A kidney transplant is a surgical procedure to place a healthy kidney from a live or deceased donor into a person whose kidneys no longer function properly.
The kidneys are two bean-shaped organs located on either side of the spine just below the rib cage. Each one is about the size of a fist. Their main function is to filter and remove excess 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 renal disease, which is also known as end-stage kidney disease). End-stage renal disease occurs when the kidneys have lost about 90 percent of their ability to function normally.
Common causes of end-stage renal disease include:
- Diabetes
- 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.
Types
- Deceased-donor kidney transplant
- Living-donor kidney transplant
- Pre-emptive kidney transplant
Why it's done
A kidney transplant is often the treatment of choice for kidney failure compared to a lifetime on dialysis. A kidney transplant can treat chronic kidney disease with glomerular filtration rate (GFR, a measure of kidney function) less than or equal to 20 ml/min and end-stage renal disease to help you feel better and live longer.
Compared to 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:
- Advanced age
- Severe heart disease
- Active or recently treated cancer
- Poorly controlled mental illness
- Dementia
- Alcohol or drug abuse
- Any other factor that could affect their ability to safely undergo the procedure and take the medications needed to prevent organ rejection
Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option.
If a compatible living donor isn't available, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor.
How long you have to wait for a deceased donor organ depends on the degree of matching or compatibility between you and the donor, time on dialysis and expected survival post-transplant. Some people get a match within several months and others may wait several years.
Risks
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
- Bleeding
- Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
- Infection
- Failure of the donated kidney
- 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:
- Acne
- Bone thinning (osteoporosis) and bone damage (osteonecrosis)
- Diabetes
- Excessive hair growth or hair loss
- High blood pressure
- High cholesterol
- Increased risk of cancer, particularly skin cancer and lymphoma
- Infection
- Puffiness (edema)
- Weight gain