Health Encyclopedia

Kidney transplant

Definition

A kidney transplant is surgery to place a healthy kidney into a person with kidney failure.

Alternative Names

Renal transplant; Transplant - kidney

Description

Kidney transplants are one of the most common transplant operations in the United States.

A donated kidney is needed to perform a kidney transplant.

The donated kidney may be from:

Living related donor -- related to the recipient, such as a parent, sibling, or child
Living unrelated donor -- such as a friend or spouse
Deceased donor -- a person who has recently died and who has no known chronic kidney disease

Persons with chronic kidney disease can receive lifesaving dialysis until a donated kidney becomes available. The healthy kidney is transported in cool salt water (saline) that preserves the organ for up to 48 hours. This gives the health care providers time to perform tests that match the donor's and recipient's blood and tissue before the operation.

PROCEDURE FOR A LIVING KIDNEY DONOR

If you are donating a kidney, you will be placed under general anesthesia before surgery. This means you will be asleep and pain-free. The surgeon makes a cut in the side of your abdomen, removes the proper kidney, and then closes the wound. The procedure used to require a long surgical cut. However, today surgeons can use a short surgical cut (mini-nephrectomy) or laparoscopic techniques.

PROCEDURE FOR THE KIDNEY RECIPIENT

Persons receiving a kidney transplant are given general anesthesia before surgery. The surgeon makes a cut in the lower belly area and stitches the new kidney into place. The wound is then closed.

Indications

A kidney transplant may be recommended if you have kidney failure caused by:

Diabetes
Glomerulonephritis
Severe, uncontrollable high blood pressure
Certain infections

A kidney transplant alone may NOT be recommended if you have:

Certain infections, such as TB or osteomyelitis
Difficulty taking medications several times each day for the rest of your life
Heart, lung, or liver disease
Other life-threatening diseases

Risks

The risks for any anesthesia are:

Problems breathing
Reactions to medications

The risks for any surgery are:

Bleeding
Infection

Other risks include:

Infection due to medications that suppress the immune response that must be taken to prevent transplant rejections

Expectations after surgery

Kidney transplants generally offer the best outlook for patients with end-stage kidney disease. Kidneys from living related donors do better than from donors who have died. (If you donate a kidney, you can usually live safely without complications with your one remaining kidney.)

Persons who receive a transplanted kidney may reject the new organ. This means that their immune system sees the new kidney as a foreign substance and tries to destroy it.

In order to avoid rejection, almost all kidney transplant recipients must have take medicines that suppress their immune response for the rest of their life. This is called immunosuppressive therapy. While the treatment helps prevent organ rejection, it also puts patients at a higher risk of infection and cancer. If you take this medicine, you need to be regularly screened for cancer. The medicines may also cause high blood pressure and high cholesterol and increase the risk of diabetes.

A successful kidney transplant requires close follow-up with your doctor and always taking your medicine as directed.

Convalescence

The recovery period is 4-6 weeks for persons who donate a kidney. If you've done so, you should avoid heavy activity during this time. Your doctor removes the stitches after a week or so.

If you received a donated kidney, you will need to stay in the hospital for about a week. Afterwards, you will need close follow-up by a doctor and regular blood tests.

Review Date:2/7/2008
Reviewed By:Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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