hospital for a few weeks to recover.
The transplanted kidney is positioned near the pelvis, below the two kidneys that are no longer working properly.
Life after a kidney transplant
After the operation, you will likely need to take medicine for the rest of your life to prevent your body from rejecting the new kidney. Your healthcare team will probably talk to you about your treatment plan, how to monitor your health and the self-care required. You will probably still need regular check-ups and you need to continue taking your medication as prescribed.
Since the anti-rejection medication weakens your immune system, you should try to avoid getting infections by:
- staying away from people who you know are sick, (e.g. with the flu or chickenpox)
- washing your hands well before eating
- covering any cuts or wounds
Also, follow your healthcare team’s advice on living a healthy lifestyle, such as getting enough physical activity and eating healthily. For instance, avoid high-salt foods and drinking excessive amounts of alcohol because salt and alcohol can raise your blood pressure, which can damage your kidney.
Most people feel they have a better quality of life after a kidney transplant.
How family and friends can help
Making the decision to have a kidney transplant, waiting for a donor organ, having the operation itself and getting used to life after the transplant can be stressful. The medication to prevent rejection can also affect your mood. However, family and friends can help in a number of ways, including:
A kidney transplant gives you a healthy kidney from another person. You may need a transplant if your kidneys work poorly because of diabetes, high blood pressure, or another illness.
You need only one kidney to live. The new kidney can do the work that your own kidneys cannot. It will remove waste from your blood. It will keep your body’s fluids and chemicals in balance. A new kidney can improve the quality of your life. You are likely to feel better and have more energy.
The new kidney may come from someone you know, a stranger, or a person who has died. Getting a new kidney can sometimes take a long time. You have to meet certain rules to be able to get a kidney. For example, your overall health (other than kidney problems) has to be good. If a relative or another living person has a kidney that is a good match, you may not have to wait long. If you need a kidney from a person who has died, your name will be put on a waiting list.
Why is a kidney transplant done?
Kidney transplant surgery is done so that a healthy kidney (donor kidney) can do what your diseased kidney can no longer do. Kidney transplant is used when you have severe chronic kidney disease (renal failure) that cannot be reversed by another treatment method. You will not be able to have this surgery if you have an active infection, another life-threatening disease such as cancer, or severe heart or lung disease.
Your doctor will put the new kidney in your body and leave your own kidneys where they are, unless there is a reason to take them out. Your doctor will connect the blood vessels of the new kidney to your blood vessels, and the ureter of the new kidney to your bladder. A ureter is the tube that carries urine from the kidney to the bladder. The new kidney may make urine right away. But in some cases it may take a while to work. If the new kidney does not work right away, you will have dialysis until it starts to work.
The transplant usually takes from 3 to 6 hours. You may stay in the hospital 5 to 10 days. After you leave the hospital, you will have follow-up visits to make sure the kidney is working well. The living person who gives a kidney to you will likely stay in the hospital for about a week.
Living donor kidney transplant
For a living-donor kidney transplant, the recipient’s diseased or damaged kidneys usually are left in place. The donor’s kidney is placed in the recipient’s lower abdomen and connected to blood vessels and the bladder. The recipient’s and donor’s surgeries are carried out at the same time in different operating rooms.
In the iSWAP program, candidates with a living donor who is medically able, but not a compatible match to their intended recipient are able to be paired with another recipient in return for a kidney that is compatible with their intended recipient
Preparing for a kidney transplant
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
Understand exactly what surgery is planned, along with the risks, benefits, and other options.
Tell your doctors ALL the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia.
If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. Bring a copy to the hospital. If you don’t have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.
What can you expect after a kidney transplant?
Within a few days, you may begin to feel much better than you did before. But you may have some pain or soreness in your belly or side. This can last for several weeks.
Most people go home from the hospital 5 to 10 days after surgery. It will probably take about 4 weeks before you can get back to your job or usual activities.
After surgery, the new kidney will start to do the work that your own kidneys cannot. It will remove waste from your blood and balance your body’s fluids and chemicals. Your new kidney may start working very soon after surgery. Or it may take a few weeks. If your kidney does not start to work right away, you will need to have dialysis until the new kidney can take over.
After the transplant, you will have to take medicines every day for the rest of your life. The medicines will help keep your body from rejecting the new kidney. These medicines will also make your immune system weaker. This means you will be more likely to get an infection or become sick. To reduce your risk of infection, wash your hands often. Stay away from crowds of people, and avoid contact with people who have a cold or the flu.
