About Kidney Transplantation

Kidney transplantation involves surgically implanting a donorís kidney into a person whose own kidneys have permanently failed due to injury or chronic end-stage renal disease.

When a person's kidneys permanently stop excreting waste products and body fluids, chronic end-stage renal disease occurs. Kidney transplantation is one method of treating this disease. Dialysis is another commonly used treatment.

Since kidney transplants enjoy a high success rate today, nearly all end-stage renal disease patients can be considered eligible candidates—providing they are medically suitable.

There are two kinds of kidney transplants: cadaveric and living donor. Cadaveric transplants involve transplanting the organs of stable, heart-beating individuals who have been declared 'brain dead' due to traumatic events.

Brain death, or the determination of death by neurological criteria, is the irreversible cessation of all functions of the brain. In the event of brain death, consent for organ donation is obtained from the donorís family or next of kin. Artificial support keeps the donor's other organs functioning until donation occurs.

Since there is a nationwide shortage of organ donors, patients who need cadaveric kidney transplants usually go on a waiting list. A national computer must consider many factors when matching these potential recipients with appropriate cadaveric donor kidneys.

Some patients have relatives or close friends willing to give them one of their kidneys. Most people have two kidneys, so one can be safely donated, although major surgery is required of the donor and recipient. Kidney donors must have compatible blood and tissue and be medically approved for the surgery. Generally, they are between the ages of 18 and 50. When these donors are family members, they are called living related donors; about one-third of the transplants performed at University Hospital fall into this category.

The term 'non-related living donors' applies to donors who are not blood relatives, but are 'emotionally' related. These transplants are also performed at University Hospital and are another option that the patient can discuss with the transplant team.

Most people are medically suitable for transplants, although certain conditions—such as ongoing infections and recurring cancer—may prevent this procedure. Before any plans for surgery are made, the transplant team at University Hospital will evaluate your medical status by interviewing with you, conducting a physical exam, and reviewing your medical history.

Age was once considered a major factor, but it no longer prohibits kidney transplantation. At University Hospital, our transplant recipients range in age from six months to 70 years, with exceptions.

Many of our transplant patients have end-stage renal disease due to diabetes. If you have diabetes, you may be a candidate for a combined kidney-pancreas transplant. For more information about transplants for patients with diabetes, please talk to your doctor and refer to Pancreas Transplantation.

Kidney failure frequently leads to temporary infertility. After a transplant, this condition is often reversed. We recommend, however, that you delay pregnancy for a least a year after your transplant. And be sure to discuss your plans for pregnancy with your transplant surgeons and physician.

As a rule, your kidneys are not removed during the transplant surgery. However, the transplant surgeon will evaluate your individual situation. The most common reason for prior removal is frequent, repeated infections of the urinary system.

The new kidney is placed in the lower right or left side of the abdomen.

Approximately 4 hours.

The average hospital stay for an uncomplicated kidney transplant is about 4–5 days.

For a living donor, the average hospital stay is 4 days. Normal activities may be resumed usually after a six-week recovery period.

Most kidney transplant patients experience a marked improvement in their quality of life—and have an increased life expectancy. They no longer require dialysis or have fluid and diet restrictions. Most have higher energy levels and are able to resume normal activities, including work. Of course, medical supervision will still be required despite these improvements.

To prevent your body from rejecting the new kidney, you will need to take medications daily for the rest of your life. These medications may have undesirable side effects. Since each patient is unique, your transplant team will discuss any potential disadvantages or special considerations involved in your case.

Private medical insurance and Medicare's End-Stage Renal Disease Program share in covering the cost of kidney transplantation. The Veteran's Administration or Medicaid may also be sources of financial aid, although aid is applied for—and eligibility determined—on an individual basis.

A University Hospital transplant social worker and the transplant financial coordinator is available to address your concerns about insurance coverage, surgery costs, the surgery itself, hospitalization, and medications.