Transplantation

Kidney transplantation is a treatment for severe kidney disease. It involves an operation to replace your damaged kidneys with a new kidney from either a living or deceased donor.

Kidney transplantation is a treatment for severe kidney disease. It involves an operation to replace your damaged kidneys with a new kidney from either a living or deceased donor.

If you have severe kidney disease, also known as end-stage renal disease (ESRD), your kidney team will talk to you about whether a kidney transplant could be a treatment option for you.

A successful transplant is a very good treatment for kidney failure. However, it will not cure the underlying cause of your kidney disease. Some kidney diseases can reoccur in the transplanted kidney and your kidney team will be able to discuss this with you.

You can receive a kidney from a living donor or a deceased donor.

On average, a kidney transplant from a living donor will last for 20 to 25 years, while a kidney from a deceased donor will last 15 to 20 years. This is very variable depending on the age of the donor and patient, and other medical issues. Please speak to your kidney team to understand more about your own situation.

What do healthy kidneys do?

Your kidneys do several important jobs to keep you healthy. They help to:

  • clean your blood
  • control your blood pressure
  • make urine and keep the right amount of fluid in your body
  • make a hormone that helps produce red blood cells
  • control minerals in your body like potassium and phosphate.

When your kidneys fail, harmful waste products build up in your body. Your blood pressure may rise, and your body may retain extra fluid, which can make it hard to catch your breath due to water in your lungs.

Treatments for kidney failure include haemodialysis and peritoneal dialysis, transplant or conservative kidney management.

Kidneys are the most common organ donated by a living person. Around 40% of all kidney transplants carried out in the UK are from living donors
NHS Organ Donation

How transplants work

Kidney transplantation is an operation that replaces your damaged kidneys with a new kidney from either a living or deceased donor.

The new kidney is inserted into your lower abdomen and connected to an artery and vein in your pelvis. Your blood flows through the new kidney, which makes urine and removes harmful waste products, just like your own kidneys did when they were healthy.

Your own kidneys are usually left in place unless they are infected, or you have very high blood pressure.

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The transplant process

Transplant work-up

You will need to have a number of tests (a work-up) to check that you are healthy enough to have a transplant. This may take several months. You can find out more about why blood tests are an essential part of kidney transplants and what you can expect.

If a family member or friend wants to donate a kidney (living kidney donation), they will have their own tests to make sure that they are healthy and that their kidney is a good match for you. See our information on donating a kidney for more information on living kidney donation.

Waiting list

If you don't have a living donor, you will be put on a national waiting list to receive a kidney from a deceased donor.

The average waiting time is around two to three years. Some people can be called with an offer within a few days of joining the kidney transplant list, while others may have to wait many years.

Transplant operation

If you have a living donor, the operation is scheduled in advance at a time that suits you both.

If you're on the waiting list for a deceased donor, you will be called to the hospital at short notice as soon as a kidney becomes available. You will have an antibody 'cross-match' test to check that your immune system will not react to the new kidney. If this test is negative, the transplant can go ahead.

The transplant operation takes place under a general anaesthetic and usually lasts three to four hours.

The new kidney will usually start working and making urine as soon as your blood starts flowing through it. However, you may need a short session of dialysis if this is delayed.

If everything goes well, you will usually be able to go home from hospital two weeks after the operation.

You will be prescribed immunosuppressant medication to stop your immune system from seeing your new kidney as ‘foreign’ and rejecting it. You will need to take these medications for the rest of your life. Make sure that you understand the instructions for taking your medicines before you leave the hospital. Missing a dose of your tablets for 24 hours can cause rejection and you may lose the kidney.

Post-transplant kidney care

You will be followed up by your kidney care team after your transplant to make sure that you remain healthy. You will have regular blood tests to make sure the new kidney is still working, and your medication will be checked.

Post-transplant diet

Within reason, you can eat and drink what you want after a transplant, but it is important to maintain a healthy, balanced diet. Be careful not to gain weight too quickly and avoid salty foods that can lead to high blood pressure.

Rejection

Rejection is when your body’s immune system recognises the kidney as coming from a different person and starts to ‘attack’ it. This can cause the new kidney to stop working.

Rejection happens in around 10 to 15 of every 100 patients in the first year after a kidney transplant.

Rejection is normally silent and occurs without any symptoms. You can minimise your risk of rejection by taking your medications as prescribed.

Unfortunately, even if you do everything you're supposed to do, your body may still reject the new kidney. If this happens, your kidney care team will discuss your options with you. This may include going back on the waiting list for another kidney.

Simultaneous pancreas and kidney transplantation

Around a third of kidney patients receiving dialysis also have diabetes.

People with insulin-dependent diabetes may be offered a simultaneous pancreas and kidney (SPK) transplant where both organs are transplanted at the same time.

A simultaneous pancreas and kidney transplant is a bigger and more complicated operation that just having a kidney transplant by itself. The operation lasts longer (four to eight hours on average) and involves two separate transplanting teams: one team preparing the pancreas for implantation and another team preparing the patient. The pancreas is put in first, followed by the kidney. Both organs will have been donated by the same deceased donor.

Transplantation: download or order Kidney Care UK's information leaflets

For more information on receiving or donating a kidney, download our transplantation leaflets for free:

You can also order printed copies of Kidney Care UK’s transplantation leaflets to be sent to you in the post.

Publication dates: 07/2023

Review dates: 07/2026

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