If your body starts to reject the kidney, your doctor may be able to stop the rejection. But if not, you will need to have dialysis again. It is possible that you can have another transplant.
You may have many different emotions after your kidney transplant. You may feel grateful and happy. But you also may feel guilty or depressed. These feelings are common. It may help to talk about your feelings with your doctor and family.
The best treatment for kidney failure in people fit enough for the operation.
In this section
Donating a kidney leaflet
Frequently asked questions about kidney transplantation
If you have end-stage renal disease (ESRD), kidney transplantation may be the treatment option that allows you to live much as you lived before your kidneys failed. However it is important to remember that it is not a cure, as it can only provide 50% of normal kidney function and requires you to take medicines for the rest of your life. Kidneys from deceased donors last, on average, 10-12 years and from living donors about 12-15 years.
What do healthy kidneys do?
Healthy kidneys clean your blood by removing waste products, excess salts and fluid (forming urine). They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, harmful wastes build up in your body, your blood pressure may rise, and your body may retain fluid leading to ankle swelling and shortness of breath (water in the lungs). When this happens you may need a transplant to replace the work of your failed kidneys.
Kidneys are the most common organ donated by a living person. About a third of all kidney transplants carried out in the UK are from living donors
Organ Donation NHS
How transplants work
Kidney transplantation is a procedure that places one healthy kidney from another person into your body to take over the work of your two failed kidneys.
It is inserted into your lower abdomen and connected to an artery and vein in your pelvis. Your blood flows through the new kidney, which makes urine and removes harmful waste products, just like your own kidneys did when they were healthy. Your own kidneys are usually left in place.
The transplant process
Transplant workup. First you'll need an assessment to determine whether your body will accept an available kidney. This may require several visits over 4-6 months. You must be healthy enough for surgery and, although there's no age limit, few units will transplant patients over 70 years old unless they are very fit.
If a family member or friend wants to donate a kidney, they'll need to be evaluated separately for compatibility, general health and counselling. Matching the kidney to your immune system is less important for living transplants.
Waiting list. If you don't have a living donor, you will be registered with UK Transplant and put on a national waiting list to receive a kidney from a deceased donor. The average wait in the UK is three years, but it varies considerably.
Transplant operation. If you have a living donor, the operation is scheduled in advance at a time that suits you both.
If you're on a waiting list for a deceased donor kidney, as soon as a kidney becomes available you must go to the hospital quickly. There you will have an antibody 'cross-match' test. If you have a negative cross-match it means that your antibodies don't react and the transplant can go ahead. The operation usually takes 3-4 hours.
Often the new kidney will start making urine as soon as your blood starts flowing through it, but you may need dialysis if this is delayed. If all works well you may get home two weeks after the operation.
To prevent your immune system from seeing your new kidney as foreign and rejecting it, you need to take drugs that suppress your immune response. Be sure that you understand the instructions for taking your medicines before you leave the hospital. Missing the tables for 24 hours can cause rejection and you may lose the kidney.
Professor Andy Demaine had a kidney transplant over 40 years ago – now he's enjoying his retirement
Diet. Within reason, you can eat and drink what you want – a normal, healthy, balanced diet. Be careful not to gain weight too quickly and avoid salty foods that can lead to high blood pressure.
Rejection is normally silent (i.e. it causes no symptoms) hence the need for regular blood tests. If anything changes, get your bloods checked as soon as possible.
Find out more about diet
Unfortunately, even if you do everything you're supposed to do, your body may still reject the new kidney, which might mean you need to go back on dialysis and on the waiting list for another kidney.
Simultaneous pancreas and kidney transplantation
Over 40% of kidney patients receiving dialysis also have diabetes. For some of those with insulin-dependent diabetes the option exists of having a simultaneous pancreas and kidney (SPK) transplant. For many patients who receive a SPK transplant, life is completely transformed for the better.
A simultaneous pancreas and kidney (SPK) transplant is a big operation. In general, it is a much more complex operation than a kidney transplant by itself. The transplant operation lasts longer (four to eight hours on average) and involves two separate transplanting teams: one team preparing the pancreas for implantation and a separate team preparing the patient for the pancreas transplant. After the pancreas is transplanted, the kidney is then implanted. Both organs will have been donated by one deceased donor and will be transplanted into a patient with insulin-dependent diabetes mellitus and chronic kidney disease (CKD).
Donating a kidney
If you are considering donating a kidney to a relative, friend or via paired donation please read our leaflet on donating a kidney
It tells you what is involved for donors before, during and after donation.
Please call the Transplant Center at 210-567-5777 for more information.
