A kidney transplant is a treatment for kidney failure. It is a surgery to give you a healthy kidney from someone else’s body. This one new, healthy kidney can do the work that your two kidneys did when they were healthy. Your new kidney might come from someone who is still alive or someone who has just died. A living donor transplant is a surgery to give you a kidney from someone who is still alive. A deceased donor transplant is a surgery to give you a kidney from someone who has just died. No matter where your kidney comes from, your doctor will make sure that it is healthy and a good match for you.

Deceased donor transplant

A deceased donor kidney transplant is a surgery to give you a kidney from someone who has just died. To get a kidney from a deceased donor, you must get on the national waiting list for deceased donor kidneys. Learn more about deceased donor kidney transplants.

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Living donor transplant

A living donor kidney transplant is a surgery to give you a kidney from someone who is still alive. People can survive with just one healthy kidney, so someone with two healthy kidneys may choose to donate one. After your transplant, you and your donor will each have one healthy kidney. You can get a living donor kidney transplant if your doctor thinks it is safe for both you and your donor, and when you and your donor are both ready. Learn more about living donor kidney transplants.

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Evaluation for transplant

If your doctor thinks you may benefit from having a kidney transplant, he or she can refer you to a transplant center, which is a hospital that does organ transplants. Once you have found a transplant center, the first step is to have a transplant evaluation. During this evaluation, you will have blood tests, x-rays and other exams to make sure that having a transplant would be safe for you.

You will need to go to the transplant center to have the evaluation. You may be able to finish the evaluation in one day, or you may have to do it over several days. On the day of your evaluation, you and your family will meet the members of the transplant team to learn about preparing for a kidney transplant, what to expect during the recovery period, medicines you will need to take and more. The transplant team members will also need to learn about you. You might need to answer questions about your finances, your support system and your health insurance policy. You will also have tests that will help the doctors learn about your kidneys and your overall health. These tests might include:

  • Blood tests to figure out your blood type
  • Tissue-typing tests to learn about certain parts of your tissue that will need to match your donor kidney
  • Screening tests for diseases, such as HIV and hepatitis
  • Prostate exam (for men)
  • Mammogram and Pap smear (for women)
  • Heart and lung exams
  • Kidney and liver function tests
  • Colon exam

The transplant team will also ensure that you are in good mental health. You will meet with the transplant social worker to have this part of the evaluation.

If, after the evaluation is complete, your transplant team decides that you are ready for transplant and you decide that you want to have a transplant, you may be added to the national waiting list for a donor kidney. If you have a living kidney donor, you may have your transplant as soon as both you and your donor are ready.

The transplant team may decide that you are not ready for transplant. This could happen if you have a health problem that could make the transplant surgery dangerous for you. Some health problems can be treated so that you can have your transplant. Other problems that could keep you from having a transplant include:

  • Drug or alcohol abuse
  • Mental illness
  • History of missing treatment sessions or not taking medicines
  • Not having a strong support system

If your transplant team thinks you are not yet ready for transplant, talk to them about what you can do to become ready.

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Finding a match

Your immune system’s job is to find anything in your body that shouldn’t be there and get rid of it. These things could be viruses, such as the flu, or a splinter in your finger. Your immune system knows that these things don’t belong in your body, and it attacks them to get rid of them. When you have a kidney transplant, your new kidney comes from someone else’s body. If your immune system notices that your new kidney is different than the rest of your body, it will attack the new kidney. To lower the chances of this happening, your new kidney will need to be very similar to the other organs and tissues in your body. This will help to keep your immune system from realizing that the new kidney is actually from someone else’s body.

The new kidney must come from someone whose blood type works with your blood type.

  • If your blood type is O, you can only get a kidney from someone with Type O blood.
  • If your blood type is A, you can get a kidney from someone with Type A or Type O blood.
  • If your blood type is B, you can get a kidney from someone with Type B or Type O blood.
  • If your blood type is AB, you can get a kidney from someone with Type AB or Type O blood.

The new kidney must also come from someone who has a similar HLA type. HLA stands for human leukocyte antigen. Your immune system uses HLA to find things in your body that shouldn’t be there, such as viruses and bacteria. If your HLA type is very similar to that of the new kidney, there is a lower chance that your immune system will try to fight the new kidney.

