Kidney Transplant: What You Need to Know Before Surgery

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Posted
September 11, 2020 by
Serban Constantinescu, MD, PhD

Our goal is to help patients feel good about our commitment to them, and that usually starts with helping them understand what they’ll go through. Kidney transplantation is a gift, and we want them to feel that too.

If you have kidney failure or end-stage renal disease (ESRD), a kidney transplant may be a life-changing option for you. Just last year, more than 23,000 kidney transplants were performed in the U.S., making it one of the more common transplant procedures performed.

I’m the Medical Director of Temple’s Kidney Transplant Program. When my team and I meet and talk to patients about kidney transplant, they naturally have a number of questions. At this stage, they’ve been through a lot, and this is a big life-changing decision.

The information I’m sharing here is based on the most common questions we receive from patients:

Jump to:

• Should I stay on dialysis or have a kidney transplant?
• How does a kidney transplant work?
• What’s the difference between deceased donor and living donor?
• Is kidney transplant safe?
• Is kidney transplant successful?
• What should I expect after my kidney transplant?
• I’ve heard of kidney transplant rejection. What is that and what are the symptoms?
• Where do I get a kidney transplant?

Should I stay on dialysis or have a kidney transplant?

When your kidneys no longer function properly due to kidney failure, your nephrologist usually offers you 2 options: dialysis or kidney transplant. Many times patients are on dialysis while they wait for transplantation, so it’s important to understand what that involves.

Our patients sometimes find dialysis to be restrictive, because appointments and maintenance take up a lot of time. Plus, dialysis only replaces part of your kidney’s function. It’s imperative that your nephrologist monitors you closely alongside your primary care provider to help ensure you’re receiving exceptional care.

With a successful kidney transplant, many of our patients are able to live more normally than with dialysis. That’s because life on dialysis means you are dependent on dialysis, which acts as your artificial kidney. With a kidney transplant, life is completely different. In my experience, it can help people get their lives back, and that’s truly a gift.

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How does a kidney transplant work?

During a kidney transplant, we replace your damaged kidney with one from a living donor or deceased donor. A transplant surgeon connects your new kidney to an artery and vein in your groin and to the ureter. This allows excess fluid and waste to be carried in the urine through the bladder from your new kidney.

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What’s the difference between deceased donor and living donor?

We’ve made quite a few advances in kidney transplant over the last 50 years. Today, you may receive your kidney from a donor who is living, or from someone upon their death:

A deceased donor is a person who decides to donate a kidney to help people who need transplants. Their family members can also make the decision.

A living donor can be a family member or friend, or someone whom you do not know who makes the decision to donate one of their kidneys.

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Is kidney transplant safe?

We make sure to always tell our patients that as with any surgery, kidney transplant does involve risks. You’ll be required to take medicines called immunosuppressants to help your body accept the new organ.

For many patients, kidney transplantation is an excellent option, even for patients who are usually considered high risk, including:

• Older patients
• People who are immunosuppressed
• Those who have multiple conditions or comorbidities

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Is kidney transplant successful?

Both a deceased donor organ and a living donor organ are excellent life-changing options and are highly successful.

According to the August 2020 Scientific Registry of Transplant Recipients (SRTR) report, 1-year national expected survival rates are:

• 98.11% success rate for living donor kidney transplant
• 94.88% success rate for deceased donor transplant

At Temple, we perform at these levels or higher.

Deceased and living donor organ transplants have great odds, and here are other benefits to receiving a kidney from a living donor:

• People who receive kidneys from living donors generally live longer than those who receive a kidney from a deceased donor.
• Kidneys from living donors tend to last longer than those from deceased donors.
• Kidneys from living donors tend to function almost immediately after surgery.

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What should I expect after my kidney transplant?

Our patients are generally out of bed and eating the day after their transplant, with the support of our nursing team. We make sure to tell our patients that in addition to their immunosuppressant medicines — which they’ll take for the rest of their lives — they may also receive antibiotics and pain relievers.

My advice is usually this: If you’re feeling well and your body is accepting the new organ, you may be released from the hospital within a few days.

