A transplant team carries out the evaluation process for a kidney. The team includes a transplant surgeon, a transplant nephrologist healthcare provider specializing in the treatment of the kidneys , one or more transplant nurses, a social worker, and a psychiatrist or psychologist.
Mental health evaluation. These issues can greatly affect the outcome of a transplant. The same kind of evaluation is done for a living donor. Blood tests. Blood tests are done to help find a good donor match, to check your priority on the donor list, and to help the chances that the donor organ will not be rejected.
Diagnostic tests. Diagnostic tests may be done to check your kidneys as well as your overall health status. These tests may include X-rays, ultrasound, kidney biopsy, and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram. The transplant team will weigh all the facts from interviews, your medical history, physical exam, and tests to determine your eligibility for kidney transplantation.
Once you have been accepted as a transplant candidate, you will be placed on the UNOS list. When a donor organ becomes available, you will be notified and told to come to the hospital right away. If you are to get a kidney from a living family member living-related transplant , the transplant may be done at a planned time. The donor must have a compatible blood type and be in good health.
A mental health check will be done to be sure the donor is comfortable with the decision. You will be asked to sign a consent form that gives your permission to do the surgery.
Read the form carefully and ask questions if something is not clear. If you have been on routine dialysis before the procedure, you will get dialysis before the procedure.
For a planned living transplant, you should fast for 8 hours before the operation, generally after midnight. In the case of a cadaver organ transplant, you should start to fast once you are told a kidney has become available. Based on your medical condition, your transplant team may ask for other specific preparation. A kidney transplant requires a stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices.
An intravenous IV line will be started in your arm or hand. More catheters may be put in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for catheters include under the collarbone area and the groin blood vessels. Kidney transplant surgery will be done while you are asleep under general anesthesia.
A tube will be inserted through your mouth into your lungs. The tube will be attached to a ventilator that will breathe for you during the procedure. The anesthesiologist will closely watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
The healthcare provider will make a long incision into the lower abdomen on one side. The healthcare provider will visually inspect the donor kidney before implanting it. The donor kidney will be placed into the belly. A left donor kidney will be implanted on your right side; a right donor kidney will be implanted on your left side.
This allows the ureter to be accessed easily for connection to your bladder. The renal artery and vein of the donor kidney will be sewn to the external iliac artery and vein.
After the artery and vein are attached, the blood flow through these vessels will be checked for bleeding at the suture lines. The donor ureter the tube that drains urine from the kidney will be connected to your bladder. Talk with your healthcare provider about what you will go through during your kidney transplant. After the surgery, you will be taken to the recovery room.
Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to the intensive care unit ICU for close monitoring. In time, you will be moved out of the ICU to a regular nursing unit as you recover and you are closer to going home. Kidney transplant usually calls for several days in the hospital.
A kidney from a living donor may start to make urine right away. Urine production in a cadaver kidney may take longer. You may need to continue dialysis until urine output is normal. You will have a catheter in your bladder to drain your urine. The amount of urine will be measured to check how the new kidney is working. Your team will closely watch how your antirejection medicines are working to make sure you are getting the best dose and the best combination of medicines.
Blood samples will be taken often to check the status of the new kidney, as well as other body functions, such as the liver, lungs, and blood system.
You will slowly move from liquids to more solid foods as tolerated. Heart valves may also be replaced with human valves allotransplant or mechanical heart valves. Ongoing medical advances and research means new opportunities for innovation in transplant are expanding to include face transplants.
Multi-organ transplants, while less common than single-organ transplants, occur each year. Common multi-organ transplants include heart and lungs or pancreas and kidney. The approach to transplantation varies greatly depending on the type of transplant. Talk to your medical team about surgical procedures, recovery and medication. This page has been produced in consultation with and approved by:.
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The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Heart. Organ and tissue transplantation. Paired-organ donation Open pop-up dialog box Close. Paired-organ donation In paired-organ donation, living donors and their recipients aren't compatible for a transplant. Living-donor organ donation chain Open pop-up dialog box Close.
Living-donor organ donation chain More than one pair of incompatible living donors and recipients may be linked with a nondirected living donor to form a donation chain in order to receive compatible organs. Kidney transplant Open pop-up dialog box Close. Share on: Facebook Twitter. Show references Roberts IS. Kidney diseases. Philadelphia, Pa. Accessed April 28, Transplant Living. Kidney transplant. Matching donors and recipients.
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Choosing a treatment for kidney failure. Living donation. The kidney transplant waitlist — What you need to know. Vella J. Risk factors for graft failure in kidney transplantation.
Bloom RD, et al. Getting a new kidney: facts about kidney transplants. American Society of Transplantation. Montgomery RA, et al. HLA in transplantation. Nature Reviews Nephrology. Husain SA, et al. Patients prioritize waitlist over posttransplant outcomes when evaluating kidney transplant centers. General information on living donation. April 28, Orandi BJ, et al. Kidney transplants from incompatible live donors.
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