A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly.
The kidneys are two bean-shaped organs located on each side of the spine just below the rib cage. Each is about the size of a fist. Their main function is to filter and remove waste, minerals and fluid from the blood by producing urine.
When your kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in your body, which can raise your blood pressure and result in kidney failure (end-stage kidney disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.
Common causes of end-stage kidney disease include:
- Chronic, uncontrolled high blood pressure
- Chronic glomerulonephritis — an inflammation and eventual scarring of the tiny filters within your kidneys (glomeruli)
- Polycystic kidney disease
People with end-stage renal disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
Having all of this subspecialized expertise in a single place, focused on you, means that you’re not just getting one opinion — your care is discussed among the team, your test results are available quickly, appointments are scheduled in coordination, and your transplant care team works together to determine what’s best for you.
Deceased-donor kidney transplant
Living-donor kidney transplant
Preemptive kidney transplant
Why it’s done
A kidney transplant is often the treatment of choice for kidney failure, compared with a lifetime on dialysis. A kidney transplant can treat chronic kidney disease or end-stage renal disease to help you feel better and live longer.
Compared with dialysis, kidney transplant is associated with:
Better quality of life
Lower risk of death
Fewer dietary restrictions
Lower treatment cost
Some people may also benefit from receiving a kidney transplant before needing to go on dialysis, a procedure known as preemptive kidney transplant.
But for certain people with kidney failure, a kidney transplant may be more risky than dialysis. Conditions that may prevent you from being eligible for a kidney transplant include:
Severe heart disease
Active or recently treated cancer
Dementia or poorly controlled mental illness
Alcohol or drug abuse
Any other factor that could affect the ability to safely undergo the procedure and take the medications needed after a transplant to prevent organ rejection
Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure. Some forms of kidney disease may return after transplant.
The health risks associated with kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and side effects of taking medications (anti-rejection or immunosuppressants) needed to prevent your body from rejecting the donated kidney.
Deciding whether kidney transplant is right for you is a personal decision that deserves careful thought and consideration of the serious risks and benefits. Talk through your decision with your friends, family and other trusted advisors.
Complications of the procedure
Kidney transplant surgery carries a risk of significant complications, including:
- Blood clots and bleeding
- Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
- Failure or rejection of the donated kidney
- An infection or cancer that can be transmitted with the donated kidney
- Death, heart attack and stroke
Anti-rejection medication side effects
After a kidney transplant, you’ll take medications to help prevent your body from rejecting the donor kidney. These medications can cause a variety of side effects, including:
- Bone thinning (osteoporosis) and bone damage (osteonecrosis)
- Excessive hair growth or hair loss
- High blood pressure
- High cholesterol
Among those disqualified were those who were obese, those who were excessive drinkers (more than four drinks a day), and those with diabetes, skin cancer, high blood pressure, HIV, coronary artery disease or congestive heart failure.
A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years. Patients who get a kidney transplant before dialysis live an average of 10 to 15 years longer than if they stayed on dialysis.
Disadvantages — Kidney transplantation is a major surgical procedure that has risks both during and after the surgery. The risks of the surgery include infection, bleeding, and damage to the surrounding organs. Even death can occur, although this is very rare.