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. 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. 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. Your social worker or insurance coordinator can help you figure out how much coverage you'll have. As with any surgery, there may be issues and complications. Potential risks after kidney transplant surgery include:.
Get the latest news in kidney care and delicious kidney-friendly recipes, plus inspiring stories from people living with kidney disease. What Is a Kidney Transplant? Home Treatments Transplant. A kidney transplant, sometimes known as a renal transplant, is a treatment for kidney failure at end stage renal disease ESRD.
Kidney transplant surgery is a major surgery during which a person with kidney failure receives a new kidney—either from a living donor or a deceased donor.
A successful kidney transplant is closest to natural kidney function and considered the most effective treatment for ESRD—offering a chance for a longer, healthier life. What does kidney transplant surgery involve? How long does a kidney transplant last? The average lifespan of a transplanted kidney is years, though some transplants will last longer. Some people may need multiple transplants in their lifetime. Find out what to consider and how to get started in your search for a kidney match.
Choose the class format that fits your life—self-guided or with an educator. Kidney transplant requirements If you choose to have a kidney transplant surgery, you should know that your best chance for a successful transplant depends on certain factors. Kidney transplant requirements include the following:. Good overall health If your doctor feels you may be a good candidate, he or she will most likely recommend a kidney transplant.
To make sure you are healthy enough for surgery, you will need to have a complete medical exam and a series of tests to screen for any medical conditions that may affect your ability to have a good outcome. A good kidney donor match For a kidney transplant to be successful, the new kidney must be from a donor who has the same tissue type and a compatible blood type.
An ideal match is from a living donor with the same tissue and blood type, whose genetic characteristics are most like your own.
However, it also involves a life-long dependence on drugs to keep the new kidney healthy. Some of these drugs can have severe side effects. Some kidney patients consider a transplant after beginning dialysis; others consider it before starting dialysis. In some circumstances, dialysis patients who also have severe medical problems such as cancer or active infections may not be suitable candidates for a kidney transplant. Sometimes family members, including brothers, sisters, parents, children 18 years or older , uncles, aunts, cousins, or a spouse or close friend may wish to donate a kidney.
That person is called a "living donor. Any healthy person can donate a kidney safely. A deceased donor kidney comes from a person who has suffered brain death. The Uniform Anatomical Gift Act allows everyone to consent to organ donation for transplantation at the time of death and allows families to provide such permission as well. After permission for donation is granted, the kidneys are removed and stored until a recipient has been selected.
Regardless of the type of kidney transplant-living donor or deceased donor-special blood tests are needed to find out what type of blood and tissue is present. These test results help to match a donor kidney to the recipient. The first test establishes the blood type. Everyone fits into one of these inherited groups. The recipient and donor should have either the same blood type or compatible ones, unless they are participating in a special program that allow donation across blood types.
The list below shows compatible types:. Blood type O is the hardest to match. Although people with blood type O can donate to all types, they can only receive kidneys from blood type O donors. For example, if a patient with blood type O received a kidney from a donor with blood type A, the body would recognize the donor kidney as foreign and destroy it.
The second test, which is a blood test for human leukocyte antigens HLA , is called tissue typing. Antigens are markers found on many cells of the body that distinguish each individual as unique. These markers are inherited from the parents. Both recipients and any potential donors have tissue typing performed during the evaluation process.
To receive a kidney where recipient's markers and the donor's markers all are the same is a "perfect match" kidney. Perfect match transplants have the best chance of working for many years.
Most perfect match kidney transplants come from siblings. Although tissue typing is done despite partial or absent HLA match with some degree of "mismatch" between the recipient and donor. Throughout life, the body makes substances called antibodies that act to destroy foreign materials. Individuals may make antibodies each time there is an infection, with pregnancy, have a blood transfusion, or undergo a kidney transplant. If there are antibodies to the donor kidney, the body may destroy the kidney.
For this reason, when a donor kidney is available, a test called a crossmatch is done to ensure the recipient does not have pre-formed antibodies to the donor. The crossmatch is done by mixing the recipient's blood with cells from the donor. If the crossmatch is positive, it means that there are antibodies against the donor. The recipient should not receive this particular kidney unless a special treatment is done before transplantation to reduce the antibody levels.
If the crossmatch is negative, it means the recipient does not have antibodies to the donor and that they are eligible to receive this kidney. Crossmatches are performed several times during preparation for a living donor transplant, and a final crossmatch is performed within 48 hours before this type of transplant.
