Kidney Transplant

What is a kidney transplant?

A kidney transplant is a surgery that involves taking a healthy kidney from a donor and placing it into a person whose kidney(s) are no longer working properly.

What’s the difference between a living donor transplant and a deceased donor transplant?

Kidneys for transplantation can come from living donors or deceased organ donors.

Living donor transplant

A living donor means your kidney comes from someone who is still alive with healthy kidneys. Common living donors are immediate family members, spouses, partners or friends, but living donors can be almost anyone. Living donor kidney transplants are more successful, with more advantages and with a lower rate of rejection. But, living donors are harder to find, which makes them more rare. A living donor must be older than 18, healthy (with no major medical issues) and pass a medical and psychosocial evaluation.

Deceased donor transplant

A deceased donor kidney comes from someone who has just died of causes that don’t affect the function of their kidney. People who want to be organ donors elect to do so while they’re still alive. In some countries, you “opt-out” of being an organ donor while you’re alive. Permission for donation can also be given by the deceased person’s family after their death. Deceased donor transplants occur more frequently.

Potential kidney donors are carefully screened to make sure they’re a match. This helps prevent complications.

Why are kidney transplants done?

Kidney transplants are done to help people with chronic kidney disease or end-stage kidney failure. When your kidneys can no longer filter waste properly, you’ll need either dialysis (which uses a machine to remove waste from your bloodstream) or a kidney transplant.

How common is a kidney transplant?

The number of kidney transplants each year in the U.S. is rising. Surgeons performed more than 25,000 kidney transplants in 2022, which was 3.4% more than 2021.

What are the kidney transplant requirements?

Each hospital has its own criteria for accepting people as kidney transplant recipients. But in general, candidates for kidney transplant should have:

• End-stage renal failure and be on dialysis
• Chronic kidney disease with a glomerular filtration rate (GFR) less than or equal to 20 mL/min
• A full understanding of postoperative instructions and care
• Be in good overall physical and mental health with strong social support

Is there an age limit to be evaluated for a kidney transplant?

While there really is no age limit, most facilities accept people who are 17 and older. Kidney transplant evaluation has more to do with meeting the criteria (both as a donor or a recipient) than age.

How many kidney transplants can a person have?

In some cases, people can have two, three or more kidney transplants in their lifetimes. Every person is different. Your healthcare provider can tell you if this is an option for you.

What disqualifies you from getting a kidney transplant?

Kidney transplants are approved on a case-by-case basis. But there are some general factors that could make a person ineligible for a kidney transplant, such as:

• A serious health condition
• Certain infections
• Cancer or history of cancer
• Certain mental health conditions
• Poor social support
• A short life expectancy
• History of noncompliance with medications and treatment

No matter what your situation, your healthcare provider can determine whether a kidney transplant is a safe treatment option.

What happens during a kidney transplant procedure?

Kidney transplantation involves placing a healthy kidney into your body, where it can perform all of the functions that a failing kidney can’t.

Your new kidney is placed on the lower right or left side of your abdomen where it’s surgically connected to nearby blood vessels. Placing the kidney in this position allows it to be easily connected to blood vessels and your bladder. The vein and artery of your new kidney are attached to your vein and artery. The new kidney’s ureter is attached to your bladder to allow urine to pass out of your body.

What happens to my old kidneys?

In most cases, your surgeon will leave your damaged kidneys inside your body. Rarely, people with a history of polycystic kidney disease will have their damaged kidneys removed.

How long is kidney transplant surgery?

On average, kidney transplant surgery takes four to six hours to complete.

What happens after a kidney transplant?

Most people spend about three days in the hospital after a kidney transplant. This way, your medical team can keep a close eye on you and make sure you’re recovering well.

Your new transplanted kidney may start working immediately. Or you may need dialysis temporarily until it starts working. This might take several days or weeks.

You’ll also need to start taking immunosuppressive medications to keep your immune system from rejecting your new transplanted kidney.

What will my kidney transplant scar look like?

Your scar will be about 2 to 5 inches long, on the right or left side of your lower abdomen.

How long does a kidney transplant last?

How long a kidney transplant lasts can vary from person to person and be based on your overall health. In general, kidneys donated by a living person last longer than kidneys donated by a deceased person. On average, however, transplanted kidneys last approximately 10 years.

What are the benefits of a kidney transplant?

A successful kidney transplant gives you increased strength, stamina and energy. After transplantation, you should be able to return to a more typical lifestyle and have more control over your daily living. You can have unrestricted food and fluid intake.

If you were dependent on dialysis before the transplant, you’ll have more freedom because you won’t be bound to your dialysis schedules.

Anemia, a common problem with kidney failure, might be corrected after transplantation. If you have high blood pressure, you could be on fewer blood pressure medications after transplantation.

What are the risks of kidney transplants?

The risks of kidney transplantation include those of any surgery. There’s a risk of bleeding, infection or other surgical complications. You also might experience some side effects from the medications, and you could be more prone to infections and certain cancers since the medicine you’ll take after transplantation lowers your body’s immune system.

