When kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in the body, which can raise blood pressure and lead to kidney failure (end-stage renal disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.
If you have chronic kidney disease (CKD) or are on dialysis, you should consider all treatment options, including a transplant. Below, you’ll find important information about discussing this option with your doctor, insurance coverage, the transplant evaluation process, and how to prepare once your transplant is scheduled.Key Considerations for Kidney Transplants:
You don’t need to be perfect to receive a transplant, but there are specific guidelines to determine eligibility.
Most insurance plans, including Medicare and private insurance, cover portions of the costs associated with kidney transplants.
You can receive a kidney from either a living or deceased donor, with different factors to consider for each.
Discussing your need for a kidney can take time and effort, but there are effective strategies to help you locate a living donor.
The evaluation for a kidney transplant is an essential step in determining if it is a safe and beneficial treatment option for you. It involves a series of medical tests and meetings with specialists at the transplant center.
What to Expect During the Evaluation Process:
- Meeting with the transplant team, which often includes a nephrologist, surgeon, social worker, dietitian, and others.
- Undergoing lab tests and medical evaluations, which may include X-rays, EKGs, colonoscopies, and more.
- Reviewing your medical history and current medications.
After the Evaluation:
The transplant center team will review your results to determine if a transplant is safe for you. Depending on your circumstances, you may be added to the waiting list for a deceased donor or proceed with plans for a living donor transplant.
Deciding to Become a Living Kidney Donor:
Donating a kidney can be a rewarding experience, giving someone the chance to live without dialysis. However, it requires good health, comprehensive medical evaluations, and emotional support throughout the process.
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What is the process for getting a kidney transplant?
If you want a kidney transplant, the process includes these steps:
- Tell your doctor or nurse you want to have a kidney transplant.
- Your doctor will refer you to a transplant center for tests to see if you’re healthy enough to receive a transplant. Living donors need to be tested to make sure they’re healthy enough to donate a kidney.
- If you don’t have a living donor, you’ll be placed on a waiting list to receive a kidney. You’ll have monthly blood tests while you wait for a kidney.
You must go to the hospital to have your transplant as soon as you learn a kidney is available. If you have a living donor, you can schedule the transplant in advance.
Have your kidney transplant
During kidney transplant surgery, a surgeon places a healthy kidney into your body. You’ll receive general anesthesia NIH external link before the surgery. The surgery usually takes 3 or 4 hours. Unless your damaged kidneys cause infections or high blood pressure or are cancerous, they can stay in your body. Surgeons usually transplant a kidney into the lower abdomen near the groin.
If you’re on a waiting list for a donor kidney, you must go to the hospital to have your transplant surgery as soon as you learn that a kidney is available. If a family member or friend is donating the kidney, you’ll schedule the surgery in advance. A kidney from a living donor doesn’t have to be transported from one site to another, so it may be in better condition than a kidney from a deceased donor. Your surgical team will operate on you and your donor at the same time, usually in side-by-side rooms. One surgeon will remove the kidney from the donor, while another prepares you to receive the donated kidney.How will I feel after my transplant?
Many people report feeling much better right after having transplant surgery. For some people, it takes a few days for the new kidney to start working. You probably will need to stay in the hospital several days to recover from surgery—longer if you have any problems after the transplant. You’ll have regular follow-up visits with your nephrologist after leaving the hospital.
If you have a living donor, the donor will probably also stay in the hospital for several days. However, a new technique for removing a kidney for donation that uses a smaller cut may make it possible for the donor to leave the hospital in 2 to 3 days.
Before you leave the hospital, you need to learn how to stay healthy and take care of your donor kidney. You will have to take one or more anti-rejection medicines—also called immunosuppressants. Without medicine, your immune system may treat your donor kidney as foreign, or not your own, and attack your new kidney. Anti-rejection medicines may have side effects.
You may also need to take other medicines—for example, antibiotics to protect against infections. Your transplant team will teach you what each medicine is for and when to take each one. Be sure you understand the instructions for taking your medicines before you leave the hospital.
How do I know my new kidney is working?
Blood tests help you know your donor kidney is working. Before you leave the hospital, you’ll schedule an appointment at the transplant center to test your blood. The tests show how well your kidneys are removing wastes from your blood. At first, you’ll need regular checkups and blood tests at the transplant center or from your doctor. As time goes on, you’ll have fewer checkups.
Your blood tests may show that your kidney is not removing wastes from your blood as well as it should. You also may have other symptoms that your body is rejecting your donor kidney. If you have these problems, your transplant surgeon or nephrologist may order a kidney biopsy.What are the possible problems after a kidney transplant?
The donated kidney may start working right away or may take up to a few weeks to make urine. If the new kidney doesn’t start working right away, you’ll need dialysis treatments to filter wastes and extra salt and fluid from your body until it starts working.
Other problems following kidney transplant are similar to other pelvic surgeries and may include
- bleeding
- infection, especially a bladder infection
- hernia
- pain or numbness along the inner thigh that usually goes away without treatment
Transplant rejection is rare right after surgery and can take days or weeks to occur. Rejection is less common when the new kidney is from a living donor than when it’s from a deceased donor.
What are the symptoms of transplant rejection?
Transplant rejection often begins before you feel any changes. The routine blood tests that you have at the transplant center will reveal early signs of rejection. You may develop high blood pressure or notice swelling because your kidney isn’t getting rid of extra salt and fluid in your body.
Your health care provider will treat early signs of rejection by adjusting your medicines to help keep your body from rejecting your new kidney. Transplant rejection is becoming less common. However, your body may still reject the donor kidney, even if you do everything you should. If that happens, you may need to go on dialysis and go back on the waiting list for another kidney. Some people are able to get a second kidney transplant.