Kidney Transplant
Surgery OverviewA kidney transplant is surgery to put a healthy (donor) kidney into your body. There are two types of donors: - Living donors. A living donor may be a
family member, a friend, a coworker, or any person who is willing to give a
kidney to someone in need. A person only needs one healthy kidney to live.
- Deceased donors. A deceased donor is someone who has recently died.
You may need to have tests to see how well the donor kidney
matches your
tissue type and
blood type. A close tissue match reduces the chances that your
body will
reject the new kidney. You will also be evaluated to
make sure that you do not have significant heart or lung disease or other
diseases, such as cancer, which might decrease your life span. Kidney transplant surgery takes about 3 hours. During surgery, the donor
kidney will be placed in your lower abdomen, blood vessels from the donor
kidney will be connected to arteries and veins in your body, and the
ureter from the donor kidney will be connected to your
bladder. Blood is then able to flow through the new kidney, and the kidney will
begin to filter and remove wastes and to produce urine. The new
kidney usually begins to function right away. In most cases, diseased or
damaged kidneys are not removed unless you have a severe infection of the
kidney (pyelonephritis), kidney cancer,
nephrotic syndrome, or extremely large
polycystic kidneys. To learn more, see the topic
Organ Transplant. What To Expect After SurgeryYou will have to stay in the hospital
for several days after you receive your new kidney. In some cases, it may take
time for your new kidney to produce urine. So you may have to receive dialysis
and take medicines, such as diuretics, that help your new kidney get rid of
excess water and salt from your body. After the surgery you will
have to take medicines to
suppress your
immune system. These medicines are used to help keep
your body from
rejecting your new kidney. You will need to take these
medicines for the rest of your life. During the first weeks to
months after your surgery, your body may try to reject your new kidney. This is
called acute rejection and occurs in about 1 out of 10 people in the first year after transplant.
Most of the time, acute rejection can be treated with antirejection (immunosuppressive)
medicines.footnote 1 Chronic rejection (also called chronic allograft failure) is a process of gradual, progressive
loss of kidney function and can occur many months to several years after your
surgery. Experts don't fully understand what causes chronic rejection. There is
no treatment for chronic rejection. Most people go back on dialysis or have
another transplant. Why It Is DoneKidney transplant surgery is done so that a healthy kidney (donor kidney) can do what your diseased kidney can no longer do. Kidney transplant is used when you have severe chronic kidney disease
(renal failure) that cannot be reversed by another treatment method. You will
not be able to have this surgery if you have an active infection, another
life-threatening disease such as cancer, or severe heart or lung
disease. How Well It WorksIf you have severe chronic kidney
disease and choose to have a kidney transplant, you may live longer than if you
choose only to treat your kidney disease with
dialysis alone. In the past, transplants using a kidney from a
first-degree relative, such as your father, mother, brother, or sister, were the
most successful. But with modern antirejection drugs, kidneys from people you are not related to work well, too. Transplants from living donors or from deceased donors can succeed. RisksThe risks of having a kidney transplant
include: - Rejection of the new kidney.
- Severe
infection.
- Bleeding.
- Reaction to the
anesthesia used for surgery.
- Failure of
the donor kidney.
What To Think AboutKidney transplant may be a better
treatment for you than dialysis, because survival rates are better after
transplant. You will also be able to live a more normal life, because you won't
have to have dialysis. Although a kidney transplant is an
expensive procedure, it may actually be less costly than long-term dialysis
treatments.
There is often a
long wait before you receive a donor kidney. And there is no guarantee that the
transplant will be successful. Fewer complications occur in people who are
good candidates for surgery and who do not have other serious medical
conditions, such as unstable
coronary artery disease or cancer, that may limit
their life expectancy.
Not everyone is able to have a
kidney transplant. You will not usually have a kidney transplant if you have an
active infection or another life-threatening disease, such as cancer or
significant heart or lung disease. After having a kidney
transplant, you will have to take medicines that suppress your immune system
(antirejection or immunosuppressive medicines) to help prevent your body from rejecting the new kidney. You
will need to take these medicines for the rest of your life. Because these
medicines weaken your immune system, you will have an increased risk for
serious infections. There is also the chance that your body may
still reject your new kidney even if you take these medicines. If this happens,
you will have to start dialysis and possibly wait for another kidney
transplant. Immunosuppressive medicines also increase your risk of
other diseases, such as skin cancer and lymphoma. You have a greater risk for diabetes, high blood pressure, heart disease, cataracts, and
inflammation of the liver (cirrhosis) if you are taking these medicines. Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery. ReferencesCitations- Hart A, et al. (2017). OPTN/SRTR 2015 annual data report: Kidney.
American Journal of Transplantation, 17(Suppl 1): 21-116. DOI: 10.1111/ajt.14124. Accessed April 26, 2017.
Other Works Consulted- Barry JM, Conlin MJ (2012). Renal transplantation. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 2, pp. 1226-1253. Philadelphia: Saunders.
- Flechner SM (2013). Renal transplantation. In JW McAninch, TF Lue, eds., Smith and Tanagho's General Urology, 18th ed., pp. 550-569. New York: McGraw-Hill.
CreditsByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Elizabeth T. Russo, MD - Internal Medicine Current as ofMay 26, 2017 Current as of:
May 26, 2017 Hart A, et al. (2017). OPTN/SRTR 2015 annual data report: Kidney.
American Journal of Transplantation, 17(Suppl 1): 21-116. DOI: 10.1111/ajt.14124. Accessed April 26, 2017. Last modified on: 8 September 2017
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