There are two possible sources of kidneys for transplantation: living donors and deceased donors. This section discusses both types of transplant.
Human beings have two kidneys but can live with only one of them, making it possible for a person to donate a kidney for transplant while still alive. Typically, a living donor is a blood type-compatible relative or close friend of the transplant recipient. Rush's experience and national statistics have shown that there is a greater chance of success with living donor transplantation. We recommend that you discuss kidney donation with your family and friends.
If you are receiving a transplant from a living donor, your surgery will be scheduled in advance. Both you and your donor will come to the hospital and undergo surgery on the same day. The donor's kidney will be removed first, and then you will undergo transplant to receive the kidney. The process will be very similar to the one described below for deceased donor kidney transplant.
A donor kidney may also come from a person who has died and who registered to be an organ donor while still living or whose family gave consent to organ donation, which is called deceased donor donation. If you are receiving a deceased donor kidney, it may become available at any time, day or night. When the time comes, a transplant nurse coordinator will call to tell you that a kidney is available. It is vitally important that you let us know then of any recent illness, infection or fever, or if you have had a recent blood transfusion. Although tests to determine the compatibility of the transplant will have been performed before you are called, you may be asked to come to Rush to give an additional blood sample.
When you are notified to come to Rush to receive your transplant, you will be instructed to come to the hospital admitting area on the fourth floor of the Atrium Building or the emergency room, depending on the time of day. Depending on the circumstances, you may go to the transplant floor of the hospital to prepare for surgery, or you may go directly to surgery.
The final preparation for transplant will include blood and urine samples, a chest X-ray and an electrocardiogram. If you are on dialysis, you may need a dialysis treatment before your surgery, depending on when you last received dialysis and the results of your blood tests.
During kidney transplant, a healthy kidney from either a living or deceased donor is placed inside your body. The operation involves disconnecting the blood vessels from a failed kidney and connecting them to the transplanted kidney so that blood is cleansed as it flows through the new kidney and then throughout your body. During the surgery, the transplanted ureter, which brings urine from the kidneys to the bladder, is connected to your bladder so that urine is removed in the normal way.
You will be under anesthesia so that you are unconscious throughout the procedure. The surgery usually takes three to four hours and requires a 5- to 10-inch incision in your abdominal area near the groin. Your own kidneys will not be removed during the surgery.
The procedure also includes temporarily inserting a bladder catheter to measure urine output and a triple lumen catheter (placed under your collarbone) to draw blood and inject intravenous medications.
As with any surgery, some bleeding can occur, and you may need a blood transfusion. If you do not wish to receive blood when you begin your pretransplant evaluation. Rush is able to perform transplants without blood transfusions, as some religions require.
After your transplant surgery, you will spend time in the surgical intensive care unit (SICU) for close monitoring. Most people are transferred from the SICU to the transplant unit the day after surgery.
While you are in surgery, your family may wait in the Smith Lounge, the surgical waiting room. Once you are in the SICU, your family will be able to visit you. Your family must observe the visiting hours and rules appropriate to each unit. Overnight guests are not allowed in patient rooms. Contact hospital guest relations at (312) 942-5574 if you need help finding accommodations in the area.
Potential Complications of Transplant Surgery
As with any surgery, transplant has certain risks. Although complications are uncommon and Rush takes all possible precautions to prevent them, you are at risk for the following complications when undergoing kidney transplantation:
- An allergic reaction to general anesthesia
- An adverse reaction to antirejection medications
- Infection of the incision or urinary tract
- Blood loss that requires blood transfusion
- Blood clots in the legs
- Gastrointestinal problems such as a blockage of the intestines, constipation or bloating
- Incisional pain and development of scar tissue
- Rejection of the new kidney
- Clotting of a blood vessel in the new kidney
- Delay in the function of the new kidney and the possibility that it might never work
- Other unforeseen complications
- Contracting infectious diseases if the disease cannot be detected in the infected donor at the time of organ recovery
- Death due to complications from transplant surgery (this is rare and more than 99 percent of transplant recipients at Rush are alive 30 days after their transplant)
(Next: After surgery)