Kidney Transplant Procedure
Living donor transplants will be scheduled on a date chosen ahead of time and will be performed on an elective basis.
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 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.
If the patient has been on dialysis, he/she may require a session of dialysis prior to the transplant procedure. The
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.
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.
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
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
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.
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
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