Treatment Option: Kidney Transplant
What is a kidney transplant?
A kidney transplant is when a healthy kidney from another person is put into your body. When your kidneys have stopped working, the new kidney can do the work that your own kidneys used to do.
There are two main types of kidney transplants:
- Deceased donor transplant
A deceased donor transplant comes from someone who has just died. To get a deceased donor transplant, you must be put on a waiting list.
- Living donor transplant
A living donor transplant comes from someone who is still living. This is possible because each person only needs one normal kidney to be healthy. A person with two healthy kidneys can donate one kidney to someone whose kidneys have failed. A living donor can be a family member, a friend or even a stranger.
How can I get a transplant?
Talk to your doctor if you think you might want to get a kidney transplant. Your doctor can help you decide if a transplant is right for you. He or she can also refer you to a transplant center, where you will work with a transplant team. Your transplant team may include:
- A surgeon
- A kidney doctor
- A nurse or transplant coordinator
- A dietitian
- A social worker
- A financial coordinator
Your transplant team will help you with the many tests you will need to have before you can get a transplant. These tests help to make sure that you are healthy enough for the operation and that your new kidney is a good match. These might include tests to:
- Check your heart and lungs
- Find the closest donor match (deceased or living)
Your doctor may order other tests, such as a colonoscopy, PAP smear, mammogram, prostate or dental exam, to check for other problems that might need to be treated first.
Once your tests are done, your transplant team will look over your results and decide if you are ready for a transplant. If you are ready to get a transplant, you can be added to the transplant waiting list to wait for a deceased donor transplant. You can also start looking for a living donor.
If the doctors decide that you are not ready for a transplant, it may be because of other health problems. Some health problems may keep you from getting a transplant, and others may just need to be treated first. For example, if you are overweight, you may need to lose weight before you can get a transplant. Your healthcare team can help you with this.
How long do I have to wait to get a transplant?
If you have a living donor, you can get your kidney transplant when you and your donor are both ready. It is usually best to get a living donor transplant either just before or soon after you need to start dialysis. Wait times for a deceased donor transplant vary, depending on:
- Time already on the waiting list
- Blood and tissue type
- Whether certain antibodies are in your blood
While you’re on the waiting list for a deceased donor transplant, you can also look for a living donor. If you are concerned about the wait time or are having trouble finding a living donor, you may want to ask your transplant team about being put on lists in other areas, too. You might also ask your transplant team if expanded criteria donation or paired donation is an option for you.
Expanded Criteria Donation
Expanded criteria donors are deceased donors who are older or have less than normal kidney function. These kidneys may not last as long as other kidneys, but expanded criteria kidneys may be available sooner than other kidneys and may improve and lengthen your life.
We’ll explain paired donation with an example (see chart on the right). Alice wants to give a kidney to Andrew, but they’re not a good match. Bill wants to give a kidney to Betsy, but they’re also not a good match. But, Alice is a good match for Betsy, and Bill is a good match for Andrew. So, Alice donates her kidney to Betsy, and Bill donates his kidney to Andrew. That way, everyone gets a kidney who needs one.
How should I take care of my new kidney?
One risk of a kidney transplant is that your body will reject (fight) the new kidney. This can happen because your body’s immune system knows that the kidney is from someone else. If your body does reject your new kidney, the kidney may stop working.
To help keep your body from fighting your new kidney, you will need to take anti-rejection medicines (also called immunosuppressants). You will need to take these medicines for as long as your new kidney is working.
Be sure to take your anti-rejection medicines the way your doctor tells you. If you have a problem with side effects, talk to your doctor. Do not stop taking the anti-rejection medicines without talking to your doctor.
Even if you take your anti-rejection medicines as your doctor tells you to, there is still a chance that your transplant might not work. If the transplant fails, you will need to go back on dialysis. You may also want to ask about having another transplant.
How will I pay for my transplant?
Kidney transplants and anti-rejection medicines can be very expensive. Many government and private insurance programs will help you pay for the surgery and medicines. Work with your transplant team to figure out a plan to pay the expenses that insurance might not cover. You can also ask your social worker about financial assistance, or contact the American Kidney Fund for more resources.
National Institute of Diabetes and Digestive and Kidney Diseases: www.kidney.niddk.nih.gov
Transplant Living: www.transplantliving.org
Kidney transplant illustration courtesy of the National Institute of Diabetes and Digestive and Kidney Diseases, www.niddk.nih.gov.