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Kidney transplantation is the best way to treat kidney failure or end-stage renal disease (ESRD). The benefits of a successful kidney transplant are many. Most people find they have increased stamina and energy. They can return to a more normal lifestyle, and those who were dependent upon dialysis can enjoy newfound freedom. Over the years, the number of successful transplants has continued to grow. However, if a kidney transplant is not successful, the recipient can return to a regular dialysis schedule. It is possible to undergo more than one transplant.
Getting on the transplant list
When a physician determines you need a kidney transplant, you can contact the Cleveland Clinic’s Kidney Transplant Office at 216.444.6996 to schedule a pre-transplant evaluation. Evaluations for pediatric patients are arranged by calling 216.445.7573. This evaluation, which is generally completed in a single day, consists of a complete physical exam and consultations with members of your personal transplant team. This team includes:
- A nephrologist, a kidney disease specialist who has training and experience in caring for kidney transplant patients, who will monitor all of your medical care before, during, and after your transplant.
- A transplant surgeon, who is specially trained and experienced in kidney transplantation and who will actually transplant the new kidney.
- A social worker, available throughout the transplant process to help you and your family identify and evaluate the problems and needs associated with your illness. He or she can provide education, counseling regarding lifestyle changes, referrals to community agencies, and any other help you need in adjusting to chronic illness.
- A Patient Financial Advocate who can answer any questions that you or a potential donor may have about insurance coverage and Medicare benefits related to surgery and care.
- A nutritionist who will work closely with you and your doctor to determine the right diet for your needs after transplant surgery and make any necessary revisions should your medical condition or treatment change.
- A transplant coordinator, who is a registered nurse, who will serve as your contact throughout the transplant process.
Learn more about the Kidney Transplant Team at Cleveland Clinic.
Once your evaluation is complete and you are determined to be a candidate for transplantation, your name will be placed on the organ waiting list (unless you have a suitable living donor). It is important during this waiting period that your transplant team knows how to contact you at all times in the event that a donor kidney becomes available.
Where does a kidney come from?
Kidneys for transplantation come from two different sources – living donors, or non-living (cadaveric) donors. Living donors are usually immediate family members or sometimes spouses. Cadaver kidneys are obtained from persons who have willed their kidneys before their death by signing organ donor cards. Permission for donation can also be given by the descendent’s family at the time of death. All donors are carefully screened to prevent any transmissible diseases.
How is the right kidney found for me?
Determining in advance whether a donated kidney is likely to be tolerated by your body is crucial to the success of your transplant. It is essential that your blood type and the donor’s blood type – whether Type A, B, AB, or O – be compatible. Your tissue type and the donor’s must also be compatible. We use an HLA (human leukocyte antigens) blood test to determine your tissue type, which is the unique design of the tissue antigens that you inherited.
Your blood will also be tested to determine whether you have antibodies to other tissue. Antibodies are substances your body produces to destroy foreign materials. While you wait for a kidney, you are asked to supply several tubes of blood each month to monitor these antibodies. Some of the blood will be stored and used for testing compatibility with potential donors. All blood tests are performed in our own Tissue Typing Lab, which was one of the first in the country when it was founded in 1968. The results of your blood tests are entered by our technologists into a computer at United Network for Organ Sharing (UNOS) so that when a cadaver donor kidney becomes available, the UNOS computer can evaluate whether or not you are an appropriate candidate for that kidney.
The Kidney Transplant Procedure
Kidney transplantation involves placing a healthy kidney into the body where it can perform all of the functions that a failing kidney cannot. In most cases, the diseased kidneys, located in the back area, remain undisturbed. The new kidney is positioned in the pelvic area where it is surgically connected to nearby blood vessels.
Thanks to years of experience, research, and improved medications that prevent rejection, kidney transplants are overwhelmingly successful and post-operative complications for transplant patients are few. On average, 85-90% of kidney transplants are successful for at least two years, the traditional measurement point for success, and most for many years more.