What is kidney transplant?

A kidney transplant gives you a healthy kidney from another person. You may need a transplant if your kidneys work poorly because of diabetes, high blood pressure, or another illness.

You need only one kidney to live. The new kidney can do the work that your own kidneys cannot. It will remove waste from your blood. It will keep your body's fluids and chemicals in balance. You are likely to feel better and have more energy.

You have to meet certain rules to be able to get a kidney. For example, your overall health (other than kidney problems) has to be good.

Getting a new kidney can take a long time. If you're getting your kidney from a living donor, you may not have to wait long. But if it's from a person who has died, your name is put on a waiting list.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid exercises that strain your belly muscles and activities that make you work hard, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 4 to 6 weeks.
• For 4 to 6 weeks, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
• Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when you can drive again.
• Most people are able to return to work about 4 weeks after surgery. It depends on the type of work you do and how you feel.
• You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when it is okay for you to have sex.

Diet

• Follow your doctor's instructions about what to eat after your surgery. You may need to follow a special diet for your kidneys or for other health problems.
• Drink plenty of fluids (unless your doctor tells you not to).
• Check with your doctor before you drink alcohol. Alcohol can cause problems with some of the medicines used to prevent organ rejection.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take your anti-rejection medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, take an over-the-counter medicine that your doctor recommends. Read and follow all instructions on the label.
  • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on your incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

After a kidney transplant, you will have to take medicines called immunosuppressants. These medicines are very important. When you take them as prescribed, they help prevent your body from rejecting your new kidney. You will need to take medicines for the rest of your life.

These medicines weaken the function of your immune system. This means that you will have an increased risk for serious infections or cancer.

Even if you take your medicines, there is a chance that your body will reject your new kidney. If this happens, you will have to start dialysis again or have another kidney transplant.

If you have severe chronic kidney disease and choose to have a kidney transplant, you may live longer than if you choose to treat your kidney disease with dialysis alone.

In the past, transplants using a kidney from a first-degree relative, such as your father, mother, brother, or sister, worked best. But with modern antirejection drugs, kidneys from people you aren't related to work well too. Transplants from living donors or from deceased donors can succeed.

During the first weeks to months after your surgery, your body may try to reject your new kidney. This is called acute rejection. It occurs in about 1 out of 10 people in the first year after transplant. Most of the time, acute rejection can be treated with antirejection (immunosuppressive) medicines.

Within a few days, you may start to feel much better than you did before. But you may have some pain or soreness in your belly or side. This can last for several weeks.

Most people go home from the hospital 5 to 10 days after surgery. It will probably take about 4 weeks before you can get back to your job or usual activities.

After surgery, the new kidney will start to do the work that your own kidneys cannot. It will remove waste from your blood and balance your body's fluids and chemicals. Your new kidney may start working very soon after surgery. Or it may take a few weeks. If your kidney doesn't start to work right away, you will need to have dialysis until the new kidney can take over.

After the transplant, you'll have to take medicines every day from now on. The medicines will help keep your body from rejecting the new kidney. They will also make your immune system weaker. This means you will be more likely to get an infection or become sick. To reduce your risk of infection, wash your hands often. Stay away from crowds of people, and avoid contact with people who have a cold or the flu.

If your body starts to reject the kidney, your doctor may be able to stop the rejection. But if not, you will need to have dialysis again. It's possible that you can have another transplant.

You may have many different emotions after your kidney transplant. You may feel grateful and happy. But you also may feel guilty or depressed. These feelings are common. It may help to talk about your feelings with your doctor and family.

A kidney transplant is surgery to give you a healthy kidney from another person. The new kidney may have come from someone you know, a stranger, or a person who has died. You need only one healthy kidney to live.

Your belly and side will be sore for the first 1 to 2 weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. You may feel tired while you are healing. It may take 3 to 6 weeks for your energy to fully return.

After the transplant, you must take medicine to keep your body from rejecting the new kidney. You will need to take anti-rejection medicine every day from now on. These medicines have side effects. One side effect is that your body may be less able to fight infections. It's important to take steps to avoid infections. Stay away from crowds of people and anyone who might have an infection or an illness such as a cold or the flu.

Your new kidney may start working very soon after surgery, or it may take a few weeks. If your kidney doesn't start to work right away, you'll need to have dialysis until the new kidney can take over.

Having an organ transplant can bring up many emotions. You may feel grateful and happy. But you also may feel guilty or depressed. Seek out family, friends, and counselors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

Kidney transplant surgery is done so that a healthy kidney (donor kidney) can do what your diseased kidney can no longer do. Kidney transplant is used when you have severe chronic kidney disease (renal failure) that cannot be reversed by another treatment method. You will not be able to have this surgery if you have an active infection, another life-threatening disease such as cancer, or severe heart or lung disease.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You may get an epidural catheter. This is a tiny tube that delivers pain medicine directly into the area in your back around your spinal cord. It will prevent pain after surgery.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 3 hours.
• You may have a tube coming out of your belly to drain fluids for a few days.
• You may have a thin, plastic tube in your nose that goes down the back of your throat into your stomach to drain stomach juices. It is usually removed within a few days after surgery.

The transplant usually takes 3 to 6 hours.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

The risks of having a kidney transplant include:

• Rejection of the new kidney.
• Severe infection.
• Bleeding.
• Reaction to the anesthesia used for surgery.
• Failure of the donor kidney.