Kidney Transplantation Process
A kidney transplant may involve one or both kidneys, if the donor is deceased, and only one kidney if the donor is living. In most transplants, only one kidney is transplanted. In certain circumstances, particularly if the donor is less than ideal, two kidneys may be transplanted.
Kidney Transplant Evaluation
Once an individual decides to consider kidney transplantation (becoming a kidney recipient), an initial evaluation is made to ensure that kidney transplantation is the right option for the patient.
Once the patient has chosen the path of transplantation for treatment, the patient will receive a thorough evaluation from the kidney transplant team, which includes transplant nephrologists, transplant surgeons, transplant nurses, financial counselors, social workers and dietitians. The overall evaluation takes approximately three days and includes:
- Diagnostic & Blood Testing, including blood tests, x-rays, ultrasounds, CT scans and cardiac testing.
- Appointments to See Other Specialists, such as cardiologists, gynecologists, urologists and gastroenterologists, as necessary, to determine if it is safe to proceed with kidney transplantation.
- Psychosocial Evaluation, to help prepare the patient and loved ones for kidney transplantation. Financial counselors are also available to help make necessary arrangements prior to transplantation.
- Patient Education, to help the patients and their loved ones fully understand the transplant process, a crucial step in successful kidney transplantation.
Once the evaluation is complete and the results of the tests are received, the multidisciplinary transplant team will confirm that kidney transplantation is a safe procedure for the patient and, if so, will place the patient on the kidney transplant national waiting list, administered by The United Network for Organ Sharing (UNOS).
Waiting times vary depending on blood type, and the average wait time at our center is the shortest in Houston and below the national average, per SRTR*.
Patients awaiting kidney transplantation on our transplant list are seen by affiliated Transplant Center physicians on an annual basis to ensure that they will be ready for transplantation when the kidney becomes available.
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 hospital. The patient will meet again with a nephrologist and a transplant surgeon to answer any questions, and the patient (or patient’s legal guardian) will sign a consent form authorizing the procedure.
If the patient has been on dialysis, he or 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 procedure is the same whether the kidney comes from a living donor or a deceased donor. It is performed under general anesthesia and typically takes about 2-3 hours. The team of specialized transplant anesthesiologists will ensure that our patients receive the best available care while the kidney transplant is being performed. 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.
Following the procedure, patients are taken directly to a dedicated Transplant Surgery Intensive Care Unit (TSICU) to recover. Most patients spend only one night in this unit before being transferred to the regular transplant surgery floor. Many patients have immediate function of the transplanted kidney and will not require any dialysis after the transplant procedure. The hospital stay following a kidney transplant is typically 3-4 days.
Kidney Transplant Recovery
The goal of kidney transplantation is to return patients to a full, satisfying quality of life, free of dialysis and dietary restrictions. Patients typically return to school, work, non-contact sports and other activities they enjoyed prior to developing kidney disease.
Following transplant surgery, the transplant physicians and staff continue to monitor recent kidney recipients very closely. Clinic visits are scheduled weekly or twice-weekly during the early period post-transplant, and the time between visits will increase according to the patient's needs. Patients from outside the Greater Houston area should plan to stay in Houston for 2 to 4 weeks after transplant to ensure that this close follow-up is possible.
Possible Transplant Risks
Kidney transplantation carries associated risks, including the risk of the body rejecting the implanted kidney(s), the risk of infection and the increased risk of cancer from the immunosuppression (anti-rejection) medication administered to reduce the risk of rejection.
It is important to know that rejection does not usually mean loss of the transplanted organ. Rather, rejection simply means that the balance of the immune system and the organ has changed and immunosuppression needs to be increased. Your doctor will discuss the risks associated with transplantation with you prior to your procedure.
To find out more about kidney transplantation or to schedule an appointment with an affiliated physician at the Transplant Center, please call (713) 704-5200.
If you are a physician and would like to refer a patient to the Transplant Center, click here.
*Source: Scientific Registry of Transplant Recipients (SRTR). Cohort: 01/01/2016 - 12/31/2016