Kidney transplant rejection

Since your body recognizes the new kidney as a foreign object, it’ll try to get rid of it or “reject” it. But you’ll be given medicine to prevent rejection.

Because of years of experience, research and improved medicines that prevent rejection, kidney transplants are very successful, with few complications after transplantation.

Is a kidney transplant better than dialysis?

While both options have pros and cons, kidney transplant is often the preferred treatment for chronic kidney disease in people who are eligible. This is because lifelong dialysis can be very taxing, and comes with its own risks and side effects. Kidney transplant offers a better quality of life for most people, and studies show that those who have a successful kidney transplant live longer on average compared to those who receive dialysis.

What is the recovery time after a kidney transplant?

On average, kidney transplant recovery time is about six weeks. This timeline is different for everyone, though. It depends on your overall health and other factors.

What are some things I can do to take care of myself during recovery?

It’s important to closely follow any instructions given by your healthcare provider. Restrictions vary from person to person. Here are some general guidelines:

• Avoid lifting heavy objects for at least eight weeks or longer after surgery. Ask your surgeon about physical limitations during your recovery, including what types of activities are safe for you and when.
• Avoid driving for at least six weeks following surgery. Plan ahead so a friend or family member can help out during this time.
• Avoid contact sports. They might cause injury to your transplanted kidney. If you have doubts about any activity, talk to your healthcare provider.

Are there foods that I should avoid after my kidney transplant?

When it comes to the food and drinks you consume, there are a few tips you should follow:

• Stay hydrated. One of the keys to a successful recovery is staying well-hydrated. You should drink plenty of water — typically 2 liters (about 68 ounces) — per day. It’s also a good idea to limit caffeine. It’s a weak diuretic and contributes to dehydration.
• Don’t eat raw or undercooked foods. With your weakened immune system, eating raw or undercooked foods — especially undercooked meat or undercooked eggs — at any time after a transplant puts you at risk of severe illness.
• Get plenty of protein. Protein is especially helpful because it helps you build muscle and recover lost weight. Your provider or a dietitian can help you figure out how much protein you need.
• Avoid grapefruit and grapefruit juice. These fruits can cause a strong reaction with medications that suppress your immune system.
• Don’t take nonsteroidal anti-inflammatory drugs (NSAIDS). Some very common over-the-counter (OTC) drugs, including ibuprofen and naproxen, can cause kidney issues. You may also want to avoid taking antihistamines and antacids. These medications, and other OTC drugs, can sometimes affect other drugs or change absorption. Talk to your healthcare provider about the safety of these medications and possible alternatives you could try.
• Avoid certain vitamins and herbal supplements. St. John’s wort, schisandra, and some herbal teas and other natural supplements interact with transplant medications. You should always discuss any supplements with your provider before using them to make sure they’re safe to use.

Your healthcare provider may recommend other restrictions based on your situation.

How long can a person live with a kidney transplant?

People can live for many years after receiving a transplanted kidney. On average, a kidney from a living donor lasts about 12 to 20 years, while a kidney from a deceased donor lasts about eight to 12 years. Some people receive more than one kidney transplant in their lifetimes.

Can you live a normal life with a kidney transplant?

Yes. Many people lead healthy, fulfilling lives after their kidney transplant. Currently, the one-year kidney transplant survival rate is 95%. The average three- to five-year survival rate is 90%. This means that 9 in 10 people who receive a transplanted kidney will still be alive five years after their surgery.

Survival rates are estimates. They can’t tell you how you’ll respond to treatment or how long you’ll live. To learn more about kidney transplant survival rates, talk to your healthcare provider.

When can I go back to work after my kidney transplant?

Most people return to work within a few months of surgery. But several aspects of the recovery process and the type of job you have can affect when you return.

You’ll need to discuss returning to your job with your surgeon. When the time approaches, your provider will give you a “return to work” letter. This will let your employer know when you may begin working and what limitations you have (if any).

When should I contact my healthcare provider?

Following your kidney transplant, you’ll see your medical team for regular follow-ups. However, if you experience any of the following symptoms, you should contact your healthcare provider immediately:

• A fever of 100 degrees Fahrenheit (or 37 degrees Celsius) or higher
• New pain or tenderness around your kidney
• Swelling (edema)
• Flu-like symptoms including chills, headaches, dizziness or nausea and vomiting
• A noticeable decrease in the amount of pee you produce
• Any changes in your health like new or unusual symptoms

What is a preemptive kidney transplant?

A preemptive kidney transplant is when you get a kidney transplant before kidney disease advances to the point you need dialysis. Most transplants occur after a person is already on dialysis, which means their kidneys are already failing. People who have a preemptive kidney transplant get a new kidney while their health is still good, which leads to a better quality of (and potentially longer) life. Plus, you avoid dialysis, which has its own disadvantages.