A kidney transplant is the surgical placement of a healthy kidney from another person into your body. Usually, your kidneys are left in place, but sometimes they must be removed.

Who needs one?

If you have End Stage Renal Disease (ESRD) or kidney failure, you will need dialysis or a kidney transplant to replace your lost kidney function. A transplant diet is less limited than a dialysis diet. Also, many medical problems like anemia, high blood pressure, heart problems, and nerve damage often improve after a transplant.

To find out if you’re a good candidate for a kidney transplant, speak with your doctor and healthcare team. You may have a medical condition that would not allow you to have a transplant or that would raise your chance of transplant failure. Your doctor will be able to tell you if this is so. If you are a good candidate for a successful kidney transplant, your social worker can help you contact your local transplant program.

Where does the donated kidney come from?

There are three ways that you can receive a kidney for transplant:

• A living related kidney can come from a brother, sister, parent, aunt, uncle, or cousin.
• A living non-related kidney can come from a husband, wife, friend, or extended family (e.g., an in-law)
• A (Cadaver) Deceased donor kidney comes from a person who has recently died and expressed a wish to donate his/her organs after death

The transplant team will do a series of blood tests on both you and the possible donor to learn your blood and tissue types. This is known as tissue typing and cross matching. This information helps figure out whether your body’s immune system will accept the new kidney or reject it. If your blood and tissue types are not compatible, the transplant will not be done and you will continue your search for a new kidney. There may be other tests you must have done before you can have a kidney transplant. The transplant team will discuss these and schedule them if necessary. If a suitable match is made, you will be scheduled for surgery.

Is giving a kidney dangerous to a living donor’s health?

If family member or friend offers to donate a kidney to you, besides the tests to see if the kidney is compatible, they will have to have a full medical screening to make sure that giving up one kidney would not harm their health. They will also have psychological testing.

There have been major advances in kidney removal and transplant over the years. However, having any surgery always carries some risks to you and your living donor. Your doctor and healthcare team will go over the risks of the surgery with you both. You can use this information to help you in your decision.

What are the pros and cons of using a living donor?

If no living donor is available, what about deceased donors?

To obtain a deceased donor transplant, you will be put on a waiting list for a kidney at a transplant center. The waiting period may be few months to several years. When a kidney becomes available, each patient on the list with a matching blood type has a tissue match done from a blood sample kept on hand at the transplant center.

What are the pros and cons of using a deceased donor?

What is rejection?

Your immune system’s job is to protect you from anything that can invade your body and make you sick. Sometimes your immune system will act as if your new kidney is an invader that it needs to get rid of. Rejection is when your body’s immune system attacks your new kidney.

To minimize the risk of rejection, you will need to take immunosuppressive drugs every day for as long as the transplanted kidney works. These expensive drugs can make you more prone to infection, diabetes, and some kinds of cancer, and may have other side effects like weight gain, hair growth, and weakened bones. Your doctor will talk to you about this, and tell you how to recognize the signs of rejection and infection. You will need to see your healthcare team regularly to check your kidney function and the effects of your drugs.

How long will the transplant work?

How long your new kidney will work can vary. Many people live well with a transplanted kidney for years or even decades before it stops working well. Right now, in the U.S., 88.4% of deceased donor kidneys survive one year, and 65.5% survive for 5 years. Among living donor kidneys, 94.4% survive one year, and 78.7% survive for 5 years. (UNOS)

If you have a kidney transplant and it fails, you will either need a new kidney, or dialysis. You can raise your chance of your new kidney working longer by following your doctor’s advice on diet and lifestyle changes, as well as taking all of your medications as prescribed.

How will life change after a kidney transplant?

For many people, life after a kidney transplant is very much like life before their kidneys failed, but there are some differences. You will need to take a number of expensive drugs each day, which may have side effects. You will also need to limit salty foods and fats in your diet. Your healthcare team will work with you to make sure that your diet is healthy. If you had hemodialysis prior to your transplant, your new diet will most likely be less limited.

Remember though, that transplantation is not a cure, it is an ongoing treatment for your CKD. You must stay in touch with your healthcare team and follow their advice to stay healthy and watch your kidney function.