- Transplant Team
- Your Care Team
- Kidney Transplant
- Your First Visit
- Kidney Transplant Evaluation & Testing
- Are You a Candidate for Kidney Transplant?
- Living Kidney Donation
- Kidney Transplant Waiting List
- Kidney Transplant Surgery
- After Transplant Surgery
- Kidney Transplant Education & Resources
Trust the expert transplant surgeons at University Health for advanced kidney transplantation to help you live longer with a better quality of life.
Highly Skilled Transplant Team
Find patient-centered care from an experienced transplant team and a supportive care team who are passionate about improving your life through transplantation.
If you face kidney failure, work with the expert team at University Health to determine whether a kidney transplant is right for you. The assessment process includes:
- Doctor or self-referral or waiting list
When a Kidney Becomes Available
Rest assured, a transplant coordinator will call you at the phone number you provided when a deceased-donor kidney is available for you.
You’ll receive specific instructions about what to do and when to go to University Health Transplant Institute in San Antonio. Do not eat or drink anything after notification to come for a transplant.
- Health insurance information
Preparation for Surgery
Expect your transplant care team to perform several pre-transplant tests to ensure you are ready for your kidney transplant.
Reasons to Delay
Sometimes we have to cancel transplants because:
- There’s a problem with the donor kidney
- Your final crossmatch test is positive, meaning you have antibodies against the donor kidney and your body would reject the transplanted kidney
- You have a new medical problem that we did not know about
- You have signs of infection
Depend on us to get your “informed consent” before a transplant operation. This means you decide whether or not to have a transplant.
Your kidney transplant will take place the day you arrive at the University Health Transplant Institute. The surgery takes between two and four hours. You’ll be under general anesthesia. Your skilled, experienced transplant surgeon will:
- Make an incision approximately 6 inches long just above the groin
- Remove your damaged kidney
- Attach the artery and vein of your new kidney to one of your existing arteries and veins
- Attach your new kidney’s ureter (the tube that carries urine to the bladder) to your bladder
After surgery, you will recover in a dedicated transplant intensive care unit.
Kidneys are vital organs that play a crucial role in the functioning of your body. They are two bean shaped organs that sit against the back muscles in the upper abdominal cavity and are usually positioned opposite each other on either side of the spine. The right kidney sits a little bit lower than the left to accommodate the liver.
Major functions of the kidneys include extracting waste products from the blood, balancing body fluids, forming urine, controlling blood pressure and the production of red blood cells and producing an active form of vitamin D that keeps bones healthy.
Effects of a non-functioning kidney
If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia. Your hands or feet may swell and you will feel tired and weak as your body builds up the waste that your kidneys are unable to expel.
Untreated, uremia may lead to seizures, coma and ultimately death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplantation.
Diseases resulting in kidney failure
Kidney failure can occur for several reasons including:
- Autoimmune kidney disorders
- Blood-clotting disorders
- Decreased blood flow caused by low blood pressure
- Urinary tract infections
- Complications from pregnancy
- High Blood pressure
The treatment choices for kidney failure include:
Dialysis or transplantation is needed when there is less than 10% of kidney function left. These options are also known as kidney replacement therapy.
Dialysis artificially removes waste from your blood. There are two forms of dialysis:
- Peritoneal dialysis
Haemodialysis filters wastes and removes extra fluid from the blood. Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) and a solution (dialysate) to remove wastes and extra fluid from the body.
The choice of dialysis method depends on factors such as your age, health, and lifestyle. Over 2,000 Australian adults commence kidney replacement therapy each year. The cost of kidney dialysis to the Australian Government is significant, running into hundreds of thousands of dollars each year.
A kidney transplant is a treatment for kidney failure, but not a cure. This is a surgical procedure that takes a kidney from the body of one person (called the Donor) and places it in the body of the person (Recipient) whose kidneys no longer function.
To receive an organ from a donor, you will need to be on the official hospital ‘waiting list’. You will be put on a transplant waiting list when you have end-stage organ failure, all other treatments have failed and your medical specialist believes you will benefit from a transplant. Additionally, you will have to commence dialysis to be placed on the waiting list. – To see more click here
A transplant offers a more active life as well as freedom from dialysis and food and fluid restrictions. It is important to remember that a new kidney requires a lifetime of management and care.
