A kidney transplant is surgery to replace
your own diseased kidneys with a healthy (donor) kidney. See a picture of a
kidney transplant. There are two types of donors:
In both cases, the key to success is having the closest
possible blood and tissue matches. A family member is not always the best
You will need to have tests to make sure the donor kidney
tissue type and
blood type. This helps reduce the chances that your
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.
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
information, see the topic
You will have to stay in the hospital
for 7 to 10 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
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 25% to 55% of people after transplant.
Most of the time, acute rejection can be treated with immunosuppressive
Chronic rejection 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
During kidney transplant surgery, a
healthy kidney (donor kidney) replaces the lost function of your own damaged
kidneys. 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
If 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
Transplants using a kidney from a
first-degree relative, such as your father, mother, brother, or sister, are the
most successful. And transplants from living donors are usually more successful than transplants from deceased donors.1
The risks of having a kidney transplant
Kidney 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
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
(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
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.
Flechner SM (2008). Renal
transplantation. In EA Tanagho, JW McAninch, eds., Smith's General Urology, 17th ed., pp. 539–558. New York:
September 15, 2011
Anne C. Poinier, MD - Internal Medicine
& Mitchell H. Rosner, MD - Nephrology
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