Kidney Transplant

Reviewed by: HU Medical Review Board | Last reviewed: January 2024 | Last updated: February 2024

Treating chronic kidney disease (CKD) begins with lifestyle changes and medicines to treat the health problems that arise from kidney damage. But over time, these treatments may no longer be enough. When kidney damage advances to the point of kidney failure and end stage, a kidney transplant may be an option.1

Kidney failure, also called end-stage kidney disease (ESKD), is when your kidneys are barely working or have stopped working. When end-stage kidney failure occurs, dialysis or a kidney transplant is needed to prevent death.2

A kidney transplant does not cure you of your kidney disease. But it can be a life-saving option for people with ESKD. A kidney transplant can give you more energy, strength, and freedom. Most people can go on to live a relatively normal life after a kidney transplant. Also, life expectancy is often better in people who receive a kidney transplant versus those who stay on dialysis.1,3,4

How does a kidney transplant work?

During kidney transplant surgery, a healthy kidney from a donor is placed into your body. The new kidney does the work of filtering your blood and removing waste that your damaged kidneys could not do.1,3

Your new kidney may start working immediately. Or you may need to be on dialysis until the new kidney works. Most people are able to go home within a week of getting their new kidney. Recovery time varies for each person, but the average recovery time is about 6 weeks.3,4

Who can receive a kidney transplant?

People of all ages can receive a kidney transplant. This includes both children and older adults.3

Each hospital has unique rules for who can receive a kidney transplant. In general, you must meet the following criteria to be considered for a kidney transplant:3,4

  • You have late-stage kidney disease and are close to needing dialysis, or you have kidney failure and are currently on dialysis.
  • You are expected to live at least 5 years.
  • You understand your pre- and postoperative instructions.
  • You have not been recently diagnosed with cancer.

What happens before a kidney transplant?

Before a kidney transplant, you will go through a thorough physical and psychological evaluation at a transplant center. These tests are done by a transplant team that includes:1-3

  • Transplant surgeons
  • Doctors who specialize in kidney care (nephrologists)
  • Social workers
  • Nurses
  • Psychologists

The purpose of these tests is to make sure you are healthy enough to have transplant surgery. For example, if you had a recent diagnosis of cancer or currently have a serious infection, a transplant is not possible.3

Who can be a kidney donor?

A kidney can come from someone who has died (a deceased donor) or from someone who is still alive (a living donor). A living donor may even be someone you know, like a relative, partner, or friend.1,3

Just as you are screened to make sure you are a good candidate for transplant surgery, your living donor will also need to be screened. To qualify to donate a kidney, a living donor needs to be:5

  • In good physical health
  • In good mental health
  • A compatible blood-type match to the recipient
  • Free of other medical issues that might put them or the recipient at risk

If your living donor is not a compatible blood-type match, you may be able to enter a paired exchange. A paired exchange is when 1 incompatible recipient/donor pair is matched up with another pair that they are compatible with. This allows the 2 recipients to receive a life-saving kidneys from the 2 donors.3,6

If you do not have a living donor or paired exchange, you will be added to the kidney transplant waiting list.1,3

How do you get on the transplant waiting list?

If you are interested in a kidney transplant, talk with your nephrologist. They can direct you to a transplant center. There, you will go through the necessary steps and tests to see if you are a good candidate for a transplant. If you are, you can be put on the waiting list for a new kidney.1

What happens after a kidney transplant?

After getting a kidney transplant, you will need to take anti-rejection medicines. This is so that your immune system does not reject the donated kidney.1-3

Anti-rejection medicines have some side effects. These will be explained to you by the transplant team as you go through the transplant process. Side effects can usually be managed by adjusting the medicine’s dosage. Talk to your doctor if you have any side effects or other concerns about anti-rejection medicines.3

You will be monitored by your transplant team to make sure your kidney is working. Following a healthy, kidney-friendly diet, controlling your blood pressure, and being extra careful with your diabetes management are just some of the many lifestyle changes you can make to keep your new kidney healthy.1,3,4

Kidney transplants have come a long way in the last few decades, and rejection is rare. But it can still happen. Talk with your doctor about your risk for kidney transplant rejection.3-5

How long will a transplanted kidney last?

A kidney transplant can last many years, depending on the person. A kidney from a deceased donor lasts an average of about 10 years. A kidney from a living donor can last upwards of 20 years.4

Depending on their age, situation, and kidney disease, some people will go on to have more than 1 kidney transplant.4

What are the risks of a kidney transplant?

Like any major surgery, there are risks that come with transplant surgery. These risks include:4

  • Bleeding
  • Infection
  • Breathing problems
  • Developing certain types of cancer

After the surgery, you are at greater risk of infection and getting sick. This is because of the anti-rejection medicines, which suppress your immune system. But, generally speaking, the benefits of a kidney transplant far outweigh the risks.4

Is a transplant right for you?

In many cases, a kidney transplant is a much better option than staying on dialysis. But each kidney transplant is decided on a case-by-case basis, and each hospital has its own requirements. Talk to your doctor to decide whether a kidney transplant is right for you.1,3,4

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.