Donation of a kidney
Kidney transplants are the most common transplants that take place in Australia. While most people are born with two kidneys, we can survive with one. The donation of the organ can be made either by:
- Deceased donors or
- Living donors
In Australia, many people sign up to donate their organs after their death. Deceased donor kidney transplants are from individuals that have died from brain death or a circulatory death and have consented through the Organ Donor Register or their next of kin have agreed to donate their loved one’s organ. Deceased donors cannot be directed to a specific recipient, and enter a rigorous and unbiased patient matching scheme. (Scroll down to the appendix to see more on the types of deceased donations).
The typical wait for a kidney transplant in Australia is 4 years. However, waiting times can sometimes be shorter or longer depending on the blood and tissue types of the recipients and donors. The waiting times are also different in each state depending on the population of the state and the number of people that are on the waiting list. E.g. South Australia has the shortest waiting list.
If you are waiting for a kidney, in some cases a person who is close to you may be willing to donate one of their kidneys. They are called living donors. Family members are more likely to match the recipient in terms of blood and tissue type, but not always.
Living donors can also be non-related individuals. In some cases, altruistic donors are willing to donate even if they do not know the recipient. Altruistic donors are entered into the same patient matching scheme as for deceased donors.
There are many steps to becoming a living donor. If you wish to become a living kidney donor, you need to be healthy and over the age of 18. Each case is assessed individually. The living kidney donation process can take up to 3 – 6 months. Even elderly people and those with certain chronic health conditions can be donors. The few medical conditions that prevent organ donation include:
- Active malignancy
- Infectious disease
- Behavior that puts you at risk of infectious disease (e.g. intravenous drug users, sex workers etc.)
- Significant lung and heart disease
- Psychiatric disorder
Living donors are required to undergo certain tests to ensure they are suitable and healthy enough to donate to their own loved ones without putting their own health at risk. Additionally, the medical staff must be certain that the potential living donor is making the decision to donate of their own free will and is not pressured into being a donor through a sense of duty, or through financial incentives. If you’re thinking of becoming a live kidney donor, you may find these videos* and fact sheets helpful to make an informed decision. Find out more about preparing to be a living donor here:
*Permission to host these videos has been provided by Queensland Health.
The Australian Paired Kidney Exchange (AKX) Program
This is a program that has been initiated by the Organ and Tissue Authority (OTA) to increase the options for kidney donation. Sometimes even if a person is ready and willing to donate, they may not be a suitable match for the recipient. The blood group or the tissue type may not be the right match. The Paired Kidney program helps people match up suitable living donors to recipients via a computer based program.
The AKX program uses a computer program to search the database of registered recipient/donor pairs where the donor is not a match for the recipient and identifies another similar pair to match them up so that two simultaneous transplants can occur by exchanging donors.
To find out more information about paired kidney programs, visit the Paired Kidney Program.
In a kidney transplant surgery, a healthy kidney is transplanted from a healthy donor when the patient's kidneys no longer function. Kidney transplant is usually the last and only option for those suffering from end-stage renal failure and have been on haemodialysis. The end-stage renal disease occurs when kidneys lose 90 percent of their normal functional ability, and when that happens, a kidney transplant is often the choice of treatment compared to a lifetime of haemodialysis.
Why choose Manipal Hospitals
At the forefront of kidney transplant, Manipal Hospitals dedicated Centre of Excellence in Organ Transplant is one of the few in its genre to facilitate kidney transplant especially in patients with multiple health problems. The Centre boasts of highly skilled transplant surgeons who have achieved excellence in this intriguing speciality by successfully conducting a number of kidney transplant surgeries in patients who need it the most. This unit sports state of the art Operation Theatres, Labs, Post-transplant ICUs and comfortable, sterile wards.
One of the first centre to do cadaver Kidney transplant in Karnataka and has an active cadaver Programme running.
Kidney transplant has emerged as a silver lining for those suffering from end-stage renal failure. Some of the common reasons for renal failure include
Chronic high blood pressure
Polycystic kidney disease
As in all transplants where your body needs to get used to a new organ, the most serious risk of a transplant is that your body rejects the kidney. However, it’s rare that your body will do that. The immunosuppressant drugs you must take after surgery can lead to some unpleasant side effects as well which may include increased hair growth, weight gain, bone thinning, acne, and a higher risk of developing certain skin cancers and non-Hodgkin’s lymphoma.
Number of cases
We have successfully performed more than 2500 Renal Transplant
Infection control protocol
We have completely isolated highly sterile controlled-environment wards, including the High Efficiency Particulate Air (HEPA) filter unit to prevent infections.
You may have been recommended for a kidney transplant by your nephrologist. This is a serious procedure, and very often you may have to wait for a long time for donor’s kidney. As such, you have to take much care to prepare for the kidney transplant.
