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About Kidney Transplants
A successful kidney transplant provides many benefits. Most people report increased strength, stamina and energy. They can return to a more normal lifestyle without being dependent on dialysis.
Kidney transplantation means placing a healthy donor kidney into the body where it can perform all the functions that a failing kidney cannot. In most cases, the diseased kidneys, located in the abdomen near the lower back, are not removed. The new kidney is positioned in the pelvic area where it is surgically connected to nearby blood vessels.
Decades of surgical experience, research advances and improved medications that prevent organ rejection have all helped improve the success rate for kidney transplants. If a transplant is not successful, the recipient can return to a regular dialysis schedule or, possibly, undergo another transplant.
Deciding that transplantation is the best option to treat your condition is a crucial phase of transplant evaluation. Many complications of advanced kidney disease can be managed with medical or surgical treatments other than transplantation. You and your physician should discuss these alternatives.
Tissue Typing
Tissue-Typing and Cleveland Clinic’s Allogen Laboratories
Determining in advance whether a donated kidney is likely to be tolerated by a recipient’s body is crucial to the success of a transplant. The recipient’s and donor’s blood type and tissue type must be compatible. The recipient’s blood also is tested for antibodies — substances the body produces to destroy foreign materials — because the body may recognize the transplanted kidney as foreign material. Patients on a waiting list for a kidney supply tubes of blood each month to monitor antibodies and test compatibility with potential donors. Blood test results are entered into a computer at UNOS, the national transplant organization, so that when a deceased-donor kidney becomes available, the UNOS computer can evaluate its suitability. For more information on UNOS and the evaluation/waiting process, visit unos.org.
Tissue-typing tests for Cleveland Clinic patients are performed at Allogen Laboratories. The lab’s highly trained technologists are on call 24 hours a day, seven days a week, to perform the necessary tests whenever a kidney becomes available. They perform more than 2,000 tests each month.
Allogen Laboratories was one of the first tissuetyping labs in the country when it was founded in 1968, and it remains one of the largest labs in the country today. The lab meets stringent standards and is fully accredited by UNOS, the American Society for Histocompatibility and Immunogenetics, and several other quality-regulating organizations.
Transplant Evaluation
Patients referred to Cleveland Clinic’s Kidney Transplant Program receive comprehensive education about the transplant process. They also will be thoroughly evaluated by our multidisciplinary team to determine whether transplantation is an appropriate treatment option. Medical tests will help the team make this determination.
Kidney Donations
Kidneys for transplantation come from living donors or deceased donors. A living-donor transplant is a procedure in which a kidney is surgically removed from a healthy person and placed in a person with kidney failure. Deceased-donor kidneys are obtained from people who have expressed their desire to be organ donors and whose family has consented. All donors are carefully screened to prevent the transmission of disease via the donor organ. Currently, nearly 40 percent of kidneys come from living donors, and 40 percent of those donations are from donors not related to the recipients.
Some people may worry about the consequences of donating a kidney. However, a healthy person can donate a kidney safely without negatively affecting his or her own kidney function, general health, lifestyle or life span. People can function as well with one healthy kidney as with two. For more information on becoming a kidney donor, call 216.445.3150.
Living-Donor Transplants
Siblings generally make the best living donors. However, with advancements in drugs and treatment to prevent rejection, anyone can be considered for organ donation if he or she has a compatible blood type and a favorable tissue-typing crossmatch with the recipient. Most healthy people between the ages of 18 and 60 are potential candidates for organ donation.
Cleveland Clinic encourages the use of living-donor transplants whenever possible because of their high success rate. Among patients who received kidney transplants from living donors at Cleveland Clinic during the past several years, on average, 96 percent had transplanted kidneys that were still functioning one year later. Of those who received deceased-donor kidneys, 93 percent had transplanted kidneys that were still functioning one year later.
Additional advantages of living-donor transplant are that the surgery can be scheduled in advance and the amount of time spent on a waiting list can be shortened. A patient awaiting a deceased-donor transplant does not know when a kidney will become available and can remain “on call” from a few weeks to several years. (The average wait time for a deceased-donor kidney is three to five years.)