In the weeks and months after your procedure, you’ll have regular check-ups and blood tests to ensure you’re healthy and your new kidney is functioning properly.

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I’ve heard of kidney transplant rejection. What is that and what are the symptoms?

Kidney rejection is a common issue. Your new kidney may take a while to start working properly or you may experience problems associated with the surgery itself, including bleeding or infection at the incision site. Immunosuppressant medicines also put you at greater risk for infection.

We advise our patients to call us if they notice any of the following:

• Fever, or a lasting cold or cough
• Seeping from surgical scar
• Burning with urination

Keep in mind that you may not notice early signs of rejection, so routine blood tests after surgery are crucial. Look for high blood pressure or swelling. These are signals that your new kidney may not be functioning properly.

If you do experience problems, we’ll work closely with you. It may be that you need your medications adjusted or you might need to go on dialysis for a while as your body gets used to its new kidney.

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Where do I get a kidney transplant?

If you do decide to have a kidney transplant, you’ll need to work closely with a nephrologist who is associated with an accredited kidney transplant program with good patient outcomes. In general, the steps to have a kidney transplant include:

1. Evaluation to see if you’re emotionally and physically healthy enough to undergo a kidney transplant.
2. Working with your hospital’s financial counselor to review your insurance and talk to you about your finances to discuss options for covering the costs of transplantation.
3. If you have a living donor — such as a family member or friend — they’ll need to undergo tests to make sure they can donate a kidney.
4. If you do not have a living donor, you’ll be placed on a waiting list.
5. As soon as a kidney is available, you’ll undergo kidney transplant.
6. You’ll work with your kidney transplant team in the hospital just after surgery and in the coming weeks and months to ensure your body is accepting the new organ.

Kidney transplantation is an excellent choice. Just be sure to work with a team that has enthusiasm and passion, who is involved in active research, and who has an active database to connect you with the right donors.

Helpful Resources

• Learn more about kidney failure and treatment options
• Become a living donor
• Read how a generous donation to our Abdominal Organ Transplant Program provides hope for future kidney transplant patients at Temple
• Watch Donnie’s story about receiving a living donor kidney transplant
• Kidney transplant: what to expect

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Kidney Transplant Success Rates and Potential Complications

Your kidneys are a pair of bean-shaped organs found below your rib cage on either side of your spine. The primary function of your kidneys is to filter waste and extra fluid from your blood to make urine.

A kidney transplant is a procedure to replace an unhealthy kidney with a new kidney from a donor. End stage kidney failure is the most common reason people receive kidney transplants. People with end stage kidney failure need long-term dialysis or a kidney transplant to survive.

Kidney transplants are generally very successful at extending life for people who are eligible. Up to 97% of transplanted kidneys survive for at least 1 year.

There are two types of kidney transplant.

Living-donor kidney transplant (LDKT) is when the kidney comes from a person who is still alive, often a family member of the recipient.

Deceased-donor kidney transplant (DDKT) is when the kidney comes from a person who is deceased.

Keep reading to learn more about the success rates of these two procedures.

The Organ Procurement Transplant Network (OPTN) is a nonprofit that manages the United States organ transplant system. Each year, together with the Scientific Registry of Transplant Recipients (SRTR), the OPTN releases an annual report providing an analysis of organ transplants.

According to the 2020 annual report, 83.9% of LDKT recipients over age 65 are alive 5 years after their transplant. The 5-year survival rate is higher in people ages 18 to 35, at 97.8%. People who had kidney failure due to diabetes had the lowest 5-year survival rate compared to other causes, at 88. 3%.

The 5-year survival rates are higher among LDKT recipients than among DDKT recipients of the same age. LDKT recipients also tend to spend less time on dialysis.

The 5-year survival rate for transplanted kidneys is slightly lower than the 5-year survival rate for people who have received a kidney. A total of 81.6% of transplanted kidneys in people over 65, and 90.9% in people ages 35 to 49, survive for at least 5 years.

