Background on Kidney Transplantation
The kidneys are located on either side of the spine behind the liver and stomach. They have a crucial role in the body, filtering the blood and balancing water, salt, and mineral levels. Kidney transplantation is a surgical procedure performed to restore kidney function in people whose own kidneys are too diseased to function.
Kidney transplantation is recommended for people with end-stage kidney (renal) disease (ESRD). End-stage kidney disease is caused by a number of other conditions including infection, hypertension, diabetes, polycystic kidney disease and acute renal injury, among others. Read more about kidney diseases and conditions.
According to the National Kidney Foundation, someone’s kidneys fail every five minutes, and nearly 382,000 people in the U.S. depend on dialysis to survive. Over 16,000 people in the U.S. receive a kidney transplant each year. There are over 90,000 people on the deceased donor kidney transplant waiting list. When the option is available, people in need of a kidney transplant increasingly turn to a living donor – such as a relative or close friend who is willing to donate one of his or her own kidneys. Read more about this below under Types of Kidney Transplantation.
Kidney transplantation is not recommended for individuals with cardiac, pulmonary or liver disease. Patients with cancer, active infection, or who are very deconditioned would also not be candidates.
Types of Kidney Transplantation
UC San Diego Health System experts have extensive skills in deceased and living donor transplant procedures. We are involved in research and clinical trials to refine and develop new surgical techniques for these delicate procedures.
Deceased Donor Kidney Transplant
In this procedure, the transplanted kidney comes from a donor who is diagnosed as “brain dead” but whose other organs are functioning. Kidneys from deceased donors represent over half of the kidneys used for transplantation in the U.S. The Center for Transplantation tests the functionality of deceased donor kidneys through high-end technology before the kidneys are transplanted into recipients. The diseased kidneys remain in the recipient and a donor kidney is transplanted into the abdomen. There is a significant shortage of deceased donor kidneys available for people in need of transplant.
Living Donor Kidney Transplant
Kidney Transplantation: Meetings for Patients and Families
- Waiting list
- Expanded donor list
- Financial issues
- Life after transplant
Programs are held 3 to 4 times a month in English and Spanish. Call 619-574-8612 for current schedule.
Living donor kidney transplantation is increasing in the U.S. The Organ Procurement and Transplantation Network (OPTN) and United Network for Organ Sharing (UNOS) designated UC San Diego Health System as an approved living donor kidney transplant program. A living transplant comes from a living donor, such as a family member or close friend, who donates one of his or her kidneys. Our kidney transplant team specializes in robot-assisted donor nephrectomy (kidney removal). This minimally invasive procedure reduces the size of the incision for the removal of the donor kidney and speeds up recovery time for the donor. For the recipient, living donor kidney transplantation has higher success rates than deceased donor kidney transplantation. Read more about living donation at the UNOS website Transplant Living under Living Donation.
Paired Kidney Transplantation (living donors)
As part of the OPTN Kidney Paired Donation Pilot Program, UC San Diego Health System performs a special form of living kidney donor transplantation. In paired kidney transplantation (PKT) a donor and recipient pair with incompatible blood types or antibodies is matched with another donor-recipient pair, enabling two recipients to receive organs with matched blood types. If you have someone who wants to donate a kidney to you, but your blood type does not match or you have antibodies to that donor, and another person in need of a transplant has an incompatible willing donor, swapping the donors and recipients can be a good option.
Overview of Kidney and Combined Kidney-Pancreas Transplantation
After a thorough evaluation, the transplant team will talk to you and your family about being placed on the national kidney transplant waiting list. The donor needs to have a compatible blood type with the recipient. Gender, age or race does not need to match. Read more about organ donation and allocation and about the steps involved before surgery.
The risks in transplantation surgery are those that are common to all forms of major surgery. There could be technical difficulties in implanting the donor kidney, leakage or blockage of urine. Immediately after the operation, risks include bleeding, poor function of the grafted kidney, and infections. We monitor transplant recipients carefully after surgery for signs the body is rejecting the new organ.
Surgery and Recovery
The average operating time for kidney transplantation is three hours. It involves an incision in the right lower abdomen. The new kidney is attached to the vessels that take blood to the leg. In most cases, your own kidneys and ureter are not disturbed. The kidney transplant procedure is an open operation under general anesthetic. You will wake up with a catheter to help you pass urine. This is removed on the fourth or fifth postoperative day. During recovery period, the transplant team makes daily rounds provides training on transplant medications.
Recovery in the hospital may take one to two weeks, and resuming normal activities may take upwards of a year. Quality of life usually improves dramatically and most people lead healthy, normal lives.
Following discharge from the hospital you will attend the post-operative follow up clinic twice a week for the first six weeks after surgery with the transplant team and continue to be followed up at the Long Term Kidney Transplant Clinic. Read more on care after surgery.