1. "Christy Castro, Maria Christabelle RN, CCRN, BSN, MSHA"

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What is a kidney transplant?

During surgery, failing kidneys are replaced with a healthy kidney from a donor. Transplanted kidneys may come from living donors (such as a family member or friend) or from people who've died. Your new kidney needs to match your tissue and blood type to increase the chances that your body will accept it. A family member isn't always suitable; the best donor kidney for you might come from a stranger.


Why do I need a kidney transplant?

If you have permanent kidney failure, also called end-stage renal disease ("renal" means kidney), your kidneys have nearly stopped working and you need either dialysis or a kidney transplant to survive. A kidney transplant may be the better option because it can help you feel better and let you lead a normal life without dialysis.


If your healthcare provider recommends a kidney transplant for you, you'll be evaluated at a transplant center. This evaluation includes tests to determine if you're healthy enough to have surgery and if you have any other diseases or conditions that could damage a new kidney. You must be willing to take medicines called immunosuppressants for the rest of your life to prevent kidney rejection.


A committee will review results of the evaluation and decide if you're a good candidate for kidney transplant. When you're approved, the search for a donor begins. If family members are willing to donate a kidney, they'll be tested to see if their tissue and blood types match yours. If not, you'll be put on a waiting list for a nonliving donor.


What can I do to prepare for my transplant?

Before surgery, stay healthy by taking your medicines as prescribed and following the diet and exercise guidelines that your healthcare provider gave you. You may have to wait for a while before a donor kidney is found, so be prepared to wait. You may be disappointed if the donor's kidney isn't a match. Try to stay positive and think about joining a support group to talk with others who are waiting for a kidney transplant or who've already had one.


What happens during and after the transplant?

A kidney transplant usually takes about 3 hours. Depending on your condition, the surgeon may remove one or both of your kidneys before placing the donor kidney in your abdomen. If they're not causing problems, he won't remove them. The new kidney will usually start to work right away, but it may not start producing urine for a few weeks.


After your transplant, you'll spend about 12 hours in the intensive care unit and 7 to 10 more days in the hospital. You'll feel some soreness and pain around the incision. Your healthcare provider will prescribe pain medicines that you either take by mouth or through patient-controlled analgesia, which lets you control the amount of pain medicine you get through an I.V. line with the push of a button. After discharge, stay close to the hospital for 3 to 4 weeks for regular checkups. To prevent problems, take all medicines exactly as prescribed.


The biggest worry after kidney transplant is rejection. This occurs when your immune system attacks the new kidney as a foreign "invader," damaging or destroying it. Rejection can happen in the first few weeks or months after your surgery. Immunosuppressant medicines usually prevent or treat rejection, so take them as prescribed for the rest of your life. If they don't work, you'll need to start dialysis or get another transplant.


Some medicines have side effects that can cause you to gain weight, develop acne or facial hair, or have stomach problems. These effects usually decrease with time. Immunosuppressants may make your body more prone to infection, certain cancers, high blood pressure, and high cholesterol. Discuss any problems with your healthcare provider. He'll prescribe medicines and regular screening tests to reduce your risk.


How can I keep my new kidney healthy?

By taking your medicine, exercising regularly as advised by your healthcare provider, developing healthy eating habits, quitting smoking if you smoke, decreasing the amount of alcohol you drink if necessary, wearing sunscreen, and getting regular checkups, you can help keep your new kidney functioning well for years to come.