Success rates for DDKT are high but lower than those for LDKT. More DDKTs are performed each year since there are more deceased donors available. Roughly four times more DDKTs than LDKTs were performed in 2020, according to the OPTN/SRTR 2020 report.

The 5-year survival rate for DDKT is 74.3% in people over 65 and 95.8% in people ages 18 to 34.

As with LDKT, people with kidney failure due to diabetes had the lowest 5-year survival rate, 81.1%.

Despite the high success rates, wait times for kidney transplants are often very long. Of people placed on waiting lists from 2015 to 2017:

• 34. 6% were still waiting after 3 years
• 25% had undergone a DDKT
• 14% had undergone an LDKT
• 6.4% had died
• 20% had been removed from the list

Many factors, including the following, can affect the success rate of a kidney transplant.

Age

The ages of the donor and the recipient can affect the chances of success. In a 2016 study, researchers found that recipient age was the second leading risk factor for predicting kidney transplant outcomes.

Perhaps counterintuitively, as age increases, so does the predicted survival time — likely because younger people have younger immune systems that can lead to more organ rejections.

In the OPTN/SRTR 2020 report, researchers reported organ rejection in 9.1% of recipients ages 18 to 34 and 5.9% of recipients over 65.

In the 2016 study, the researchers found that donor age was the fourth leading risk factor. Increasing donor age was associated with a higher chance of kidney rejection.

Cold ischemic time

Cold ischemic time is the time between chilling the donated kidney and restoring its blood supply. A shorter duration is associated with higher rates of successful surgery. In the 2016 study, the researchers found that this was the top factor for predicting outcomes.

Creatinine levels at discharge

Creatinine levels give your doctor a good estimation of how well your kidneys are working. In the 2016 study, the researchers found that creatinine levels at hospital discharge were the third most important factor for predicting outcomes.

Duration of hospitalization

The same group of researchers found that the duration of hospitalization was the fifth leading risk factor. Longer-than-typical hospital stays were associated with poorer survival.

Ethnicity

According to the OPTN/SRTR 2020 report, Asian recipients had the highest survival rate and Black recipients had the lowest.

According to 2020 clinical practice guidelines on kidney transplantation, all people with chronic kidney disease who are expected to reach end stage kidney disease should be considered for transplantation.

The guidelines recommend that doctors refer all potential candidates for evaluation at least 6 to 12 months before those people are likely to need dialysis.

The incidence of end stage kidney failure is rapidly increasing. The most common causes are diabetes and high blood pressure.

Each transplant center has its own guidelines for transplants. Some centers may have age restrictions or may not consider you a candidate if you have certain medical conditions.

According to the National Kidney Foundation, factors that might affect candidacy include:

• recent cancer diagnosis
• severe heart disease
• insufficient health to survive the transplant
• active infection
• tobacco use or substance misuse
• obesity

People with end stage kidney failure need to undergo continuous dialysis or a kidney transplant to survive. Kidney transplants have high rates of success and are the preferred treatment for people who are eligible. However, finding an appropriate donor can take years.

Your doctor can help you figure out whether you qualify for a kidney transplant and start the process of applying for a donation.

What is the success rate of a kidney transplant

If you have end stage kidney disease, your nephrologist can offer you two treatment options: dialysis or a kidney transplant for kidney failure. Both dialysis and kidney transplant have their pros and cons. But if you’re considering a kidney transplant, then knowing the benefits, risks, and success rate of the procedure can help you make an informed decision for your health.

A A kidney transplant is a surgical procedure that involves replacing a failed kidney with a healthy kidney from a deceased or living donor. Learn about kidney transplant success.

Living and deceased donor kidney transplant success rate

Generally speaking, living donor kidney transplantation has a higher success rate than deceased donor kidney transplantation. Kidneys from a living donor last longer and also function better than kidneys from a deceased donor.

However, both deceased and living donor kidney transplantation has a high success rate and increases the life expectancy of many patients with end-stage kidney disease.

In the US, about 90,013 97% of 90,014 living donor kidney transplant patients were healthy and alive 1 year after surgery. Whereas, after 5 years, the success rate for living donor kidney transplantation was 86% . In the case of kidney transplantation from a deceased donor, the success rate was 96% at 1 year and after 5 years the transplant success rate was 79% .