Your HLA type depends on your parents’ HLA types. Some HLA types are more common among certain racial or ethnic groups and may not match the HLA type of someone from another racial or ethnic group. For example, if you are African-American, you are more likely to have a kidney with a matching HLA type from someone who is also African-American.

Unfortunately, there are not enough organ donors from racial and ethnic minority groups. Therefore, if you are African-American, Asian-American, Hispanic or Native American, you may have more trouble finding a matching kidney, which can cause you to have to wait longer for a transplant.

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The transplant surgery

If you have a living kidney donor, you will be able to schedule the date of your transplant. You and your donor will have surgery in the same hospital, on the same day.

If do not have a living donor and you are on the waiting list for a deceased donor kidney, you will not know when your surgery will happen. If a kidney becomes available, you will get a phone call telling you to get to the hospital right away. Once you get to the hospital, you will have a blood test to make sure your body will not have a bad reaction to the donor’s blood. If the test does not show a problem, the doctors and nurses will prepare you for surgery.

In most cases, kidney transplant surgery takes three to four hours. During the surgery, you will be under general anesthesia, which means you will be asleep and unable to feel pain. Your new kidney will be put into your body through a small cut in your lower abdomen. You will need to stay in the hospital for about a week after the surgery, to recover and make sure that your new kidney is working well.

It is possible that you will arrive at the hospital, ready for your transplant, only to find out that the donor kidney is not healthy enough to give to you. If this happens, try not to be discouraged—another kidney might be available soon!

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Caring for your new kidney

Preventing rejection

One risk of a kidney transplant is that your body will reject (fight) the new kidney. This can happen if your body’s immune system realizes that the kidney is from someone else. To prevent this from happening, you must take medicine to weaken your immune system. This medicine is called an immunosuppressant, or an anti-rejection medicine. You should take your anti-rejection medicine exactly the way your doctor tells you to. If you miss even one dose, you could risk losing your new kidney. But anti-rejection medicine also comes with risks and side effects. Talk to your doctor about what you might experience with the type of anti-rejection medicine you take.

Diet and exercise

If you were on dialysis before your transplant, you will notice a difference in what you can eat and drink once you have your new kidney. You should still eat a diet low in salt and fat to prevent high blood pressure, and if you have diabetes, you will still need to manage your blood sugar. However, you will be able to eat many more fruits and vegetables and drink more fluids than you could when you were on dialysis. Ask your dietitian to help you make a healthy eating plan that will work for you with your new kidney.

Once you have recovered from the transplant surgery, you may be able to start a new exercise routine. Exercise can help improve your heart and lung health, prevent weight gain and even improve your mood. Talk to your doctor about the types of exercise that are right for you, how often you should exercise and for how long.

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Paying for transplant

Selling organs is illegal in the United States, so you will not pay for your kidney. However, you will have to pay for your transplant surgery, transportation to and from the transplant center, medicines and follow-up care. Medicare, Medicaid and many private insurance policies cover kidney transplant surgery. Each policy may be different in terms of how much it covers and what requirements you must meet to qualify for coverage. Talk to your social worker or the financial coordinator on your transplant team to find out what your insurance policy covers and if you are eligible for financial assistance.

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Get to know your transplant team

This team of health professionals will help you through the transplant process and all that comes with it before, during and after your surgery.

Transplant coordinator

This team member is usually a nurse. You may contact your transplant coordinator if you have any questions or need any help at any point throughout the evaluation process, the waiting period and your recovery period.

Transplant surgeon

This is the doctor who will decide if you are ready for transplant. If you are able to have a transplant, this doctor will do the transplant surgery.

Transplant nephrologist

This doctor will help the transplant surgeon with your evaluation and your care.

Transplant financial coordinator

This team member will work with you and your social worker to help you figure out how you can best use your resources to pay for your transplant.

Transplant social worker

This team member can help you and your family apply for financial assistance, find support groups or other emotional support resources, and manage the stress that comes with transplant surgery and recovery.

Transplant dietitian

This team member will help you stay on track with your diet before transplant and during your recovery.

Some transplant centers might have more people on their transplant teams, but you will likely find this core group of team members on the transplant team at any transplant center you choose.

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