OverviewA kidney transplant is a surgery to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly. Show
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 kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in the body, which can raise blood pressure and result in kidney failure (end-stage renal disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally. 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:
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. At Mayo Clinic, health care professionals trained in many medical specialties work together as a team to ensure favorable outcomes from your kidney transplant. 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. Mayo Clinic's approach Types
Why it's doneA 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:
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 riskier than dialysis. Conditions that may prevent you from being eligible for a kidney transplant include:
Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation an option. Start Your Donor EvaluationBegin the process of becoming a living kidney or liver donor by clicking here to complete a health history questionnaire.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 on the transplant waitlist, and expected survival post-transplant. Some people get a match within several months, and others may wait several years. At Mayo Clinic, surgeons perform more than 650 kidney transplants a year, including numerous complex surgical procedures at campuses in Arizona, Florida and Minnesota. As a three-site institution, Mayo Clinic has one of the largest living-donor kidney transplant and paired kidney donor programs in the United States. Our experts have pioneered many procedures, including living-donor kidney transplants and kidney transplant before dialysis is needed. The Mayo Clinic kidney transplant team has extensive experience in the most complex types of kidney transplantation, including ABO incompatible, positive crossmatch and paired donation kidney transplants. Mayo Clinic in Rochester, Minnesota, is ranked as the best hospital in the nation for diabetes and endocrinology for 2022-2023 by U.S. News & World Report. Mayo Clinic in Phoenix/Scottsdale, Arizona, and Mayo Clinic in Jacksonville, Florida, are ranked among the Best Hospitals for diabetes and endocrinology by U.S. News & World Report. RisksKidney transplantation can treat advanced kidney disease and kidney failure, but the surgery isn't a cure. Some forms of kidney disease may return after a transplant. The health risks associated with a kidney transplant include those associated directly with the surgery and rejection of the donor organ. Risks also include the side effects of taking anti-rejection medications (immunosuppressants) needed to prevent the body from rejecting the donated kidney. Deciding whether a 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 family, friends and other trusted advisers. Complications of the procedureKidney transplant surgery carries a risk of significant complications, including:
Anti-rejection medication side effectsAfter 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:
Other side effects may include:
How you prepareChoosing a transplant centerIf your doctor recommends a kidney transplant, you'll be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers. When you consider transplant centers, you may want to:
You may also consider:
EvaluationAfter you've selected a transplant center, you'll be evaluated to determine whether you meet the center's eligibility requirements for a kidney transplant. The team at the transplant center will assess whether you:
The evaluation process may take several days and includes:
After your evaluation, your transplant team will discuss the results with you and tell you whether you've been accepted as a kidney transplant candidate. Each transplant center has its own eligibility criteria. If you aren't accepted at one transplant center, you may apply to others. What you can expectBefore the procedureFinding a matchA kidney donor can be living or deceased, related or unrelated to you. Your transplant team will consider several factors when evaluating whether a donor kidney will be a good match for you. Tests to determine whether a donated kidney may be suitable for you include:
Additional factors your transplant team may consider in finding the most appropriate donor kidney for you include matching age, kidney size and infection exposure. Living kidney donationFinding a willing living kidney donor is an alternative to waiting for a compatible deceased-donor kidney to become available. Family members are often the most likely to be compatible living kidney donors. But successful living-donor transplants are also common with kidneys donated from unrelated people, such as friends, co-workers or religious congregation members. Paired donation is another type of living kidney donation if you have a willing kidney donor whose organ isn't compatible with you or doesn't match well for other reasons. Rather than donating a kidney directly to you, your donor may give a kidney to someone who may be a better match. Then you receive a compatible kidney from that recipient's donor. In some cases, more than two pairs of donors and recipients may be linked with a living kidney donor who hasn't named a specific person to receive the kidney. They form a donation chain with several recipients benefiting from the nondirected donor's gift. If a compatible living donor isn't available, your name will be placed on a waiting list for a deceased-donor kidney. Because there are fewer available kidneys than there are people waiting for a transplant, the waiting list continues to grow. The waiting time for a deceased-donor kidney is usually a few years. Staying healthyWhether you're waiting for a donated kidney or your transplant surgery is already scheduled, work to stay healthy. Being healthy and as active as you're able can make it more likely you'll be ready for the transplant surgery when the time comes. It may also help speed your recovery from surgery. Work to:
Stay in touch with your transplant team and let your team know of any significant changes in your health. If you're waiting for a donated kidney, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag ready and make arrangements for transportation to the transplant center. During the procedureKidney transplants are performed with general anesthesia, so you're not awake during the procedure. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the procedure. During the surgery:
After the procedureAfter a kidney transplant, you can expect to:
ResultsAfter a successful kidney transplant, your new kidney will filter your blood, and you will no longer need dialysis. To prevent your body from rejecting your donor kidney, you'll need medications to suppress your immune system. Because these anti-rejection medications make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications. It is important to take all your medicines as your doctor prescribes. Your body may reject your new kidney if you skip your medications even for a short period of time. Contact your transplant team immediately if you are having side effects that prevent you from taking the medications. After the transplant, be sure to perform skin self-checks and get checkups with a dermatologist to screen for skin cancer. Also, staying up to date with other cancer screening is strongly advised. Kidney transplant success ratesSurvival rates among kidney transplant recipients in U.S. transplant centers can be found online at the Scientific Registry of Transplant Recipients website. If your new kidney fails, you can resume dialysis or consider a second transplant. You may also choose to discontinue treatment. If you decide to discontinue treatment, your doctor can give you medicines to help relieve your symptoms. This decision depends on your current health, your ability to withstand surgery and your expectations for maintaining a certain quality of life. Clinical trialsExplore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. Coping and SupportIt's normal to feel anxious or overwhelmed while waiting for a transplant or to have fears about rejection, returning to work or other issues after a transplant. Seeking the support of friends and family members can help you cope during this stressful time. Your transplant team can also assist you with other useful resources and coping strategies throughout the transplant process, such as:
Diet and nutritionAfter your kidney transplant, you may need to adjust your diet to keep your new kidney healthy and functioning well. You'll have fewer dietary restrictions than if you were receiving dialysis therapy before your transplant, but you still may need to make some diet changes. Your transplant team includes a nutrition specialist (dietitian) who can discuss your nutrition and diet needs and answer any questions you have after your transplant. Some of your medications may increase your appetite and make it easier to gain weight. But reaching and maintaining a healthy weight through diet and exercise is just as important for transplant recipients as it is for everyone else to reduce the risk of heart disease, high blood pressure and diabetes. You may need to keep track of how many calories you consume or limit foods high in sugar and fat. Your dietitian will also provide you with several healthy food options and ideas to use in your nutrition plan. Your dietitian's recommendations after kidney transplant may include:
Your dietitian may also recommend:
ExerciseOnce you recover from your transplant surgery, exercise and physical activity should be a regular part of your life to continue improving your overall physical and mental health. After a transplant, regular exercise helps boost energy levels and increase strength. It also helps you maintain a healthy weight, reduce stress, and prevent common post-transplant complications such as high blood pressure and cholesterol levels. Your transplant team will recommend a physical activity program based on your individual needs and goals. Soon after your transplant, you should walk as much as you can. Gradually, start incorporating more physical activity into your daily life, including participating in at least 30 minutes of moderate exercise five days a week. Walking, bicycling, swimming, low-impact strength training and other physical activities you enjoy can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine. Which manifestation indicates acute rejection of a transplanted kidney?Fever higher than 100 degrees Fahrenheit (38 degrees Celsius) "Flu-like" symptoms: chills, aches, headache, dizziness, nausea and/or vomiting. New pain or tenderness around the kidney. Fluid retention (swelling)
What is the first phase of acute kidney injury?Oliguric Phase: The most common initial clinical mani- festation of AKI is oliguria, defined as a reduction in urine output less than 400 mL/day. Oliguria is manifested with- in 1 to 7 days of kidney injury. This phase typically lasts 10 to 14 days but can last months in some cases.
What are the 3 phases of acute kidney injury?Types and phases of AKI. Onset phase: Kidney injury occurs.. Oliguric (anuric) phase: Urine output decreases from renal tubule damage.. Diuretic phase: The kidneys try to heal and urine output increases, but tubule scarring and damage occur.. Recovery phase: Tubular edema resolves and renal function improves.. What should be monitored when caring for a patient with AKI?Urinalysis All Patients should have a urinalysis performed. insult are at high risk of developing AKI & need to be assessed by Medical, Nursing & Pharmacy staff which should include a review of medications, SHEWS & Urine Output monitoring. Make sure daily & post operative bloods are taken to monitor creatinine levels.
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