What to Expect Before, During, and After Your Kidney Transplant
Your First Evaluation
Your first appointment with our kidney transplant team will last approximately four hours.
You will meet with a variety of different transplant team members, including:
- Transplant nephrologist
- Transplant surgeon
- Nurse coordinator
- Transplant dietitian
- Social worker
- Transplant financial counselor
Having you meet with all of these different specialists will help us personalize your care plan and make the most informed decision about whether or not you are a candidate for transplant. Some additional testing may be necessary at your initial appointment. Once we have all of the necessary information, the transplant team at RWJUH will evaluate your case individually and determine if you are a candidate for a new kidney.
Scheduling and Timing
If you are receiving a kidney from a living donor, your surgery will be scheduled. Approximately two weeks prior to surgery, the donor, recipient, and family members will attend a pre-surgical meeting. At this meeting the surgical procedures for both the donor and recipient will be reviewed. The risks and benefits of receiving this living donor organ will have been reviewed with you by this time. Your medical suitability to undergo the transplant operation will be re-evaluated. A significant change in the candidate’s health status may, in certain circumstances, lead to postponement or possibly cancellation of the transplant surgery.
If you will be receiving an organ from a deceased donor, you will be admitted to the hospital as directed by the transplant coordinator.
About Your Procedure and Stay at RWJUH
Surgery will be performed by board-certified, United Network for Organ Sharing (UNOS)-approved transplant surgeons. You should plan to be in the hospital for four to 10 days.
Hospital Admission
You will need to bring your:
- Insurance card
- Photo ID
- Medication list
- Advanced Directive (if you have one)
You will be admitted by the transplant physician who will review the known risks and benefits of that donor organ with you. You will meet the surgeon and anesthesiologist at this time also. You will have necessary laboratory and medical testing done.
Before the Transplant
In preparation for surgery, you may expect to have blood drawn to determine whether or not dialysis treatment is necessary before your surgery. In addition, an electrocardiogram (EKG) will be done to ensure your cardiac status is stable. An intravenous (IV) line may be inserted into a large vein (near your collarbone). It will provide a way to administer medications, fluids, and possible blood products prior to, during, and after surgery. An additional IV line may be started in your arm. Antibiotics and antirejection medications will be administered either orally or through the IV.
The Kidney Transplant Operation
You will meet the transplant surgeon who will discuss the technical aspects of the operation with you and will ask you to sign an informed consent form. When you are taken to the operating room you will be given general anesthesia. The average length of surgery is three to four hours. A tube (catheter) will be inserted in your bladder to help pass urine and monitor urine output.
Once a compatible organ has been found, the surgeon places the kidney on one side of the recipient’s front lower abdomen. The kidney placement in the abdomen allows the surgeon to more easily connect the kidney to the bladder. To ensure an adequate blood supply, the surgeon also attaches the kidney to an artery and vein that lead to the legs. In most cases, the patient’s native (original) kidneys are not removed. A tube (catheter) will be inserted in your bladder to help pass urine and monitor urine output.
After the transplant operation is completed, you will be brought to the recovery room, where you will stay until the transplant physician decides that you can be transferred to the next level of care, which is usually a direct transfer to the Transplant Floor.
The Hospital Stay
Because your immune system will be suppressed by medications, you should have as few visitors as possible. To further prevent infection, flowers are not allowed. You will remain in the hospital until discharged by your physician (the average length of hospital stay is three to five days).
Several members of the transplant team will teach you how to care for yourself following transplantation including how to organize and take your medications.
You will receive an educational manual called "Planning for Home" that has been prepared especially for you and your family. It will help you understand the best way to take care of yourself and your new transplant.
Life After Kidney Transplant
After transplant, our team continues to support you in your goal of resuming a normal life.
We have two dedicated transplant pharmacists to assist you in managing your daily immunosuppressive medications. The most important thing to remember is to take your immunosuppressive medications to prevent rejection.
Several months after successful transplantation, you may return to your own kidney doctor (nephrologist) for monthly check ups with regular periodic monitoring at the Transplant Clinic. Some nephrologists prefer that their patients return to them even sooner and this decision will be made by you, your transplant doctor and your nephrologist.
A nurse coordinator who can help with any questions or problems will be assigned to you.
We have a dietitian and social worker dedicated to educating and supporting you to ensure transplant health.
More Information
For a comprehensive overview of what to expect as a kidney transplant candidate, download the brochure, Transplant Candidate Education Program.