After you are recommended a kidney transplant, the first and most important thing to do is to get registered with the national wait-list of organ donors.
Check List for Waiting List
- You have to select a transplant centre (your choice or referral by a doctor). Do research on best kidney transplant hospitals in India.
- Select a centre that matches your requirements (experience/ geographical location/ financial suitability).
- Set up an appointment with the centre.
- Following doctor’s diagnosis, get your transplant team to add your name to the national organ waitlist.
- Get a letter of confirmation from the transplant centre conforming name on waiting list.
- If you haven’t heard from transplant team since long, call coordinator for follow-up.
- Complete all scheduled appointments and evaluations for joining a waiting list.
Your transplant team requires conducting some medical tests for putting your name on the list:
- Function test for kidneys.
- Routine lab tests and physical exam.
- Social, familial and medical histories.
- Compatibility testing (blood type/ tissue type and measurement of PRA or Panel Reactive Antibodies).
- Check for active infections (HIV, Hepatitis).
- Urine tests for 24-hours.
- Imaging tests like Ultrasound.
Based on your health, other tests may be necessary. Your team for kidney transplant will inform you about all tests needed to be an renal transplant candidate.
Throughout the entire transplantation process, the Cleveland Clinic transplant team ensures that you receive the best possible care. Team members are there each step of the way.
Your length of stay and recovery in the hospital will depend on a few factors including: type of transplant procedure, your body’s acceptance of the new organ and your overall health. Remember, each patient has a different rate of recovery. You will be discharged only after your Transplant Team has determined that you have regained your strength and your health is stable.
Transplant team members are available after patients have returned home to provide additional information and answer questions. The team also can help with follow-up care, including routine blood testing, medication evaluation and adaptation, and visits to ensure that patients are doing well. Your transplant team will give you instructions on how and when to contact the post-transplant office following your discharge.
Taking Care of Yourself
Soon after surgery and during your stay in the hospital, your Transplant Team will teach you more about taking your new medicines. You will learn when to take your medicines, how to take them, what happens if you miss a dose, and what side effects the medicines might cause.
A daily record of your health is kept during your stay at the hospital, and you will need to continue monitoring your health when you go home. Before you leave, a nurse will teach you how to accurately measure both your liquid intake and urine output. To ensure that your kidney is functioning well, you will need to measure and record how much you drink and the amount you urinate for at least six weeks after the transplant surgery. You will also need to record your daily temperature, blood pressure, and weight.
When will I be able to go home?
Our goal is to help you feel comfortable and confident about taking care of yourself before you go home. Before going home, you will need to be able to:
- Follow your medicine schedule correctly without assistance
- Take your temperature and blood pressure
- Keep track of and record your fluid intake and urine output
- Know whom to call for an emergency appointment
- Know what problems should be reported to the transplant coordinator
The Transplant Team will be monitoring your health closely after the transplant and during your follow up appointments. Therefore, it is very important to keep your scheduled lab and follow-up appointments.
How should I take care of myself once I go home?
Once you are discharged home, you will need to continue recording your daily temperature, blood pressure and weight in a notebook. It is also very important to keep your list of medications updated.
Remember to keep the records in your notebook for at least six weeks, or longer if you have complications. The Transplant Team will let you know when it is okay to stop recording this information. Remember to always bring your post-transplant notebook and medicines to each Transplant Clinic visit.
What will I need before I go home?
It is important to make sure you have each of these before you go home:
- Blood pressure cuff
- Medication organizer
To decrease the chance of infection, you must avoid people with colds or flu for at least three months. By avoiding illness now, you will be able to return to an active life within a few months.
Tips for a Healthy Transplant Recovery
- Take all your medicines exactly as prescribed
- Keep all of your scheduled appointments with the Transplant Team
- Call the Transplant Team if you have any questions or concerns
- Have your blood drawn promptly, as recommended by the Transplant Team
- Follow your recommended dietary plan
- Follow your recommended fluid intake
- Follow your recommended exercise plan
- Avoid being around anyone who has an infection
Call the Transplant Team if you experience any of the following
- A fever higher than 100°F (38°C)
- Flu-like symptoms such as chills, aches, headaches, dizziness, nausea or vomiting
- New pain or tenderness around the transplant
- Fluid retention (swelling)
- Sudden weight gain greater than 4 pounds within a 24-hour period
- Significant decrease in urine output
What You Need to Know About Kidney Transplant Rejection
What is transplant rejection?
One of the most common complications following a kidney transplant is rejection. Rejection is your body’s way of not accepting the new kidney. Although rejection is most common in the first six months after surgery, it can occur at any time.