Testing is also done for viruses, such as HIV human immunodeficiency virus , hepatitis, and CMV cytomegalovirus to select the proper preventive medications after transplant.
These viruses are checked in any potential donor to help prevent spreading disease to the recipient. This period refers to the time that a patient is on the deceased donor waiting list or prior to the completion of the evaluation of a potential living donor.
The recipient undergoes testing to ensure the safety of the operation and the ability to tolerate the anti-rejection medication necessary after transplantation. The type of tests varies by age, gender, cause of renal disease, and other concomitant medical conditions. These may include, but are not limited to:. The transplant surgery is performed under general anesthesia. The operation usually takes hours. This type of operation is a heterotopic transplant meaning the kidney is placed in a different location than the existing kidneys.
Liver and heart transplants are orthotopic transplants, in which the diseased organ is removed and the transplanted organ is placed in the same location. The kidney transplant is placed in the front anterior part of the lower abdomen, in the pelvis. The original kidneys are not usually removed unless they are causing severe problems such as uncontrollable high blood pressure, frequent kidney infections, or are greatly enlarged.
The artery that carries blood to the kidney and the vein that carries blood away is surgically connected to the artery and vein already existing in the pelvis of the recipient. The ureter, or tube, that carries urine from the kidney is connected to the bladder. Recovery in the hospital is usually days. Complications can occur with any surgery. The following complications do not occur often but can include:. The post transplant period requires close monitoring of the kidney function, early signs of rejection, adjustments of the various medications, and vigilance for the increased incidence of immunosuppression-related effects such as infections and cancer.
Just as the body fights off bacteria and viruses germs that cause illness, it also can fight off the transplanted organ because it is a "foreign object. Most rejections occur within six months after transplantation, but can occur at any time, even years later.
Prompt treatment can reverse the rejection in most cases. Anti-rejection medications, also known as immunosuppressive agents, help to prevent and treat rejection. They are necessary for the "lifetime" of the transplant. If these medications are stopped, rejection may occur and the kidney transplant will fail.
Below is a list of medications that might be used after a kidney transplant. A combination of these drugs will be prescribed dependent on the specific transplant needs. Prednisone is taken orally or intravenously. Most side effects of prednisone are related to drug dosage levels. Prednisone is used at low dosages to minimize side effects. The possible side effects of prednisone are:. The most common side effects associated with azathioprine are:.
The most common side effects of mycophenolate mofetil are:. It provides the same active ingredient as mycophenolate mofetil and generally has the same side effect profile. It is enterically coated to potentially reduce abdominal aches and diarrhea. The most common side effects of sirolimus are:. The most common side effects of cyclosporine therapy are:. These medications rarely cause side effects but can include:. Any healthy person can donate a kidney.
When a living person donates a kidney the remaining kidney will enlarge slightly as it takes over the work of two kidneys. Donors do not need medication or special diets once they recover from surgery. As with any major operation, there is a chance of complications, but kidney donors have the same life expectancy, general health, and kidney function as most other people. The kidney loss does not interfere with a woman's ability to have children.
If a person successfully completes a full medical, surgical, and psychosocial evaluation they will undergo the removal of one kidney.
Most transplant centers in the United States use a laparoscopic surgical technique for the kidney removal. This form of surgery, performed under general anesthesia, uses very small incisions, a thin scope with a camera to view inside of the body, and wand-like instruments to remove the kidney.
Compared with the large incision operation used in the past, laparoscopic surgery has greatly improved the donor's recovery process in several ways:.
The operation takes hours. Recovery time in the hospital is typically days. Donors often are able to return to work as soon as weeks after the procedure.
Occasionally the kidney needs to be removed through an open incision in the flank region. Prior to the use of the laparoscopic technique, this surgery was the standard for the removal of the donated kidney. It involves a inch incision on the side, division of muscle and removal of the tip of the twelfth rib. The operation typically lasts 3 hours and the recovery in the hospital averages days with time out of work of weeks. Although laparoscopy is increasingly used over open surgery, from time to time, the surgeon may elect to do an open procedure when individual anatomic differences in the donor suggest that this will be a better surgical approach.
The quality and function of the kidneys recovered with either technique work equally well. Regardless of technique all donors will require lifelong monitoring of their overall health, blood pressure and kidney function.
Many patients have relatives or non-relatives who wish to donate a kidney but are not able to because their blood type or tissue type does not match.
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