Kidney Transplant

Many people may not have any symptoms at all until the late stages of kidney failure. But, signs of kidney failure can include:

• swelling of the hands, feet and face (edema)
• headaches (due to high blood pressure)
• seizures
• pale skin color (due to low iron)
• coffee colored urine
• foamy urine
• depression
• fatigue
• itchy skin

Over 800,000 people in the U.S. are living with end stage kidney disease.  The most common causes of kidney failure are:

• high blood sugar (diabetes)
• high blood pressure
• glomerulonephritis (scars in the kidneys' tiny filters)

Other causes of kidney failure include:

• inherited kidney diseases
• autoimmune conditions
• recurrent kidney infections
• blockage of the urinary tract
• long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen

Dialysis

The most common treatment for end stage kidney disease is dialysis. Dialysis removes waste and extra water from the blood regulates many body electrolytes Dialysis will not cure kidney failure. But dialysis can replace the work of the kidneys, and help a person feel better and live longer.

The two types of dialysis are hemodialysis and peritoneal dialysis.

In hemodialysis, a person’s blood is filtered by a machine outside the body and then returned to the bloodstream. Hemodialysis is most often done three times per week and each session takes about four hours.

Peritoneal dialysis is done through a tube in the belly. Special fluid is delivered through the tube which then collects waste products from the blood and balances chemicals. The fluid is then drained from the belly.

Diagram of Dialysis Treatment

Enlarge

Kidney Transplant Operation

Kidney transplant is another treatment option for people with kidney failure if they are healthy enough to have major surgery. This surgery returns kidney function by replacing two failed kidneys with one healthy organ. Most kidneys for transplant come from people who have recently passed away but have stated they want to donate their organs after they die. But, living family members, spouses, friends, and even anonymous strangers can also donate if they are healthy enough. They can continue to live normal healthy lives with just one remaining kidney.

A kidney transplant is usually placed in the lower belly without taking out the failed kidneys. The artery and vein of the new kidney are joined to an artery and a vein in the pelvis next to the bladder. The ureter (the tube that drains urine from the kidney to the bladder) of the new transplanted kidney is joined to the bladder.

If You are the Donor:

• You will undergo a thorough evaluation to decide if you are healthy enough to donate a kidney. This includes a physical exam, blood and urine tests and imaging tests like a CT scan. You will also meet with many different doctors and experts as part of the evaluation.
• Surgery is usually done as a minimally invasive procedure, which means large incisions (cuts) are avoided. A few small incisions, each less than an inch, are made to pass instruments through your body. A slightly larger incision is also made to remove the kidney from your body.
• Most donors stay in the hospital just one to two days after surgery. Total recovery time is usually four to eight weeks.

If You are Receiving a Kidney Transplant:

• You will have a catheter (a thin tube to allow urine to drain) in your bladder for a few days to allow the new connection between the transplant and your bladder to heal. You may also have a small plastic tube called a stent in the new transplant that will be removed with a short procedure a few weeks after surgery.
• Most patients will be out of bed and walking within 24 hours after their transplant operation.
• You can likely leave the hospital within a week or less.
• Often the new kidney starts working right away. But, it is not uncommon for the new kidney to take a couple days to a few weeks to “wake up”, so you may need dialysis for a short time until the kidney starts to function.

Results

About 95 out of 100 transplanted kidneys are working at the end of one year. The average lifespan of a kidney from a deceased donor is about 10 to 12 years, and about 12 to 15 years from a living donor. But, some kidney transplants can last 20 years or more. The kidney is always at risk for rejection, so it is vital to take all of your medications as you are told by your health care provider.

I'd like to donate one of my kidneys to my brother but our blood types are not the same. Does it matter?

No. Blood types do not have to be the same, just compatible. Markers or "antigens" on the surfaces of red blood cells decide blood type. If the donor and patient do not have compatible blood types, the kidney can be rejected right away. Even if you are not compatible, you may still be able to take part in in a “kidney exchange” program where you donate to someone else who is compatible to you, and in return your brother could receive a kidney from another living donor who is compatible to them.

How long will I have to wait for a kidney transplant if I do not have a living donor?

When an organ becomes available, a patient is chosen using a nationwide point system. This system is based on blood type, waiting time, time on dialysis, tissue match, antibody levels and the location of the donor and recipient. While some people get a kidney within a few months, the average patient could wait three to ten years based on where they live. In contrast, a living donor kidney transplant can be scheduled as soon as the donor and patient are ready.

My father had autosomal dominant polycystic kidney disease. What is the chance that I will have the same disease?

The chance that you inherited this disease is about 50%. This disease results in a buildup of non-cancerous cysts that wipe out the normal tissue in both kidneys. Signs like abdominal swelling, pain, bloody urine and frequent urinary tract infections (UTIs) may show up at any time, but they often start in middle age. High blood pressure and renal failure may result as the disease progresses. There is no way to preserve kidney function in autosomal dominant polycystic kidney disease, but dialysis or a kidney transplant can be used to treat the kidney failure.

Autosomal dominant polycystic kidney disease should not be confused with multiple simple cysts of the kidneys. These simple cysts are often the result of age and don't cause kidney failure.

Updated July 2024.