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Kidney Transplant Procedure

Kidney Transplant Procedure

Living Donor Transplant Admission Process

Living donor transplants will be scheduled on a date chosen ahead of time and will be performed on an elective basis.

Deceased Donor Transplant Admission Process

For deceased donor transplants this scheduling is not possible, as the transplant must be performed soon after the organ becomes available. When a deceased donor kidney becomes available the patient will be notified and will be admitted to the hospital.

The patient will meet again with a nephrologist and a transplant surgeon to answer any questions, and a consent form will be signed to authorize the procedure.

Dialysis

If the patient has been on dialysis, he/she may require a session of dialysis prior to the transplant procedureThe Transplant Center provides both hemodialysis and peritoneal dialysis so it is unnecessary for the recipient to bring his/her peritoneal dialysis supplies. Sometimes, a final matching test (histocompatibility) must be done before the transplant can happen. If the patient and donor do not match, the patient may have to wait for another kidney.

Transplant Operation

The transplant operation itself is the same whether the kidney comes from a living donor or a deceased donor.

Kidney transplantation is performed in about 2-3 hours under general anesthesia. Our team of specialized transplant anesthesiologists will ensure that our patients receive the best available care while the kidney transplant is being performed.

Opening and Transplant

Once the patient is asleep, the surgeon will make an incision in the lower abdomen, usually on the right side. The surgeon will identify the blood vessels that bring blood to and from the leg, and these blood vessels will be used to bring blood into and out of the donor kidney. The ureter (urine tube) from the donor kidney will be implanted directly in the bladder so that the urine will be passed normally.

The native kidneys will not be removed unless there is a specific reason to remove them. Finally, the incision will be closed and the anesthesia team will wake the patient from anesthesia.

Surgical Closing

Most kidney transplant incisions are closed with surgical glue and dissolving stitches placed beneath the skin to maximize the cosmetic effect and to promote better wound healing. Tubes and drains are usually not placed except for a temporary urine catheter and a special IV for administering medications.

A plastic stent is usually placed inside the ureter and bladder during the procedure and will be removed by an urologist several weeks after the transplant.

Kidney Re-transplantation

Patients who have had previous transplants or previous surgery on the urinary tract may require different incisions and different connections to enable kidney transplantation. Our team of surgeons has extensive experience in kidney re-transplantation and "unusual" kidney transplants. We are committed to transplanting all eligible patients including those with complicated surgical histories.

Recovery

Following kidney transplantation surgery the patient is taken to our dedicated Transplant Surgery Intensive Care Unit (TSICU) for monitoring. Most patients spend only one night in this unit before being transferred to the regular transplant surgery floor. The vast majority of patients have immediate function of the transplanted kidney and will not require any dialysis after the transplant procedure.

Typically, kidney recipients will only require 3 or 4 days of recovery in the hospital after surgery. The urine catheter and IV will usually be removed on the third day after surgery. Wound care is minimal after surgery and showering soon after surgery is encouraged.