The entire kidney transplant surgical procedure typically lasts from two to four hours. In most cases, neither of the recipient’s kidneys – regardless of functionality – will be removed. In the rare case that removing one or both of the patient’s kidneys could be advantageous, the nephrologist and/or surgeon will discuss this option with the patient.
Surgery will be performed while the patient is asleep under general anesthesia. A ventilator will take care of the patient’s breathing during this time. The surgeon will begin by making an incision into one side of the patient’s groin. After the surgeon inspects the donor kidney, it will be placed into the patient’s abdomen and the donor kidney’s renal artery and vein will be sewn to the patient’s iliac artery and vein. Once blood is properly flowing into the new kidney, the ureter will be attached to the patient’s bladder. The surgeon will then close the site, mostly with sutures that do not need to be removed.
Immediately after surgery, the kidney transplant recipient, in most cases, will be taken to a special floor staffed by personnel experienced in caring for kidney transplant patients. In rare cases, kidney transplant recipients will be transferred to the intensive care unit (ICU) for a brief period of observation. The patient will remain in the hospital for a total of about five to seven days following surgery.
Kidney function will need to be monitored closely for the first several months after a patient leaves the hospital. The frequency of a patient's visits to the clinic and the need for blood work depends on the individual’s progress and will lessen as they recover. Risk for rejection and infection decreases with time, but is never completely gone. Follow-up visits will be more flexible when the wound is healed, kidney function is normal, and medication dose is adequate. At this time, blood tests may be done at a location closer to the patient's home. Follow-up care will be managed by the local doctor and lab facility.
The kidney transplant team will continue to follow a patient's progress as long as they have their new kidney. Patients can either be seen by our transplant specialist or closer to their home by an experienced nephrologist in collaboration with our team.
Exercise and diet after transplant are very important factors in feeling healthy again. Post-transplant patients are encouraged to resume or begin a regular exercise plan when they leave the hospital, and the regimen should be done under a doctor’s guidance. It is very unhealthy for a patient's new kidney and their general well-being to put on excessive weight. The most effective method of maintaining a desired weight is to limit calories and to exercise regularly. Exercise for transplant patients has been shown to increase endurance, increase muscle strength, enhance bone remodeling, and reduce the need for anti-hypertension medication.
Our nutrition staff will help develop meal plans that are both nutritious and low in calories. Diet is important in the total rehabilitation process and for maintaining good nutritional status throughout a patient's life with a new kidney.
When does someone need a kidney transplant? What is the surgery like? What is the recovery like? Anil Chandraker, MD, MBChB., Medical Director, Kidney and Pancreas Transplantation at Brigham and Women's Hospital and Associate Professor at Harvard Medical School, explains how to prepare for a kidney transplant and maintain kidney health after a transplant.
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