Removing a Kidney from a Living Donor
Since 1995, Cleveland Clinic urologists have been primarily using a minimally invasive procedure known as laparoscopic donor nephrectomy to remove a kidney for donation. The operation typically requires three to four small incisions, including one to remove the kidney, intact, from the donor’s body. Cleveland Clinic urologists pioneered the technique and have experience with over 1000 procedures. The main advantage to the donor for laparoscopic removal is a more rapid recovery to normal activities, compared to an open technique. There is also less pain medication required and an improved cosmetic appearance.
Open nephrectomy is typically performed using a muscle cutting incision on the side of the abdomen. Sometimes a portion of a rib needs to be removed. Open nephrectomy is performed in selected circumstances to preserve the anatomic integrity of the donor organ to ensure it functions well in the recipient, especially for removal of a right donor kidney. The recovery and pain medication requirements for open donor nephrectomy patients are slightly greater than with laparoscopic removal.
The vast majority of living donor kidneys can be removed using the laparoscopic technique. Your doctors will advise you when an open technique would be a better approach.
Paired Donation Network
Living donors that do not match their intended transplant recipient have the option of participating in a paired donation program. This program allows the living donor to give his or her kidney to another recipient, and the donor’s intended recipient would receives a kidney from another compatible living donor
Laparoscopic Procedure
Laparoscopy is a minimally invasive surgical procedure in which a special camera, called a laparoscope, is used to produce an inside view of the abdominal cavity. Surgeons use the laparoscope, which transmits a real-time image of the internal organs to a video monitor, to guide them through surgical procedures. The laparoscope magnifies these images many times their actual size, providing surgeons with a superior view of the abdomen.
Laparoscopic nephrectomy is a minimally invasive procedure that uses a laparoscope to help remove a kidney for donation. Laparoscopic kidney removal is considered minimally invasive because it requires only three or four small non-muscle-cutting incisions rather than one large muscle-cutting incision in the abdomen.
Deceased-Donor Kidneys
Transplant candidates who do not have a living donor whose kidney is a suitable match can receive a deceased-donor kidney transplant. Candidates’ names are placed on the United Network for Organ Sharing (UNOS) national transplant waiting list, and every effort is then made to find a compatible donor kidney as soon as possible.
To help locate and transport donor kidneys from anywhere in the country, Cleveland Clinic coordinates transplant activities with LifeBanc, the Northeast Ohio organ procurement organization.
Are You an Organ Donor?
Are you an organ donor? Spread the word!
Talking about donation doesn’t mean talking about death. Talking about donation means talking about the opportunity to give another person a second chance at life — about giving that final gift that will impact another person and his or her family forever.
If you haven’t discussed with your family how you feel about donation, they may not know what to do. Knowing that their loss has given hope and help to others in need can provide lasting consolation to your family.
For information on how to sign up to be an organ donor, visit Donate Life America at www.donatelife.net.
Multiple Listing for Kidney Transplant
Multiple listing is registering at two or more transplant centers. Candidate listing in two or more separate geographic areas will increase the number of potential organ offers by exposing candidates to a larger pool of donors.
Our Transplant Team
Throughout the transplantation process, Cleveland Clinic’s transplant team ensures that you receive the best possible care. Team members are there at every step to provide guidance, discuss what to expect and answer questions.
- Board-certified nephrologists - kidney disease specialists who have training and experience in caring for kidney transplant patients and who monitor their medical care
- Transplant coordinators - registered nurses who serve as the transplant patient’s contact throughout the transplant process and who educate patients and family members about new medications and life after transplantation
- Board-certified urologic surgeons - surgeons with specialized training and experience in kidney transplantation and who perform the operation
- Living-kidney-donor advocates - trained, knowledgeable professionals who can explain the donation and transplantation process and answer living-kidney-donors’ questions
- Nurse Practitioners - advanced practice nurses who have experience in caring for kidney transplant patients and monitor their medical care in collaboration with transplant nephrologists and transplant surgeons.
