After you have decided to go ahead with kidney transplantation, the next step is to have a complete medical examination and a series of diagnostic tests to determine whether or not you are a good candidate, including:
- Comprehensive history and physical examination by a transplant nephrologist
- Surgical evaluation by a transplant surgeon
- Evaluation by a transplant dietitian
- Evaluation by a transplant social worker to assess family or other support systems that may be necessary to ensure proper care post-operatively
- Chest X-ray to check the lungs for disease
- Cardiovascular tests – EKG – to evaluate the condition and strength of your heart
- Blood tests consisting of blood chemistry, kidney function and immune system test
- Ultrasound to look at your kidneys and surrounding structures
- Transplant psychiatric evaluation in order to determine your understanding of the benefits and risks as they were explained to you
typical kidney transplant surgery takes from two to four hours. A healthy kidney (from either a living or deceased donor) is surgically placed in the pelvis of a patient with end-stage renal disease. Blood flow is established by connecting the artery and vein of the transplanted kidney to the recipient’s iliac vessels. These are the blood vessels that supply blood to the lower abdomen and legs. Urinary flow is then re-established by connecting the transplant kidney ureter to the recipient bladder.
Complicated cases (for example, patients who have had multiple previous surgeries or have unusual anatomy) may require placement of the kidney in other locations in the abdomen and use of different blood vessels. These situations also require significantly more time in the operating room.
Once blood flow is established in the new transplant, the kidney will begin filtering, removing waste and producing urine. The native kidneys are usually not removed and will no longer function. Most kidneys will begin to function within 24-48 hrs. However, up to 30 percent of kidneys, particularly those from deceased donors may take several days to weeks before working normally.
Possible complications include:
- Your body may reject the donor kidney.
- The daily medication to combat organ rejection that is required for life may have side effects.
- You may have an increased susceptibility to infection as a consequence of immunosuppressive medication.