Fortunately, the Transplant Team can usually recognize a rejection episode before it causes any major or irreversible damage. It is very important for you to continuously take your medications as prescribed and have your blood work drawn as scheduled.
What are the warning signs of possible rejection?
It is vital for you to be aware of the possible signs of kidney rejection. If you think you are experiencing any of these symptoms, contact the Transplant Team immediately:
- Fever over 100°F (38°C)
- “Flu-like” symptoms: chills, aches, headache, dizziness, nausea and/or vomiting
- New pain or tenderness around the kidney
- Fluid retention (swelling)
- Sudden weight gain greater than 2 to 4 pounds within a 24-hour period
- Significant decrease in urine output
How is rejection identified?
The Transplant Team will be able to determine if your body is rejecting your kidney by completing routine tests of kidney function. If the Team thinks you may be experiencing any problems with your new kidney, the following tests may be completed:
- Repeated blood work
- Renal flow scan (which checks blood flow to the kidney)
- Renal ultrasound (which checks for other physical problems)
- Kidney biopsy
What is a kidney biopsy?
- A kidney biopsy is a procedure in which a small sample of kidney tissue is removed and tested.
- A kidney biopsy is usually performed on an outpatient basis.
- In order to take a biopsy, or a small sample of tissue, the skin above your kidney is numbed to allow a small needle to pass directly through to your kidney. Ultrasound is used to determine the appropriate location to biopsy.
- Once complete, a microscope is used to examine the sample of tissue and establish a diagnosis.
- The actual biopsy generally takes between 20 to 30 minutes.
- You will be required to lie flat for two hours following the procedure to prevent bleeding.
How is rejection treated?
If rejection develops, your physician may prescribe medications to treat rejection and prevent continued complications. In order to control the rejection, you may need to be admitted to the hospital, or you may receive care in the outpatient setting.
Will rejection treatment cause side effects?
The medications used to treat a kidney rejection episode are strong drugs. The first few doses may cause the following side effects:
- Fever, chills
- Nausea, vomiting
- General flu-like symptoms
To help control these symptoms, you may receive a pre-medication of acetaminophen (Tylenol) and diphenhydramine hydrochloride (Benadryl) before each dose.
Waiting for a deceased donor kidney transplant can take an average of three years, or longer. At Memorial Transplant Institute, our dedicated transplant specialists understand how stressful this waiting period can be. We stay in close contact with patients and provide the support you need to ensure you’re ready for kidney transplant surgery at a moment’s notice.
Before Kidney Transplant Surgery: How to Prepare
We add all eligible patients to the United Network for Organ Sharing (UNOS) kidney transplant list, which matches organs from deceased donors with individuals based on the severity of their condition. Because there are more people in need of a kidney than available organs, most people wait at least three years for a deceased donor kidney transplant.
Our team is committed to working with patients to ensure you’re ready for transplantation when a donor organ becomes available. We:
- Tell you what to expect: Someone waiting for a kidney could receive a call that an organ is available at any time — day or night, even on a weekend or holiday. Because of the timely nature of transplantation, once a donor organ becomes available, you’ll be asked to come to the hospital immediately. As soon as you’re eligible for the national kidney transplant list, our transplant coordinator will start preparing you for what to expect when you receive the organ offer call.
- Help you keep track of medical tests: There’s no time to redo medical tests once an organ becomes available, so up-to-date medical tests are essential for transplantation. Certain tests need to be repeated yearly (or more often). We’ll help remind you of testing requirements and give you tips to help you keep track of testing dates.
- Provide regular follow-up care: If you’re waiting to be matched to a deceased donor kidney, we’ll see you every six months or sooner to monitor your health. During these visits, our team will also ask about the support network available to you and ensure that a plan for who will take care of you after kidney transplant surgery is still in place.
- Support you at every point: Our caring professionals will point you to resources that can help you cope with any anxiety or stress you may feel during the waiting process. We’ll make sure you know that you can always reach out to us with any questions or concerns you have.
Your life after kidney transplantation will change in many ways, from the kind of medical care you need to your energy levels and so much more. Start preparing yourself for what’s to come by learning about our resources for patients and families. You can also read our kidney transplant caregiver tips.
Learn More About Adult Kidney Transplant
We are always just a phone call away. You can learn more about our customized adult kidney transplant care by calling us anytime at 954-265-7450.
Learn More About Pediatric Kidney Transplant
If you believe your child may benefit from a kidney transplant, we want to hear from you. You can learn more about our personalized pediatric kidney transplant care by calling us anytime at 954-265-7450.
