What is a kidney transplant?
A kidney transplant is a treatment for kidney failure. It involves an operation to place a healthy kidney from someone else (a donor) into a person with kidney failure (the recipient). The new kidney can come from someone who has died (deceased donation) or from a living donor (living donation).
Who is a kidney transplant for?
If you have severe kidney disease, also known as kidney failure, 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 discuss this with you.
Your new kidney could be donated by someone who has died (a deceased donor) or from a living donor.
People can live perfectly healthy lives with just one kidney. Most living kidney donations come from a friend or relative, but you can also receive a kidney from a stranger (non-directed donation).
What does a kidney transplant operation involve?
The transplant operation is carried out under general anaesthetic, so you’ll be asleep throughout. The operation usually lasts around three to four hours.
When you are asleep, a surgeon will make a cut into your abdomen.
- The new kidney is inserted into your lower abdomen and connected to an artery and vein in your pelvis so that blood can flow in and out.
- The new ureter will be joined to your bladder, so that urine can flow from your new kidney into the bladder.
- A short piece of soft plastic tubing called a stent is placed inside the ureter to help the connection to heal.
- The stent will be taken out a few weeks after the transplant surgery.
You will usually only be given one new kidney. However, if you are receiving a kidney from a deceased donor that has a low level of function you may be given both of the donor's kidneys in order to give you a good level kidney function after the transplant. This is called a dual kidney transplant.
Your own kidneys are usually left in place unless they are infected or have grown too large for a new kidney to fit in (for example in conditions like ADPKD).
Children who receive a transplant may have their old kidneys removed so that there is room in their abdomen for the new kidneys.
Does a transplanted kidney start working straight away?
The transplant procedure is designed so that the new kidney can start working and making urine as soon as your blood starts flowing through it. However, sometimes the new kidney is ‘sleepy’ and takes a while to start working once it has been transplanted. You may need a short session of dialysis if this happens.
Most kidney transplants start working within a week of the operation.
Simultaneous pancreas and kidney transplantation
Around a third of kidney patients receiving dialysis treatment also have diabetes.
People with insulin-dependent type 1 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 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.
Are there any alternatives to a kidney transplant?
A kidney transplant is a treatment for kidney failure.
Other treatment options include
Your kidney team will discuss your options with you and help you to decide which treatment pathway you will follow.
Ideally, if you are suitable, your healthcare team will add you to the transplant waiting list before you need dialysis (this is known as a pre-emptive transplant). This is more likely to be possible if you have a friend or relative willing to donate a kidney to you, as the surgery can then be planned in advance.
Pre-emptive transplant is not always possible so you may already be having dialysis before you receive a kidney transplant.
Is a kidney transplant safe?
Any type of surgery under general anaesthetic carries some risks but these are usually small.
Generally, a kidney transplant is a safe procedure, and the benefits are likely to outweigh any risks.
Side effects and complications may include:
- bleeding (you may need a blood transfusion if you bleed a lot).
- infection in the incision site. You’ll be given antibiotics to help prevent this.
- an incisional hernia. This is when the abdominal wall does not fully heal where the surgeon cut through it during the transplant. This can cause organs such as the small bowel to push through and will need further treatment.
- damage to the lung cavity, nearby organs or blood vessels. This is rare but can be repaired if it occurs, although it may sometimes require further surgery
- serious complications such as blood clots. These are very rare but can potentially occur in many types of surgery.
Where will the kidney transplant take place?
The operation will be carried out in hospital.
It will be performed by a surgeon, supported by a team of other doctors and nurses, including an anaesthetist.
What happens before a kidney transplant?
You will need to have a number of tests (a work-up) to make sure that you are healthy enough to have a kidney transplant. These include:
- Blood tests to check your blood group and tissue type and to monitor your general health
Why blood tests are an essential part of kidney transplants and what you can expect.
- An echocardiogram (echo) and electrocardiogram (ECG) to check how healthy your heart is
- A chest X-ray to check your lungs
- An ultrasound scan to examine the blood vessels in your groin where the new kidney will be placed
The work-up tests may take several months.
If a family member or friend wants to donate a kidney to you (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.
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 on the kidney transplant list 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.
The amount of time you may wait for a kidney can depend on:
- Blood and tissue type It is important that there is a close match between the donor and you as the recipient to prevent your body from rejecting the new kidney. If you have a rare blood or tissue type, it might take longer to find you a suitable match.
- Age Younger and older patients may be prioritised in different ways during the matching process.
- Antibody level People who have had previous transplants, blood transfusions or pregnancies may have fewer compatible donors.
- Waiting time Your priority improves the longer you wait on the list.
If you become unwell, you may be temporarily suspended from the waiting list. This is because a kidney transplant is a major operation and you will need to be well enough to cope with the surgery and to recover fully afterwards. You will be added back onto the list once your kidney team feel you are well enough.