The success rate of a kidney transplant can also vary depending on the equipment available in the hospital and the experience of the surgeons who will perform the procedure. Many countries around the world have a pool of talented kidney transplant surgeons and accredited hospitals to perform highly successful kidney transplants.

In countries such as India, the success rate for a living donor kidney transplant is 90-95% 1 year after surgery. Many kidney transplant patients 15-20 years ago are still healthy and alive. If the kidney is healthy in the first year after transplantation, then there is a high probability that it will remain healthy for a long time. Even 5 years after transplantation , 80% of patients have healthy kidneys.

Kidney transplant success rate at 1 year in Thailand is 93-98% while at 5 years survival is 73-82% . This is higher compared to hemodialysis and peritoneal dialysis, which have a survival rate of 78% (1-year survival rate) and 29% (5-year survival rate.

keep your transplanted kidneys healthy and ensure a successful kidney transplant

After your kidney transplant, you will have regular follow-up sessions to check if your kidneys are functioning well. 0003

To prevent rejection of your transplanted kidney, you will need to take immunosuppressants for life so that your immune system does not reject the transplanted kidneys.

In addition, leading a healthy lifestyle and

Affordable kidney transplant worldwide

Conclusion

Successful kidney transplantation can be achieved with the treatment of experienced and well-trained transplant surgeons. Proper postoperative care after a kidney transplant is essential to keep the transplanted kidneys healthy for a long time.

Reference links: https://www.templehealth.org/about/blog/kidney-transplant-what-you-need-to-know

Kidney transplant – Acıbadem

Kidney transplant is the best treatment option kidney failure. Acıbadem Medical Group is the leading kidney transplant center in Turkey.

Kidney transplant surgery

Kidney transplant is an operation for patients with kidney failure. Healthy kidneys perform many functions, including filtering waste products and toxins, secreting erythropoietin to stimulate red blood cell production, renin release to help control blood pressure, and more. Kidney failure affects the vital functions of the body and causes problems with the heart, lungs and bones. The progressive loss of kidney function is known as kidney failure, or end-stage renal disease (ESRD). People with kidney failure need dialysis or a kidney transplant. In some cases, dialysis can save a life, but the machine cannot completely replace all the functions of a healthy organ. Research shows that a successful kidney transplant results in better quality and longer life than dialysis. In the long run, it is also the most cost-effective alternative to dialysis.

During a kidney transplant, the recipient receives a healthy organ from a deceased or living donor. The new kidney is placed in the abdominal cavity and connected to the vessels and bladder. Damaged kidneys are usually not removed unless they are causing problems. Kidney transplantation is a major operation and its success depends on many factors, including the experience of the team and the transplant center.

Living Kidney Donation

Worldwide, despite all efforts, there is a shortage of organs from deceased donors. It is known that one healthy kidney is enough to live a full life. Thus, a living donor kidney transplant may be an alternative to long waiting lists for some patients. Healthy people who want to help a loved one can choose to donate a live kidney. In this case, the donor and recipient must have compatible blood types and tissue types. However, today there are effective solutions for successful transplantation from a living donor, even if the donor and recipient are incompatible. In this case, another pair of recipient-donor is selected, and in case of compatibility, two successful transplants take place at once (paired donation, or cross-transplantation). Paired donation ensures that each recipient receives a suitable kidney.

In Turkey, foreign patients can only apply for a living donor kidney transplant. They must have a donor who is willing to donate it for free. There are criteria for living donors: over 25 years of age, a close relative (up to the 4th degree of kinship), or another donor with a healthy functioning kidney and good general health, approved by the Ethics Committee. At Acıbadem Kidney Transplant Center, due to a thorough preoperative examination, it is possible to perform a safe transplant from a living donor – if there are any potential risks to the health of the donor, the operation is not performed.