Schedule an Appointment
Call Memorial Transplant Institute to schedule an appointment or to learn more.
A transplant nurse coordinator will collect the appropriate medical records and schedule a transplant evaluation. Your transplant nurse coordinator will communicate with you and your medical team throughout the transplant process.
You will have a comprehensive evaluation by all members of our transplant team, including the transplant physicians, transplant surgeons, transplant nurse coordinator, social worker, financial coordinator, dietitian and psychologist.
The team will determine which tests and labs will be required to determine if you are a transplant candidate.
After completing the evaluation process and determining that you are eligible for a kidney transplant, you may be transplanted with a kidney from a living donor, if one is available. You can also be placed on the waiting list with the United Network of Organ Sharing (UNOS).
For patients on the kidney transplant waiting list, the Missouri Kidney Collaborative has created a resource for patients and caregivers, My Transplant-Ready Workbook. This free online workbook will help prepare patients for the transplant process and recovery.
Once an organ is available for transplantation, you will be notified by one of the transplant coordinators. You will go to University of Missouri Health Care to be admitted to the surgery floor.
After the surgery, the transplant team will follow the patient closely during recovery. In the first few weeks after discharged from the hospital, you will be seen frequently.
Once you are home, your nurse coordinator will be in regular contact with you. In the first few weeks after discharge from the hospital, you will be seen once or twice per week in our outpatient transplant clinic. Over time, routine care will be transitioned to your primary care physician. For continuity of care and to ensure the best outcomes, we continue to follow our transplant patients for life.
Adjusting to life after a kidney transplant will take time. Our doctors and staff work with you to make sure you’re taking care of your physical and emotional health. Learn more about what to expect after your kidney transplant and find helpful resources by visiting our life after transplant page.
Having a kidney transplant is a life-changing event, and the steps involved can be challenging. We want to make sure you and your loved ones know what those steps are, what to expect, and how to prepare. We also want you to know we’ll be right there with you, providing the care and support you need — before, during, and long after your kidney transplant.
Here’s what happens after we receive the referral from your doctor and an appointment is made.
You’ll Be Assigned a Transplant Coordinator
Your pre-transplant coordinator is a nurse with special training and experience in organ transplants. They will be your main point of contact — answering your questions and helping you arrange tests and appointments — from your initial evaluation until your transplant surgery.
You’ll Have a Comprehensive Evaluation to See if You’re a Candidate
You and your caregivers will come to our clinic for a one-day evaluation. You’ll see a nephrologist, kidney transplant surgeon, and other members of our transplant team. You will also undergo a series of tests during or following your evaluation. Some of these tests can be performed close to your home. The transplant team will use the information they gather to understand your needs and to determine if a kidney transplant at Duke will meet those needs.
Your Kidney Transplant Options
Once you are approved for a kidney transplant, we start the process of finding the right kidney for you. You may have the option to receive a kidney from a living donor, or you will be placed on the waitlist for a kidney from a deceased donor.
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Kidney Transplant Surgery
Scheduling Kidney Transplant Surgery
If you are receiving a kidney from a living donor, they will undergo an evaluation and tests to determine if you are a match. Once that is complete, your surgery can be scheduled in advance for a date that is convenient for both of you.
If You Are on the Kidney Waitlist
If you are receiving a kidney from a deceased donor, you will need to arrive at Duke University Hospital within several hours (ground travel time) of when we notify you that a kidney is available. Before the surgery, we’ll do blood tests to confirm that the kidney is a match for you.
If you are interested in making an appointment for an evaluation, please ask your nephrologist to submit a referral.
Your Transplant Coordinators Will Guide You
You will have an inpatient transplant coordinator when you are in the hospital for your transplant surgery and a post-transplant coordinator for your follow-up care.
Typical Length of Kidney Transplant Surgery
Kidney transplant surgery typically takes four to six hours. After the surgery, you’ll remain in the hospital for four to six days to recover. We’ll carefully monitor your fluid status and urine output to make sure your new kidney is functioning adequately. Your surgeon, nephrologist, transplant coordinator, and others will visit you daily to check on your progress.
Kidney transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our nephrology clinics in Durham.
Kidney Transplant Recovery
In the First Weeks
During the initial weeks after your kidney transplant, you’ll need to follow a strict medical regimen to recover and reduce the chances your body will reject the transplanted kidney. In addition to taking anti-rejection medications, you’ll be asked to regularly measure and record your fluid intake and output, blood pressure, temperature, and (if you have diabetes) blood sugar.
