Before Your Transplant
Before you receive a kidney transplant, you have a series of tests to determine your current health.
After these tests are performed, you have a thorough evaluation with various members of the kidney transplant medical team.
Following your tests and evaluation, your case will be presented to the Kidney Transplant Selection Committee, which consists of transplant experts. The committee is made up of transplant experts who determine whether kidney transplantation is a safe procedure for you. They also will discuss a plan of care for you after transplant.
Your transplant nurse coordinator will inform you of the committee’s decision and plan.
Your coordinator will notify you if/when you are placed on the active transplantation waiting list or registry (see "Kidney Transplant Wait List" below).
Once on this list, you should be prepared to come to the hospital at any time, day or night.
Your Transplant Surgery
After you have received a call to come to the hospital for your transplant surgery, you are admitted to the transplant unit. This is where preparation for surgery begins. You may have some preoperative tests done and be given some medications.
Your surgery will not begin until the donor kidney:
- Arrives at the hospital
- Is examined by the transplant surgeon
- Is considered to be acceptable
Once the medical team decides to proceed with your surgery, you will be given an anesthetic to put you to sleep for the procedure.
Most living kidney donor surgeries are scheduled after all testing has been completed on both the recipient and the donor.
Summary of the Procedure
An incision is made in the lower abdomen on either side. The end of the artery on the donor kidney is attached to the side of one of your arteries. The veins are attached in the same fashion. Clamps are used on the vessels while the surgeon sutures them together.
Once the clamps are removed, blood is circulated through the new kidney. The kidney should turn pink in color and may begin to make urine within minutes. The donor ureter (tube that carries urine) is then connected to your bladder.
The surgery lasts about two to three hours, but may vary. A transplanted kidney is placed in the lower abdomen of the recipient rather than in its natural position in the back (it’s easier to connect it to your bladder in this location).
In most cases, your native kidneys are left in place.
After Your Procedure
After surgery, you will be transferred to the recovery room. Once the anesthesia has worn off, you will be transferred back to the transplant unit.
The amount of time a patient is in the hospital after kidney transplant surgery varies. It can be as little as two days, barring complications.
Most transplanted kidneys work immediately after the surgery. Sometimes, the transplanted kidney doesn’t function completely or at all for a few days or a few weeks. This type of early non-function is called acute tubular necrosis, or ATN. ATN is usually reversible and resolves eventually. You may need dialysis once or a few times after surgery until the transplanted kidney recovers.
You may return to work as early as four weeks after surgery. Depending on your condition, it may take longer.
Most complications are seen in the first few months. We recommend that you wait six months after transplant surgery before planning a vacation or long-distance trip.
Your Life Post-Transplant
Your kidney function will need close monitoring for the first several months after you leave the hospital.
Initially you will be seen in the renal transplant clinic very often. The frequency of your visits to the clinic and the need for blood work depends on your individual progress and will lessen as you recover.
You need to have blood tests done at least once a month as long as you have your new kidney. Your risk for rejection and infection decreases with time, but is never completely gone.
Your follow-up visits will be more flexible when your:
- Wound is healed
- Kidney functions normal
- Medication dose is adequate
At this time, you also may have your blood tests done at a location closer to your home. Your follow-up care to be managed by your local doctor and lab facility.
The kidney transplant team will continue to follow your progress as long as you have your new kidney. We encourage you to return to University of Colorado Hospital’s Transplant Center for a check-up once a year.
Diet and Exercise After Your Kidney Transplant
Exercise and diet after transplant are very important factors in feeling healthy again. Post-transplant patients are encouraged to resume or begin a regular exercise plan when they leave the hospital.
It is very unhealthy for your new kidney and your general well-being to put on excessive weight. The most effective method of maintaining a desired weight is to limit calories and exercise regularly.
Exercise for transplant patients has been shown to
- Increase endurance
- Increase muscle strength
- Enhance bone remodeling
- Reduce the need for anti-hypertension medication
Proper nutrition also is critical in post-kidney transplant patients. Certain medications you may be taking will affect the way your body processes food.
Your dietician at the hospital will help you devise meal plans that are both nutritious and low in calories. Your diet is important in the total rehabilitation process and for maintaining a good nutritional status throughout your life with your new kidney.
UNOS is a nationwide network supervised by the federal government to help ensure that all patients receive healthy organs as soon as they become available. All transplant centers in the United States belong to UNOS.
For this system to work, it relies on organ procurement organizations, called OPOs. OPOs match and distribute donated organs, 24 hours a day, 365 days a year.
The process of matching donor organs to patients waiting transplantation is based on a point system. Points are given for several factors, including:
Because the antigen match varies with each donor kidney, the points vary each time a kidney becomes available.
Organs donated for transplantation in Colorado and Wyoming are offered first to patients on the UNOS list in these states.
If there are no suitable candidates for the organ, then it is offered to patients located outside this area.
The average patient can expect to wait up to three or four years on the list before an organ becomes available.