There are many steps you need to take to get ready for a kidney transplant. First, you must have an evaluation by a transplant center to decide if you are ready for the kidney transplant. If the evaluation teams decides you are ready, the next step is to find a kidney match, which your transplant team will help you with. There are other things you will need to prepare for, like paying for your transplant, and paying for the medicines you will take after. You will also need to prepare for the transplant surgery itself.
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.
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.
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.
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!