You may come out of the operation with tubes at the operation site a drain or a catheter in your bladder. Some kidneys start to work straight away, but others may take a few days or weeks. You'll be in hospital for about a week, depending on how quickly you recover from the surgery.
The transplants kidney will be closely monitored with blood tests and scans. You may also be required to undergo a transplant biopsy where they take a small sample of the tissue.
You will need ongoing frequent monitoring of blood tests, blood pressure, drug levels and your health. Initially this will be very frequent daily and over time will become less frequent depending on your progress. Be prepared to come into the hospital daily after discharge. You'll take medications, for the life of the transplanted kidney, to stop your body from rejecting it. These medication can make you more prone to serious illnesses such as infections and cancers.
Sometimes a kidney stops working because people stop taking these medications, so it's incredibly important that you take them regularly and a s prescribed. Along with general health and fitness, your kidney will last longer if you follow advice about caring for your kidney.
We welcome you to call our Kidney Helpline on for additional support. Before you decide to have a transplant, it's important to talk to your doctor and understand the risks. You might also find the resources below useful. With roughly 1, people waiting for a kidney transplant at any one time, and an average wait time of 2.
Learn more. Our Kidney Transplant Houses are free to eligible applicants to stay and recover in post-transplant. Before you download We use your information to keep you updated on kidney health matters of interest to you. Find out how we protect your information in our Privacy Policy. Home Choosing your treatment Kidney transplants. Prednisone is used at low dosages to minimize side effects.
The possible side effects of prednisone are:. The most common side effects associated with azathioprine are:. The most common side effects of mycophenolate mofetil are:. It provides the same active ingredient as mycophenolate mofetil and generally has the same side effect profile. It is enterically coated to potentially reduce abdominal aches and diarrhea. The most common side effects of sirolimus are:.
The most common side effects of cyclosporine therapy are:. These medications rarely cause side effects but can include:. Any healthy person can donate a kidney. When a living person donates a kidney the remaining kidney will enlarge slightly as it takes over the work of two kidneys. Donors do not need medication or special diets once they recover from surgery. As with any major operation, there is a chance of complications, but kidney donors have the same life expectancy, general health, and kidney function as most other people.
The kidney loss does not interfere with a woman's ability to have children. If a person successfully completes a full medical, surgical, and psychosocial evaluation they will undergo the removal of one kidney. Most transplant centers in the United States use a laparoscopic surgical technique for the kidney removal.
This form of surgery, performed under general anesthesia, uses very small incisions, a thin scope with a camera to view inside of the body, and wand-like instruments to remove the kidney. Compared with the large incision operation used in the past, laparoscopic surgery has greatly improved the donor's recovery process in several ways:. The operation takes hours.
Recovery time in the hospital is typically days. Donors often are able to return to work as soon as weeks after the procedure. Occasionally the kidney needs to be removed through an open incision in the flank region. Prior to the use of the laparoscopic technique, this surgery was the standard for the removal of the donated kidney. It involves a inch incision on the side, division of muscle and removal of the tip of the twelfth rib. The operation typically lasts 3 hours and the recovery in the hospital averages days with time out of work of weeks.
Although laparoscopy is increasingly used over open surgery, from time to time, the surgeon may elect to do an open procedure when individual anatomic differences in the donor suggest that this will be a better surgical approach. The quality and function of the kidneys recovered with either technique work equally well. Regardless of technique all donors will require lifelong monitoring of their overall health, blood pressure and kidney function.
Many patients have relatives or non-relatives who wish to donate a kidney but are not able to because their blood type or tissue type does not match.
In such cases, the donor and recipient are said to be "incompatible. This program is a way for a living donor to benefit a loved one, even if their blood or tissue types do not match. The donor gives a kidney to another patient who has a compatible blood type and is at the top of the kidney waiting list for a "deceased donor" kidney. In exchange, that donor's relative or friend would move to a higher position on the deceased donor waiting list, a position equal to that of the patient who received the donor's kidney.
For example, if the donor's kidney went to the fourth patient on the deceased donor waiting list, the recipient would move to the fourth spot on the list for his or her blood group and would receive kidney offers once at the top of the list. This program is another way for a living donor to benefit a loved one even if their blood or tissue types do not match.
A "paired exchange" allows patients who have willing but incompatible donors to "exchange" kidneys with one another-the kidneys just go to different recipients than usually expected. An example of how this works would be if Mary wanted to give her sister Susan a kidney, but differences in blood type made it impossible, and Kevin wanted to give his sister Sarah a kidney, but differences in blood type made that impossible see picture below. A paired exchange would be arranged so that Mary would donate to Sarah and Kevin would donate to Susan.
The two pairs can thus "exchange" kidneys so that both donors give kidneys and both patients receive kidneys. That means that two kidney transplants and two donor surgeries will take place on the same day at the same time. This is a program that lets patients receive a kidney from a living donor who has an incompatible blood type.
To be able to receive such a kidney, patients must undergo several treatments before and after the transplant to remove the harmful antibodies that can lead to rejection of the transplanted kidney.
A special process called plasmapheresis, which is similar to dialysis, is used to remove these harmful antibodies from the patient's blood. Patients require multiple treatments with plasmapheresis before transplant, and may require several more after transplant to keep their antibody levels down.
Some patients may also need to have their spleens removed at the time of transplant surgery to lower the number of cells that produce antibodies. The spleen, a spongy organ about as big as a person's fist, produces blood cells. Located in the upper left part of the abdomen under the rib cage, the spleen can be removed laparoscopically. This program makes it possible to perform kidney transplants in patients who have developed antibodies against their kidney donors-a situation known as "positive crossmatch.