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.
- You may need a session of dialysis before the operation takes place.
- Your transplant surgeon will check the donated kidney to make sure it is suitable to be transplanted.
- When you’re admitted to hospital, you’ll be asked to wear anti-thrombosis stockings to help prevent blood clots in your legs.
- You will be told when to stop eating or drinking. It is very important that you have an empty stomach during the transplant operation to reduce the risk of vomiting, and help to prevent any damage to your lungs when you are under the general anaesthetic.
- You’ll be seen by different members of the team that will be performing the transplant and looking after you afterwards. This will include the anaesthetist, who may give you some medication to make you feel relaxed.
- Once you’re taken to the operating theatre, you’ll be given anaesthetic that makes you go to sleep. The procedure will take around 3-4 hours.
What happens immediately after a kidney transplant?
You’ll be taken to the recovery room, where you’ll gradually wake up from the anaesthetic.
- You may have a drip into your arm for fluids, along with a bladder catheter and an oxygen mask or nasal prongs if you need extra oxygen.
- You may also have a drain (tube) to drain blood and fluid.
- Staff will monitor you and provide fluids and medication such as pain relief if needed. You may be given a patient controlled analgesic system (PCAS) which allows you to give yourself some pain relief when you need it.
When you’re ready, you’ll be taken back to the ward, where staff will continue to monitor you.
- You’ll be encouraged to eat and drink within a few hours of the operation.
- After 6-12 hours, you will be helped out of bed to sit in a chair and encouraged to start taking some short walks.
The time spent in hospital varies but the average is around a week. You’ll be discharged when staff are happy that you’re safe to go home.
If you receive a kidney from a living donor the amount of time you will spend in hospital is usually shorter than if you receive a kidney from a deceased donor. This is because kidneys from living donors are usually healthier than those from deceased donors, so they tend to start working in the recipient sooner.
What should I expect when I get home after a kidney transplant?
- You’ll need someone at home with you for the first 24 hours after you are discharged from hospital in case of any problems.
- It’s normal to have some discomfort in the incision sites for a few weeks. This can usually be managed with paracetamol.
- You’ll be told how to look out for signs of complications like infection, such as a temperature and increasing redness. Contact your GP or the hospital team if you notice these.
- You won’t be able to drive for a few weeks after the operation.
- You will need some time off work after having this operation. Most people return to work after a few weeks, but this depends on what job you do. You may need longer off work if you have a manual job or one that involves heavy lifting.
- You will be able to resume sexual activity when you feel comfortable to do so but you may wish to wait 4-6 weeks to allow time to heal. Women should avoid getting pregnant for at least a year after a transplant to allow their body to get used to the new kidney.
Recovery time varies. Many people can get back to their usual activities after about four weeks, but full recovery may take up to 12 weeks. During this time, you should avoid heavy lifting and strenuous activities.
What medication is taken after a kidney transplant?
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.
It is vital 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 and diet
You will be followed up by your kidney team after your transplant to make sure that you remain healthy.
A few weeks after the transplant surgery, the stent placed in your ureter will be removed.
You will have regular blood tests to make sure the new kidney is still working, and your medication will be checked. At first these appointments will likely be once or twice a week. As you recover, these appointments will become less frequent. After about a year, if you have no other problems, you will probably only need to be seen in clinic once every 3-4 months.
To prepare for your post-transplant apppointments with our guide to questions to ask yourself in preparation.
Once your transplanted kidney is working, you will be able to eat more foods and have a less restrictive diet than you may have had to follow when receiving dialysis treatment.
It is important to follow a healthy, balanced diet that is low in salt and high in fruit and vegetables.
What is kidney transplant failure?
Kidney transplant failure 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.
There are lots of different reasons why kidney transplants fail. Some of the most common reasons are:
- rejection of the transplant. This is when your body’s immune system attacks the kidney transplant, which can happen if you do not take your transplant medications as prescribed
- the transplanted kidney has been damaged by the condition or disease that damaged your own kidneys (for example, diabetes or IgA nephropathy). Your kidney team will tell you if this is likely to happen before you have a transplant
- a blood clot blocks one of the kidney transplant blood vessels
- there is an infection in the transplant that cannot be treated
- longterm effects of medication you take to prevent rejection.
In some cases, kidney transplants can fail very quickly. In other cases, the failure happens very slowly over several years.
Your kidney team can tell you if they think your kidney transplant is failing and what your treatment options might be. This may include going back on the waiting list for another kidney.
How long will a kidney transplant last?
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.
Where can I find more information?
- NHS Blood and Transplant: Kidney transplantation
For more information on receiving a kidney or donating a kidney, read our information pages or 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: 09/2026
Review dates: 09/2029