A kidney transplant is a surgery done to replace a diseased kidney with a healthy kidney from a donor. The kidney may come from a deceased organ donor or from a living donor. Family members or others who are a good match may be able to donate one of their kidneys. This type of transplant is called a living transplant. People who donate a kidney can live healthy lives with one healthy kidney.
A person getting a transplant most often gets just 1 kidney. In rare situations, he or she may get 2 kidneys from a deceased donor. The diseased kidneys are usually left in place. The transplanted kidney is placed in the lower abdomen on the front side of the body.
You may need a kidney transplant if you have end stage renal disease (ESRD). This is a permanent condition of kidney failure. It often requires dialysis. This is a process used to remove wastes and other substances from the blood.
Some conditions of the kidneys that may result in ESRD include:
Other conditions, such as congenital defects of the kidneys, may result in the need for a kidney transplant.
There may be other reasons for your doctor to recommend a kidney transplant.
As with any surgery, complications can occur. Some complications may include:
The new kidney may be rejected. Rejection is a normal reaction of the body to a foreign object or tissue. When a new kidney is transplanted into a recipient's body, the immune system reacts to what it thinks as a threat and attacks the new organ. For a transplanted organ to survive, medications must be taken to trick the immune system into accepting the transplant and not attacking it as a foreign object.
The medications used to prevent or treat rejection have side effects. The exact side effects will depend on the specific medications that are taken.
Not everyone is a candidate for kidney transplantation. You may not be eligible if you have:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your transplant team before the procedure.
To get a kidney from an organ donor who has died (cadaver), you must be placed on a waiting list of the United Network for Organ Sharing (UNOS). Extensive testing must be done before you can be placed on the transplant list.
A transplant team carries out the evaluation process for a kidney. The team includes a transplant surgeon, a transplant nephrologist (doctor specializing in the treatment of the kidneys), one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Other team members may include a dietitian, a chaplain, and/or an anesthesiologist.
The evaluation includes:
The transplant team will weigh all the facts from interviews, your medical history, physical exam, and tests to determine your eligibility for kidney transplantation.
Once you have been accepted as a transplant candidate, you will be placed on the UNOS list. When a donor organ becomes available, you will be notified and told to come to the hospital right away.
If you are to get a kidney from a living family member (living-related transplant), the transplant may be done at a planned time. The donor must have a compatible blood type and be in good health. A mental health check will be done to be sure the donor is comfortable with the decision.
These steps will happen before the transplant:
A kidney transplant requires a stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Generally, a kidney transplant follows this process:
Talk with your healthcare provider about what you will go through during your kidney transplant.
Tell your doctor if you have:
Fever and tenderness over the kidney are some of the most common symptoms of rejection. A rise in your blood creatinine level (blood test to measure kidney function) and/or blood pressure may also suggest rejection. The symptoms of rejection may look like other medical conditions or problems. Consult your transplant team with any concerns you have. Frequent visits to and contact with the transplant team are vital.
Avoid places in which you may be exposed to anyone who may be sick. This is because your immune system will be suppressed to protect you from rejecting the new kidney. This will be a lifelong precaution.
Your healthcare team may give you other instructions after the procedure, depending on your situation.
To allow the transplanted kidney to survive in your body, you will be given medications for the rest of your life to fight rejection. Each person may react differently to medications.
New anti-rejection medications are continually being developed and approved. Your health care team will tailor medication regimes to meet your needs.
Usually several anti-rejection medications are given at first. The doses of these medications may change often, depending on your response. Because anti-rejection medications affect the immune system you will be at higher risk for infections. A balance must be maintained between preventing rejection and making you very susceptible to infection.
Some of the infections you will be especially at risk for include oral yeast infection (thrush), herpes, and respiratory viruses. Avoid contact with crowds and anyone who has an infection for the first few months after your surgery.