- Social workers - Available throughout the transplant process to help identify and address patients’ social issues and needs, providing services such as education and counseling about lifestyle changes and referrals to community agencies
- Registered dietitians - are available throughout the transplant process to provide nutritional education and support.
- Transplant pharmacists - evaluate patients for potential medication interactions and provide education regarding new medications. Additional consultations may also be needed to evaluate the health status of the potential transplant recipient.
- Financial counselors - can answer questions about insurance coverage and Medicare benefits related to transplant surgery and care
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.
Special Care for Pediatric Patients
Cleveland Clinic’s Pediatric Kidney Transplant program began in 1963 with the goal of providing the most normal life possible for young patients. Pediatric and adolescent patients receiving a kidney transplant are admitted to Cleveland Clinic Children’s, where they receive leading-edge care in a homelike setting. Because family members play an important role in a hospitalized child’s recovery, our hospital rooms are designed to enable parents to spend the night with their child.
For more information on Cleveland Clinic’s pediatric transplant program, call 216.444.6996.
Patient Services
Medical Concierge
If you are traveling from out of state and need any assistance, call the complimentary Medical Concierge at 800.223.2273, ext. 55580, or email medicalconcierge@ccf.org.
Global Patient Services
Complimentary assistance for national and international patients and families is available at 001.216.444.8184, or visit clevelandclinic.org/gps.
MyChart
Cleveland Clinic MyChart® is a secure, online personal healthcare management tool that connects patients to portions of their medical record at any time, day or night. Patients can view test results, renew prescriptions, review past appointments and request new ones. Our latest feature, Schedule My Appointment, allows patients to view their primary care physician’s open schedule and make appointments online in real time. Patients register for MyChart through their physician’s office or online.
Accommodations for Families
Support from loved ones is an important part of the recovery process after transplant surgery. Visitors will find ample lodging accommodations in the area around Cleveland Clinic. For more information on nearby accommodations, call our transplant office at 216.444.6996 or visit clevelandclinic.org and click on Patients & Visitors. For families of pediatric transplant patients, there is a Ronald McDonald House adjacent to Cleveland Clinic. For more information, call 216.229.5758.
Appointments & Locations
Appointments
For more information about Cleveland Clinic’s kidney transplant program or to schedule an appointment, call:
Cleveland Clinic main campus Pre-Kidney Transplant
216.444.6996
Akron General Kidney Transplant Evaluation Clinic
330.344.5369
Cleveland Clinic Florida
954.659.5133
Charleston Area Medical Center
304.388.6370
Locations
Cleveland Clinic urologists also perform kidney transplants at this affiliate location:
Charleston Area Medical Center
1201 Washington St. East
Charleston, WV 25301
Virtual Second Opinion
If you cannot travel to Cleveland Clinic, help is available. You can connect with Cleveland Clinic specialists from any location in the world via a phone, tablet, or computer, eliminating the burden of travel time and other obstacles. If you’re facing a significant medical condition or treatment such as surgery, this program provides virtual access to a Cleveland Clinic physician who will review the diagnosis and treatment plan. Following a comprehensive evaluation of medical records and labs, you’ll receive an educational second opinion from an expert in their medical condition covering diagnosis, treatment options or alternatives as well as recommendations regarding future therapeutic considerations. You’ll also have the unique opportunity to speak with the physician expert directly to address questions or concerns.
Why Choose Us?
Cleveland Clinic has made significant contributions to the prevention and treatment of kidney disease.
Our commitment to innovation in treating kidney failure dates back to the 1950s, with the development and refinement of dialysis techniques to enable patients’ survival.
Other milestones include:
- Developing one of the first deceased-donor kidney transplant programs in the world in 1963
- Performing the first kidney transplant in Ohio
- Pioneering extracorporeal renal surgery (in which the kidney is removed from the body, repaired and reimplanted) to treat complex kidney disorders
- Pioneering laparoscopic minimally invasive procedures to treat kidney diseases
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