Kidney transplant

What is 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. The wait is usually a few years.

Symptoms

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:

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.

Complications of the procedure

Kidney transplant surgery carries a risk of significant complications, including:

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:

Choosing a transplant center

If your doctor recommends a kidney transplant, you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.

When you're considering transplant centers, you may want to:

After you've selected a transplant center, you'll need an evaluation to determine whether you meet the center's eligibility requirements for a kidney transplant.

The team at the transplant center will assess whether you:

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:

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.

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:

Kidney transplant surgery usually lasts about three to four hours.

After a kidney transplant

After your kidney transplant, you can expect to:

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.

Kidney transplant survival rates

According to the Organ Procurement and Transplantation Network:

Results for each transplant center can be found at the Scientific Registry of Transplant Recipients.

If your new kidney fails, you can resume dialysis or consider a second transplant. You may also choose to discontinue treatment. This important decision depends on your current health, your ability to withstand surgery and your expectations for maintaining a certain quality of life.