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A surgical procedure to place a healthy kidney, from a donor, in a patient with severely diseased and damaged kidneys. The donor may be a living relative, a close friend whose tissue closely matches yours, or someone who has died and donated his or her organs. The transplant involves the kidney, ureter, and the involved blood vessels.
A kidney transplant is done to treat irreversible, end-stage kidney diseases. The procedure is most often performed when the kidneys fail for the following reasons:
- Pre-existing medical conditions, especially certain heart, lung, and/or liver diseases
- Autoimmune disease
- Age extreme (young or old), of either the recipient or the donor
- Difference in race between the recipient and donor
- Prior blood transfusion
- Prior failed transplant
- Pregnancy
- Conditions that will likely result in a recurrence of kidney failure in the new kidney
- Cancer
-
Certain infections, such as
osteomyelitis,
tuberculosis, hepatitis
Because of a shortage of donors, you may be on a transplant list for some time. You may need to carry a pager or cellular phone at all times so that the transplant team can reach you if a donor kidney becomes available.
Your doctor will likely do the following:
- Physical exam
- Review of medications
- Blood tests to include blood chemistries, liver function, coagulation, and to assess infectious profile
- Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
- Chest x-ray
- Extensive tissue typing
You may be asked to undergo psychological testing and counseling to ensure that you are well-prepared for the stress of this procedure.
The days leading up to your procedure:
- Continue renal dialysis as directed by your doctor.
- Take medications as directed; do not take over-the-counter medications without checking with your doctor.
- The night before, eat a light meal and do not eat or drink anything after midnight unless told otherwise by your doctor.
- Arrange for help at home after returning from the hospital.
You will receive
IV fluids, antibiotics, and anesthesia.
The surgeon cuts into the lower abdomen and connects the donated kidney to your arteries, veins, and ureter, which carries urine to the bladder. The diseased kidneys are usually left in place. The incision is closed. Your new kidney may start producing urine immediately or within a short time.
A catheter that is connected to a bag collecting urine will be left in your bladder.
The surgery typically takes about 3 to 6 hours. Anesthesia prevents pain during surgery. You may experience pain while recovering, but you will receive pain medication to relieve this discomfort. - Infection
- Rejection of the new kidney
- Leakage from ureter
- Heart problems from prior heart disease (such as heart attacks, heart failure, or heart rhythm problems)
- Blood clot in the bladder or vein connected to the kidney
- Postoperative diabetes
- Gastrointestinal ulcers (sores in the lining of the stomach or intestines)
- Phlebitis (blood clots of a vein)
- Excessive swelling of your wound or legs
- Damage to blood vessels or nerves
- Cancer risk due to prolonged use of immunosupression drugs
- Urinary obstruction
- Kidney stones
You are also specifically at higher risk for activation or progression of a number of diseases due to the use of immunosuppressive drugs, including:
- Recurrence of cancer
- Liver disease if you have hepatitis C or B
- Infections like tuberculosis or AIDS if you are infected before surgery
The typical recovery time in the hospital is
1 to 2 weeks.
- Take deep breaths and cough 10 to 20 times every hour to decrease the risk of fluid building up in your lungs and pneumonia.
- Expect to get out of bed the day after surgery.
- You will be started on drugs to suppress your immune function and therefore decrease the risk that your body will reject your new kidney.
- You may be given steroid medications to decrease inflammation in your new kidney.
- You may be given diuretic medications to help rid your body of accumulated fluid.
- Only take medications approved by your doctor.
- Your new kidney may be monitored via ultrasound examinations and nuclear medicine scans.
- You may be asked to weigh yourself , take your blood pressure daily, and to measure the amount of fluids you take in as well as the amount of urine you pass.
- The amount of salt and protein you eat may be restricted.
- You may be asked to avoid alcohol for at least a year.
After a period of recuperation, you will most likely be able to return to work and normal activities. To reduce the chance that your body will reject the donor kidney, you will need to take immunosuppressive drugs for the rest of your life. Additional drugs may be ordered to manage side effects. These drugs may increase your risk of developing cancer, kidney disease (in the new kidney), and weak bones. More than 80% of transplanted kidneys from cadaver donors remain working after one year. The success rate often improves with a kidney from a living donor, because the donated tissue more closely matches your tissue. - Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
- Passing no or only small amounts of urine
- Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain
- Coughing up blood
- Sudden headache or feeling faint
- Malaise
- High blood pressure
- Weight gain greater than three pounds in one day
Last reviewed November 2007 by A. Carmack, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved. |
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