The process is similar to that for blood type-incompatible kidney transplants. Patients receive medications to decrease their antibody level or they may undergo plasmapheresis treatments to remove the harmful antibodies from their blood. If their antibody levels to their donors are successfully reduced, they can then go ahead with the transplants. Success rates are close to those for transplants from compatible living donors and are better than success rates for deceased donor transplants.
This act prohibited the sale of human organs and mandated a national Organ Procurement and Transplantation Network OPTN to oversee organ recovery and placement and equitable organ distribution policies. It was awarded the national OPTN contract in It is the only organization ever to operate the OPTN.
Organ Procurement Organizations OPO are non-profit agencies operating in designated service areas covering whole states or just parts of a state.
OPOs are responsible for: approaching families about the option of donation, evaluating suitability of potential donors, coordinating the recovery and transportation of donated organs and educating the public about the need for organ donation. Most deceased donor kidneys are transplanted to recipients in the same service area as the deceased donor. Although there are recommended guidelines for organ allocation, each OPO may request a "variance" to fit the special needs to the patients waiting for kidney transplantation in their service area.
Unfortunately, many more patients are medically suitable for transplants than organs available. The waiting times are many years and growing longer.
Many patients develop medical and surgical complications while waiting which may prevent them from receiving a deceased donor kidney transplant in the future. Although the most commonly transplanted deceased donor kidneys come from previously healthy donors between the ages of 18 and 60, kidneys from other deceased donors have been successfully transplanted.
The goal of this program is to use organs from less traditional donors more effectively so that more patients can receive kidney transplants. Patients who are most likely to benefit from a kidney through this program are dialysis patients who are older and have a greater risk of problems, including death, while waiting for a transplant.
Accepting a kidney from an expanded criteria donor may shorten the waiting period for a transplant. Patients who are considered for this type of transplant also remain on the waiting list for standard kidney offers. By accepting a kidney from a deceased donor who also had Hepatitis C, these patients could shorten the waiting time for a deceased donor kidney.
The use of kidneys from donors who had Hepatitis C does not appear to have a harmful effect on the survival of the transplanted kidney or on the overall health of the patient, provided that he or she has been evaluated carefully before receiving the transplant.
A growing number of patients with end-stage renal disease are infected with the HIV virus. Through the use of effective antiviral therapy, these patients are surviving on dialysis with their HIV disease and are being considered more and more frequently for kidney transplantation. The success rate of kidney transplantation varies depending on whether the donated organ is from a living donor or a deceased donor as well as the medical circumstances of the recipient.
Kidneys from living donors generally last longer. Most kidney losses are due to rejection, but infections, circulation problems, cancer, and return of the original kidney disease can also cause kidney loss. In contrast, dialysis patients have fold greater chance of dying as compared to transplant recipients.
Currently the organ supply cannot meet the demand and there is no foreseeable end to the problem. Patients wait many years for a transplant. People are dying or becoming medically unsuitable for transplantation as these waiting times grow longer.
Also, there are significant geographic differences in access to transplantation and wait times. As each organ is a precious resource that should be utilized for maximum efficiency, the transplant community is changing the way kidneys are distributed to patients on the waiting list. Some patients may benefit, others are disadvantaged, and a delicate balance must be struck between fairness and equality.
On one hand, organs are a scarce resource and could be given to patients who would maximize the duration of the transplanted organ.
In contrast organs are a societal resource that could be distributed to all potential patients based on waiting time. These two views represent utility versus equity in organ allocation.
The final decision regarding the allocation policy will likely fall somewhere in between the two viewpoints. Even with creative ways to utilize more living and deceased donors, another source of kidneys is most likely necessary.
Xenotransplantation has already occurred from non-human primate donors such as chimpanzees, monkeys and baboons. However these animals are endangered species and the size and blood type differences as well as the concern of transmission of infectious diseases has led to a ban of these transplants by the Food and Drug Administration.
Currently most of the research in this field is centered on the pig as the potential xenograft donor. Pigs have desirable characteristics: multiple offspring, rapid maturity to adult age, lower risk of transmissible infectious diseases and appropriate size. The many barriers to successful xenotransplantation are under study and continued advances may lead to this type of transplantation solving the organ shortage crisis.
With the short supply of organs and long waiting times, patients are now traveling outside of the United States to receive a kidney transplant. Commercialism and poor regulation can undermine the true nature of transplantation and put patient's lives at risk.
When the kidney is properly in place, the incision in your abdomen will be closed with surgical staples, stitches or surgical glue. Although the procedure may sound relatively straightforward, it's very demanding and complex surgery that usually takes around 3 hours to complete. Once you've recovered from the effects of the anaesthetic, it's likely you will feel some pain at the site of the incision. Painkillers will be provided, if necessary. After the operation, you'll immediately begin treatment with medication designed to prevent your immune system from rejecting your new kidney.
See living with a kidney transplant for more information on this. Most transplanted kidneys will start working immediately, particularly if they come from a living donor, although sometimes they may take a few days or weeks to work properly.
If this is the case, you'll need to have dialysis during this time. Most people can leave hospital in about a week, but you'll need to attend frequent appointments at the transplant centre, so your kidney function can be assessed and tests can be carried out to check how well your medications are working.
For the first month after surgery, you may need to have 2 to 3 appointments a week.
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