Patients

Eligibility depends on physical health, emotional well-being, and the ability to manage post-transplant care plans. Age in itself is not a barrier, as many people in their seventies and even older receive kidney transplants.

The best time to have a kidney transplant is before you start dialysis. We call this a preemptive transplant. Most of the time this can be done only if you have a living donor. To do this, you need to contact a transplant center when your kidney function (glomerular filtration rate, or GFR) is at about 20 percent. The transplant will typically occur when your GFR is between 10 and 20 percent.

Evaluation includes medical tests to assess overall health and kidney function. A good time to start looking for a living donor and begin evaluation for transplant is when your GFR is between 20 and 25 ml/min.

The UNOS wait time varies depending on the availability of a compatible deceased donor kidney and is typically three to ten years. Waiting times in the United States vary by region, with some areas having much longer waiting times than others. Patients with a living donor can avoid or minimize the time on dialysis.

This is one of the most difficult and yet important parts of preparing for a transplant. As you go through your transplant evaluation process, you will hear multiple times, “you need to find a living donor.” How do you do that? There are multiple strategies that have been proven successful:

1. Identify a Living Donor Champion. This is someone, who is close to you, who can spread the word amongst your family and friends that you need a living donor kidney. It is typically a spouse, a close relative or a friend. They need to educate themselves about kidney donation so they can answer questions of people that might be interested in considering the donation.

2. Spread the word. You don’t need to ask anyone directly to consider giving you a kidney. But you need to let people know that you need someone to donate a kidney for you to avoid years on dialysis and return to health. Your most likely donors are going to be people who know you well, like family members and friends. You can do this with an open letter, an email, through a microsite arranged by NKR, or through social media. NKR also offers mentors who help those needing a transplant navigate the experience.

3. Do not turn people away. It is always hard for a parent to accept that their adult children might be the best donor for them. You need to accept that they are adults and can decide for themselves. Kidney donation today is very safe and they will also benefit from the joy of having a healthy parent who will likely live a long time. So, their donation is also a gift to themselves.

Kidneys are matched based on blood type, tissue type (HLA), and eplet matching. A crossmatch test is frequently done to check for antibodies in the recipient’s blood that could cause the recipient’s immune system to reject the transplanted kidney. We also take other factors into consideration when matching a donor and recipient, such as age, size, and viral serologies.

Medicare, Medicaid, and most health insurance policies cover transplant costs. Recipients meet with a financial counselor during the evaluation process.

The surgery is performed by the transplant team, which includes a transplant surgeon or surgeons, surgical assistants, nurses, and technicians. Postoperative care is usually done with a team that includes surgeons, transplant nephrologists, nurses, pharmacists, social workers, and dietitians as well as other specialists.

Kidney transplant surgery typically takes two to four hours.

After the surgery, a typical hospital stay is two to four days. Most transplant recipients can return to normal life within four to eight weeks after the transplant. A lot depends on the physical condition of the patient prior to the surgery. It is important to try to stay fit while awaiting kidney transplantation.

Some pain is normal after surgery. You will get medications to manage it. Your doctor will specify some lifting and pushing restrictions for about six weeks.

You will need to take immunosuppressant medications for the rest of your life to help prevent your body from rejecting the new kidney. Otherwise, you should have a very good quality of life with relatively few restrictions.

Kidney rejection is usually silent at the beginning. And it is important to catch it early, before it damages the kidney. This is why we monitor your kidney function through lab tests. The tests are done frequently at the beginning, and they are spaced out as time from the transplant passes. During your pretransplant evaluation, the team will assess your ability to keep up with these requirements. It is a crucial factor that will predict your chances for long-term success.

You will need regular follow-up appointments and blood tests to ensure the kidney is functioning properly and to monitor your overall health.