Kidney Transplant Procedure

Where does your new kidney come from?

Kidneys for transplantation come from two sources: living donors and deceased (non-living) donors. Living donors are usually immediate family members or sometimes spouses. Deceased donor kidneys usually come from people who have willed their kidneys before their death by signing organ donor cards. Permission for donation can also be given by the deceased person's family at the time of death.

All donors are carefully screened to make sure there is a suitable match and to prevent any transmissible diseases or other complications.

What happens during 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.

The new kidney is placed on the lower right or left side of your abdomen where it is surgically connected to nearby blood vessels. Placing the kidney in this position allows it to be easily connected to blood vessels and the 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, the diseased kidneys are not removed. There are three conditions that might require your diseased kidneys to be removed:

• Repeated infection that could spread to the transplanted kidney.
• Uncontrollable hypertension caused by your original kidneys.
• Backup of urine into your kidneys (a condition called reflux).

What are the benefits of kidney transplantation?

A successful kidney transplant gives you increased strength, stamina, and energy. After transplantation, you should be able to return to a more normal lifestyle and have more control over your daily living. You can have a normal diet and more normal 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 hypertension (high blood pressure), you could be on fewer blood pressure medications after transplantation.

What are the risks of kidney transplantation?

The risks of kidney transplantation are the same as those of any surgery. There is the risk of bleeding, infection or breathing problems. You also might experience some side effects from the medications, and you could be more prone to infections, since the medicine you will take after transplantation lowers your body's ability to fight infection.

There is also the risk of rejection. Since the body recognizes the new kidney as a foreign object, it will normally try to get rid of it or "reject" it. However, you are 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.

When can I return to my regular activities?

You can resume your previous activities as soon as you feel better — and you might even feel good enough to add some new activities. A daily exercise program will continue to improve your health and help you maintain a positive attitude.

You will not injure yourself or your new kidney if you follow some of these general guidelines:

• Avoid lifting heavy objects and strenuous physical work for at least six to eight weeks following surgery. It is important that you do not lift anything heavier than 20 pounds for two to three months, and nothing heavier than 40 pounds for four to six months from the date of your surgery.
• Avoid driving for at least six weeks following surgery. Plan ahead so a friend or family member can help out during this time. When you are in a moving vehicle, always use your seat belt.
• Exercise is encouraged. We recommend beginning with stretching exercises and walking. Other excellent exercises include jogging, hiking, bicycling, tennis, golf, swimming and aerobics. All of these can help you regain your strength and may be started gradually after your incision has healed.
• As a general rule, rough contact sports should be avoided since they might cause injury to your transplanted kidney. If you have doubts about any activity, please ask the Transplant Team.

When can I go back to work?

Many kidney transplant patients are able to return to work within a few months following a successful surgery. However, various aspects of the recovery process can affect the timing of your return.

You will need to discuss returning to your job with the Transplant Team. When the time approaches, a “return to work” letter will be provided. This will let your employer know when you may begin working and what limitations, if any, you have.

How soon can I take a vacation?

You may travel after 12 weeks when you are feeling better, but always let the Transplant Team know when you plan to go, and provide a phone number where you can be reached. By remembering these traveling tips, your vacation will be worry free:

• Always take all of your medicines with you and make sure you have enough medicines to last throughout your trip.
• If you are traveling by plane, carry your medicines with you. Never check them with your luggage.
• Make sure you have the phone number for the transplant center where you have been treated.
• Check to see if there is a medical lab or transplant center nearby where you can have your blood work completed. This lab will need to report your results to the transplant office.

Are there any foods, medications or supplements I should avoid after a kidney transplant?

There are a few foods and other substances that you should avoid after a kidney transplant. These items can hurt your kidney function and put you at risk for complications. It’s important to follow your healthcare provider’s recommendations on what you should and shouldn’t consume after your transplant. Dietary changes can sometimes be necessary after a kidney transplant, on a short-term basis. If your transplant is working well, you’ll also need to learn about possible interactions with transplant-sustaining drugs. If your new kidney is not doing well, dietary recommendations might be similar to those for chronic kidney disease (CKD).

It’s important that you practice good hygiene to avoid infections when you’re eating. In the first 90 days after surgery, your weakened immune system puts you at high risk for infectious diseases. Your provider will likely advise you to avoid close crowds where contact with an infected person is more likely. When you do go out, be sure to wash your hands frequently and stay away from people who are ill.

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

• Staying 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.
• Not eating raw or under-cooked foods. With your weakened immune system, eating raw or under-cooked foods — especially under-cooked meat or under-cooked eggs — at any time after a transplant puts you at risk for severe illness.
• Getting plenty of protein in your diet. Eating a well-balanced diet with a few special dietary considerations is important. 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. It’s possible to overdo it, however you can usually avoid this issue by avoiding protein supplements.
• Avoiding grapefruit and grapefruit juice. These fruits can cause a strong reaction with medications that suppress the immune system.
• Not taking nonsteroidal anti-inflammatory drugs (NSAIDS). Some very common over-the-counter (OTC) drugs, including ibuprofen and naproxen, can cause kidney dysfunction. You may also want to avoid taking antihistamines and antacids. These medications, and other common 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.
• Avoiding certain vitamins and herbal supplements. St. John’s wort, schisandra, and some herbal teas and other natural supplements interact with transplant medications. You should discuss these supplements with your provider before using them to make sure they are safe to use.

How will the transplant affect my sexuality?

Although a kidney transplant can cause many life changes, it does not affect a woman’s desire to become pregnant or hinder a man’s ability to father a child.

What addition information should women know about the recovery process?

Although fertility is not a problem, rejection or high blood pressure are both complications a woman might experience for at least one year after transplant surgery. Therefore, it is important to prevent a pregnancy during this time by using birth control.

Women who have a kidney transplant can have a healthy pregnancy later. Talk to the Transplant Team about the timing of your pregnancy after your transplant. Also, know the risks and make sure your obstetric provider is experienced in dealing with transplant patients.

A female transplant patient who becomes a new mother should not breastfeed her baby. The immunosuppressive medicines prescribed after transplantation can be passed through the mother’s breast milk and can cause harm to the baby.

Female transplant patients should be sure to have a yearly Pap test (a test for cancer of the cervix) and a mammogram. Immunosuppressive medicines could cause increased susceptibility to various types of cancer. Pap tests and mammograms are preventive measures that can help your healthcare providers detect any problems.