A kidney transplant is a treatment for advanced kidney failure – often caused by diabetes or high blood pressure. During this surgery, doctors implant a kidney from a living or deceased organ donor. Getting a new kidney renews your energy and health. It frees you from needing regular dialysis to remove toxins and perform other vital functions. You’ll also be free of many diet and dialysis-related restrictions.
If you have life-threatening kidney failure, your doctor may refer you to Temple’s transplant team. Nephrologists (kidney doctors) and other specialists discuss details – including kidney transplant complications, risks and benefits – to see whether it’s right for you.
Benefits of a Kidney Transplant
If eligible, patients with end-stage kidney disease tend to prefer kidney transplant over being on lifelong dialysis.
While there are advantages and disadvantages to both approaches, kidney transplantation can provide you with a better overall quality of life than dialysis.
When compared with dialysis, the benefits of kidney transplant include:
The ability to lead a more normal life, without the need for multiple dialysis sessions per week connected to a dialysis machine.
A better quality of life. Patients report that they feel stronger with more energy and have a better outlook after a successful kidney transplant.
Fewer eating and drinking requirements than dialysis patients, who work with a nutritionist to watch salt and fluid intake.
Longer life expectancy, with better overall health.
The Kidney Transplant Procedure
Who Can Donate the Kidney?
There are 2 options for a kidney transplant — a living donor or a deceased donor. Your family members or other volunteers may be tested to determine if they’re a suitable match for living kidney donation. If we don’t find a living donor match, you’ll go on a national waitlist for a deceased donor.
To find out if you and a potential donor are a match, you’ll have a series of blood tests, which may include:
Blood type
This test ensures your blood type is compatible with the donor’s blood type. For example, donors with blood type O can potentially donate to those with blood type A, B, AB and O. You may still receive a kidney with someone whose blood type does not match yours if your transplant team determines it’s possible. This requires therapy to remove antibodies from your bloodstream.
Tissue type
There are 2 blood tests involved in tissue typing. The first determines your body’s tissue type. Parents and siblings have a greater chance of matching your tissue type than those who are not genetically related to you.
The second blood test measures the number of antibodies you have to certain proteins found in the donor’s kidneys. You’ll have this blood test a number of times, because the number of antibodies you have at any given time can increase or decrease.
Crossmatching
You and your potential kidney donor will have this test multiple times. A sample of your blood serum is mixed with cells from the donor. If you have a high number of antibodies, these antibodies will destroy the donor’s cells. This is an indication that your body may reject the donated kidney.
This comprehensive evaluation helps ensure that you have the best chance of having a successful kidney transplant. According to the Scientific Registry of Transplant Recipients (SRTR), national 1-year survival rates are 95.19% for living donor kidney transplant and 94.00% for deceased donor transplant. Temple’s Kidney Transplant Program meets or exceeds national survival rate percentages.
How to Prepare
When it’s time for your surgery, a transplant coordinator (nurse specialist) will guide you through the process and surgery preparation, including:
Placing lines, such as an IV, a bladder tube for urine, heart and blood pressure monitors, and a mouth tube attached to a ventilator
Shaving and sterilizing operating areas
Positioning you on your back
A doctor gives you general anesthesia and checks heart rate, blood pressure and breathing during surgery
During the Procedure
Your surgeon makes an incision in your lower abdomen. Unless there is a medical reason to remove your damaged kidney, your surgeon leaves it in place. Your new kidney is placed and attached to nearby blood vessels and your bladder. This procedure takes 3 to 4 hours.
Surgeons close the incision and add protective dressing.
Criteria for a Kidney Transplant Procedure
Requirements for adults include:
Chronic advanced or end-stage renal disease
Strong heart and blood vessels
Financial, practical and emotional support
Good overall health, as determined by your doctor’s assessment
Positive kidney donor match
Kidney Transplant Recovery
After surgery, you’ll go to recovery for observation before resting in your hospital room. Your team will discuss these or other details:
You may need dialysis until your kidney makes urine.
You’ll receive IV fluids, slowly progressing toward liquids and solids.
Your team will monitor medications and kidney or other functions.
Within a day, you’ll get out of bed and move around.
Hospital stays range from 3 to 5 days or more. Kidney transplant donors typically stay 2 days. Before leaving, your care team will instruct you. You’ll learn about transplant side effects, preventive steps and follow-up care. Your nurse will discuss blood pressure management and kidney failure symptoms. A dietitian will discuss your kidney transplant diet.
You’ll need lifelong immune-suppressing medications so your immune system won’t attack your new kidney. Once home, you can relax or walk. Your physical therapist may suggest exercises but avoid strenuous lifting. Most people return to normal routines in 2 or 3 months. Full recovery takes 6 months or more.
Risks and Complications
As with any surgery, kidney transplantation is not without risk. Your transplant team will review the risks of the procedure with you and discuss any side effects you may have after the surgery.
Risks and complications may include:
Lack of kidney function, or kidney failure
Organ rejection
Blood clots or bleeding
Infection
Ureter leak
Side Effects
After your kidney transplant, you’ll take medicines to suppress your immune system. This is to help keep your body from rejecting the new organ. Sometimes these medicines cause side effects, including:
Diabetes
High blood pressure or high cholesterol
Weight gain
Fluid retention, also called edema
Your transplant team will monitor you closely for signs of infection, organ rejection and other problems after surgery. You’ll also receive education that will help you and your caregivers know what to watch for and when to contact your doctor.
Trust Temple’s Innovation, Experience and Commitment to Your Care
At Temple Health, many specialists cooperate to manage kidney failure. With decades of nephrology and transplant surgery experience, we understand complex kidney disease. You receive top-level care and therapies.
Highlights include:
Skilled teams – Philadelphia magazine and Best Doctors in America® rank Temple Health doctors among the best. Our specialists manage kidney and related conditions, such as cancer or diabetes. Learn about your care team.
Innovative care – Temple Health doctors apply the latest evidence-based findings to your care. We partner with academic pioneers who explore every detail – from T-cells to transplant immunology – to advance new therapies.
Transplant success – Our program has successfully treated hundreds of transplant patients. Temple’s kidney transplant program consistently transplants patients at a higher rate than the national average.*
Acute-care hospital – Temple University Hospital is one of the region's most respected academic medical centers.
*According to the July 2021 Scientific Registry of Transplant Recipients report.
George had a kidney transplant at Temple, after facing complete kidney failure.
George’s Story
When George was told he needed a kidney transplant, he felt like all hope was lost. But even with a weak heart and end-stage kidney disease, Dr. Antonio Di Carlo felt he was a candidate for transplant. Thanks to the expertise of Temple and his wife’s loving gift of a living kidney, George has his life back.
Healio Nephrology highlighted a presentation by Dr. Avrum Gillespie at ASN Kidney Week on the impact of mass incarceration and health disparities on kidney transplantation.
Drs. Antonio Di Carlo and Serban Constantinescu and Liz Lowry, Transplant Outreach Education Coordinator, joined 6ABC for a Facebook Live discussion about living kidney donation.
You may have heard some positives and negatives about being an organ donor. Transplant surgeon Dr. Antonio Di Carlo explains the facts about organ donation, and how you can register.
