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Step-by-Step Guide: Kidney Transplant 

If you or someone you love needs a kidney transplant, understanding the following steps will help:

Pre-transplant Evaluation

Although you have discussed transplantation with your doctor and decided you may need a transplant, your doctor may refer you to the Baylor transplant program. Each patient referred for a transplant undergoes an evaluation including various physical examinations, diagnostic tests and educational meetings, usually performed on an outpatient basis.

To be considered for a kidney transplant, you must have a diagnosis of end-stage renal disease without any conditions that would exclude you from getting a transplant.  It is not necessary to be on dialysis prior to transplant.  Pre-dialysis candidates should have a GFR of 20 to be placed on the transplant waiting list.

Patient Selection Process

If you are approved as a candidate for transplantation and reimbursement for the transplant has been cleared with your insurer, you will be placed on Baylor’s transplant waiting list and registered with the United Network for Organ Sharing (UNOS), the national organ-donor system.

Transplant

The most successful transplants are from living donors. You may receive a kidney from:

  • Live Donor - such as a relative or a close friend
  • Paired Kidney Donor – a program that matches you and your donor with other registered recipients and donors
  • Deceased Donor – a person who has recently died

Before a kidney from any donor can be used, it is tested to determine whether it matches your tissue type and blood type. This test helps reduce the likelihood that your body will reject the new kidney.

During kidney transplant surgery, a surgeon will place the healthy donor kidney into your body. The new kidney will do the work that your failing kidneys can no longer perform. Generally, your damaged kidneys will not be removed unless they are causing problems that cannot be treated with medication.

After placing the donor kidney in your body, the surgeon will connect blood vessels from the donor kidney to ateris and veins in your body. After the ureter- the tube that carries urine to the bladder – from the donor kidney is connected to your ureter, surgeons can allow blood to flow through the new kidney, and it can begin to function. Kidney transplant surgery may take two to four hours.

Frequently Asked Questions

What are the options for patients with end-stage renal disease? People with end-stage renal (kidney) disease (ESRD) have two treatment options: dialysis or transplantation. The decision to have a transplant is one that you will make along with the advice of your nephrologist (kidney doctor).

Why can’t I stay dialysis for the rest of my life?

While dialysis is a lifesaving treatment, it involves dependence on a hemodialysis machine or on peritoneal dialysis exchanges (machines that clean your blood and replace the function of your kidneys). For many people, the quality of life on these two types of dialysis is unsatisfactory. Transplantation is another lifesaving option that can provide improved life and freedom from dialysis.

What are the advantages of kidney transplant?

A successful kidney transplant allows most patients to feel better and have an improved quality of life. Although medical supervision will continue after transplant, you will no longer be dependent upon dialysis. There may also be fewer dietary and fluid restrictions.

What are the risks of a kidney transplant?

Transplantation has risks as well as benefits. Your body may reject the transplant. You may experience side effects from the medications. There are surgical risks with all surgical procedures. Your physician will discuss the risks and benefits with you.

What happens during kidney transplantation?

Kidney transplantation is a procedure in which a new kidney from another person is placed into your body, taking over the work of your two failed kidneys. The new kidney can do all the work that your failing two kidneys could not. Candidates for kidney transplantation can be put on a waiting list for a healthy kidney, but some may receive a kidney from a living donor who is usually a family member or close friend of the recipient.

How can a patient prevent organ rejection?

A number of very effective medications are available to prevent organ rejection. These medications suppress the immune system, which inhibits rejection of foreign tissue. After a kidney transplant, recipients must take medications daily for the rest of their lives.