Kidney anatomy
Kidney anatomy
Kidney - blood and urine flow
Kidney - blood and urine flow
Kidneys
Kidneys

Kidney transplant

Definition:
Kidney transplant is a surgical procedure to implant a healthy kidney into a patient with kidney disease or kidney failure. The kidney transplant may be taken from a living donor or from a recently deceased donor.

Alternative Names:
Renal transplant; Transplant - kidney

Description:

Kidney transplants are second only to corneal transplant as the most common transplant operation in the United States. There are over 9,000 kidney transplants performed each year.

This operation is easier than all other major organ transplants. The patient can be treated with dialysis (to filter the blood and remove fluid and waste products) until a suitable kidney donor can be found.

The healthy kidney is obtained from a living donor (may be a blood relative or an unrelated donor, such as a spouse) or from a donor that has recently died, but has not suffered kidney injury.

Transportation of the healthy kidney is done in a cooled saline solution that preserves the organ up to 48 hours, permitting the necessary analyses to determine blood and tissue donor-recipient matching (this matching is done before the operation).

Living donors (donates kidney):
While the patient is unconscious and pain-free(general anesthesia), an incision is made in the side of the abdomen (flank). The kidney is removed and the incision is closed.

Kidney recipient (receives kidney):
While the patient is unconscious and pain-free (general anesthesia), an incision is made in the lower abdomen. The new kidney is stitched into place within the pelvis and the incision is closed.

Indications:
Kidney transplant may be recommended for patients with kidney failure caused by:

Kidney transplant alone may not be recommended for patients who have:

  • heart, lung, or liver disease
  • other life-threatening diseases
  • an infection (such as TB or osteomyelitis)
  • difficulty taking medications several times each day for the rest of their lives
Risks:
Risks for any anesthesia are:Risks for any surgery are:Additional risks include:
  • infection due to the immunosuppressive medications that must be taken to prevent transplant rejections
Expectations after surgery:

Kidney transplants require life-long treatment with medications that suppress the immune response (immunosuppressive therapy). Transplants from a blood-related living donor are considered a slightly better risk (in terms of avoiding rejection) than from a cadaver (nonliving donor).

Between 80% and 90% of transplanted kidneys are functioning two years after the operation. The main problem (as with other transplants) is graft rejection.

The patient is encouraged to resume normal activities as soon as possible after surgery.

The major obstacles for kidney transplants are the problem of finding a suitable donor, coping with potential rejection of the organ by the immune system, and cost.

Convalescence:
The recovery period averages 1 month. The average hospital stay is 1 week. The sutures or clips are removed about one week after surgery. Move the legs often to reduce the risk of deep venous thrombosis.

Review Date: 5/21/2002
Reviewed By: Debbie Cohen, M.D., Renal and Electrolyte Division, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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