You’ll Receive Nutrition Instructions
While it’s likely that you’ll no longer need to follow a “renal diet,” you will be given comprehensive nutrition instructions to follow for the first six weeks after your transplant. For the first month, you’ll also come in for weekly clinic visits. We’ll check your incisions, medication levels, and kidney function.
Follow-up Clinic Visits
After the first four to six weeks, your visits will be spaced further apart — but we’ll continue to monitor you to manage your risks and the side effects from your anti-rejection medications. Your post-transplant coordinator and your care team will be there to promote your long-term health — and that of your transplanted kidney — for the rest of your life.
One of North Carolina’s Best Kidney Transplant Centers
If you need kidney transplant surgery, you can feel confident choosing Duke for your care. Our team has performed thousands of complex kidney transplants that have improved the quality of life for our patients and their loved ones.
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Why Choose Duke
We offer a comprehensive, one-day evaluation. You’ll be seen by all the necessary specialists — a nephrologist, transplant surgeon, dietitian, social worker, financial counselor, and possibly a psychologist — during one visit, at one clinic location. We conduct these evaluations three times a week and often have appointments available within a few weeks. You’ll get from a referral by your doctor to a decision by our team faster than any other center in the state.
We’re Good (Organ) Matchmakers
We get to know you, your medical conditions, and what kind of kidney transplant you need, and we stay up-to-date on your status. When we get offers for available kidneys, we use a systematic approach to consider each one carefully, to ensure it is the offer that will fit your needs the best. During the process, we make every effort to find you a kidney, and we make sure you’re ready when the right one becomes available.
We Achieve Excellent Results
Our outcomes are consistently excellent — a notable accomplishment considering that we often perform transplants for people who have multiple, complex medical problems.
We Have Extensive Experience
The Duke kidney transplant program has been performing kidney transplants for nearly 50 years. It is one of the highest volume programs in North Carolina.
Kidney transplant surgery is performed at Duke University Hospital. Pre- and post-transplant appointments take place at our nephrology clinics in Durham.
You Have Options if You and Your Donor Don’t Match
If a loved one offers to donate a kidney and it’s medically safe for that person to do so, there are multiple routes for you to take. The simplest is for you to receive your donor’s kidney if blood and tissue tests show that you’re a match. If you and your donor aren’t a match, you may be eligible for another option such as:
- ABO-incompatible transplantation: You receive medical treatments before and after transplant that allows you to receive a kidney from a donor with a different blood type.
- Paired exchange: You receive a kidney from someone else’s donor, and another recipient receives your donor’s kidney.
We Prepare You for Transplant Quickly
If you are considered a candidate for a kidney transplant but do not have a potential living donor, you will be waitlisted in a national database maintained and administered by the United Network of Organ Sharing (UNOS). While our wait times are on par with national averages, we prepare you to be transplanted quickly. We have one of the largest active waiting lists in the region, meaning more of our patients are ready to get a kidney when a kidney is offered.
You’ll Stay in a Dedicated Hospital Unit for Transplant Patients
Our solid organ transplant unit is dedicated to caring for people throughout their organ transplant journey, whether they are waiting for a transplant, recovering from surgery, or are returning to the hospital. The unit is staffed by a dedicated team of providers experienced in caring for people undergoing liver, kidney, small bowel, pancreas, or intestinal transplants. These include doctors, nurses, pharmacists, social workers, patient coordinators, and more. Patients and their families can establish relationships with our providers and staff and feel secure in the hospital environment.
If you are interested in making an appointment for an evaluation, please ask your nephrologist to submit a referral.
HIV-Positive Kidney Transplants
The HOPE Act made it possible for HIV-positive donors to offer their organs to HIV-positive recipients. Duke is the only transplant center in North Carolina, and one of just a few in the nation currently approved to perform HOPE Act living donor kidney transplants. In 2019, our kidney transplant surgeons performed the first live kidney donation under the HOPE Act in North Carolina and the Southeast region, and the second in the United States.
Options if You’ve Had a Prior Transplant
If you’ve had a prior transplant, we offer multiple anti-rejection regimens. These options can make it more likely you’ll find a match among potential living donors and more likely we can waitlist you for a deceased donor transplant. If your immune system is highly sensitized, our innovative, newly available approaches are proving better at overcoming this problem.
We Perform Multi-Organ Transplants
Our colleagues in the other Duke organ transplant teams share our commitment to providing you the life-changing transplant you need with the best possible outcome. We regularly partner with them to help you and your caregivers throughout each step of the process.