Kidney Transplant Procedure

Before a living donor kidney transplant, both the donor and the recipient undergo detailed laboratory tests, imaging tests, and physical examinations. After the assessment is completed, if all is well, surgery can be scheduled. At Acıbadem Kidney Transplant Center, donors can benefit from minimally invasive surgery (laparoscopic donor nephrectomy). It involves a small incision and, as a result, a faster recovery process. Advanced surgical techniques allow the kidney to be removed through a single opening (navel or birth canal in women). The recipient is usually taken to the intensive care unit for close observation immediately after transplantation. If the kidney is from a living donor, it usually starts working immediately or shortly after surgery.

Kidney transplant for children

Kidney transplant may be required for infants and children of all ages. In children, the most common causes of kidney failure are congenital anomalies and genetic conditions. Congenital urinary tract disease and multiple organ involvement complicate the transplantation process, as additional surgeries such as open vesicostomy and bladder enlargement may be required. Acıbadem Transplant Center specialists have extensive experience in neonatal and pediatric patients, including complex cases and combined liver and kidney transplants. Our graft and patient survival rate for pediatric kidney transplants is 100%.

Transplant recovery

After a kidney transplant, patients must spend several days in the clinic to recover. They are closely monitored for any complications such as bleeding or infection. Most patients can walk the day after surgery. At Acıbadem Kidney Transplant Center, the donor usually stays at the clinic for two days. The recipient is discharged after seven days. Patients can return to normal life within a few weeks. They will have to take immunosuppressive drugs for the rest of their lives to help prevent rejection of the new organ. During the first months after surgery, regular follow-up examinations will be required to make sure that the kidneys are working well and immunosuppressants are properly selected.

After kidney transplant

Life after kidney transplant is similar to life before kidney failure. After a successful transplant, the recipient does not need dialysis, is not significantly restricted in food, and generally feels well. However, some rules must be followed to keep the new organ healthy. It is recommended to maintain an active lifestyle, implement healthy habits and follow a diet low in salt and fat. Immunosuppressants should be taken every day as prescribed. The most common cause of organ rejection is precisely the irregular intake of drugs that prevent rejection. The symptoms of transplant rejection are often mild, so regular tests and check-ups are a must. In most cases, experienced professionals can handle organ rejection.

How long does a kidney last after transplantation?

A transplanted kidney does not have an “expiration date”. For some patients, it may last a lifetime, while others may require several transplants. The lifespan of a transplanted organ depends on many factors, including the general health of the donor and recipient, whether the donor was alive or deceased, the reason for the transplant, etc. In the event that the transplant fails, the patient can start dialysis or retransplantation – retransplantation.

In 2020, a French woman celebrated 50 years of active life after a kidney transplant. A man who underwent a transplant in 1971 is considered one of the longest living kidney transplant recipients in the UK. Another example: a patient who survived a transplant in June 1977 is considered the longest-lived in Asia. Currently, surgical techniques and immunosuppressive drugs are much more advanced, and kidney transplant recipients can expect even better results.

Kidney transplant success rates

Kidney transplant outcomes have improved dramatically in recent decades. Advances in surgical techniques, a deeper understanding of the immune system and immunosuppression regimens, and better antibiotic treatment are contributing to higher kidney transplant survival. However, kidney transplantation is still a highly specialized medical intervention. Success rates largely depend on the medical center and the team responsible for the operation and long-term follow-up. Acıbadem Kidney Transplant Centers have a transplant survival rate of 99% after the first year, and 94% in the fifth year. Patient survival is 99% in the first year and 95% in the fifth year, respectively.

Kidney transplant in Turkey

Turkey is the world leader in kidney transplantation. More than 3,500 operations are performed here annually. Since there are not enough organs from deceased donors worldwide, 80% of kidney transplants in Turkey are performed from living donors. Transplant programs and success rates are regulated and strictly controlled by the Ministry of Health. Transplant centers are regularly evaluated and their success rate should be over 85%. Many patients from all over the world prefer Turkey for kidney transplant because of the great experience, affordable cost and high success rate.

Why choose Acıbadem for kidney transplant?

Our kidney transplant surgeons perform over 300 surgeries a year and have success rates above the global average.