Kidney Transplant

Kidneys are vital organs that filter blood to remove waste, extra fluid, and salt from the body. If they stop working, it's known as kidney failure. A person with kidney failure must go on dialysis or get a kidney transplant.

What Is a Kidney Transplant?

A kidney transplant is an operation where doctors put a new kidney in the body of someone whose own kidneys no longer work. One healthy kidney will do the work of two failed kidneys.

Because people can survive with one kidney, a living person can give a healthy kidney to someone with kidney failure (this is called being a donor). A kidney also can come from a donor who has recently died, but the wait for this kind of donated kidney can often take a year or more.

Most kidney transplants are successful. People who have kidney transplants will take medicines for the rest of their lives to prevent the body from rejecting the kidney. Rejecting means that the body's immune cells destroy the transplanted kidney because they sense that it's foreign.

But aside from that, many teens who have kidney transplants go on to live normal, healthy lives after they recover from surgery.

What Are the Different Types of Kidney Transplants?

There are two kinds of kidney transplants depending on who donates the new kidney.

A living-donor transplant is when a person with kidney failure gets a kidney from someone who is still alive and well. It's usually from a relative or close friend, but sometimes strangers donate.

A deceased-donor transplant is when people donate their kidneys for transplant after they die. This requires people who need kidneys to put their names on a waiting list until a suitable donor can be found.

What Happens Before a Kidney Transplant?

If your doctor thinks you can have a kidney transplant, your first step is to visit a transplant center. A health care team there will check to make sure you're healthy enough to have surgery and take the medicines you'll need to use after the transplant. This will include blood tests, X-rays, and other tests, and can take a few weeks or months.

If the transplant team decides you're a good candidate, the next step is to find a kidney. In  most living related transplant cases, a kidney comes from a close relative or friend who has a compatible blood type.

If a living donor can't be found, your name will go on a waiting list until a kidney from a deceased donor is matched to you. The need for new kidneys is far greater than the number donated, so this can take a long time.

If your name is on the waiting list for a kidney transplant, you'll need to stay in close touch with your doctors and the rest of your health care team. Make sure they know how to reach you at all times.

While you wait for a transplant, do your best to stay as healthy as possible. That way, you'll be ready for transplant surgery when the time comes. Be sure to:

• eat healthy foods and follow any special diet recommendations from the doctor, nurse, or dietitian
• take all medicines as directed
• keep all medical appointments

 Tell your doctor and the transplant center right away if there is any change in your health.

What Happens During a Kidney Transplant?

You will probably give doctors a blood sample so they can do an antibody cross-match test. This finds out if your immune system will accept the new kidney. If the test comes back negative, the kidney is acceptable. You'll also have other blood tests, a chest X-ray, and an EKG.

In the operating room, you'll get general anesthesia so you'll sleep through the operation. The surgeon will make a small cut in the lower belly, just above your hips. The new kidney is placed, then surgeon attaches its blood vessels (artery and vein) to blood vessels in your lower body. Then the new kidney's ureter (a tube that carries pee from the kidney to the bladder) is connected to your bladder.

In most cases, your own kidneys stay in place. They won't be removed unless they cause problems like high blood pressure, loss of protein, or an infection. Kidney transplant surgery usually takes about 3 to 4 hours. If you need more than one organ (such as a combined kidney–liver transplant), the surgery time will be longer.

What Happens After a Kidney Transplant?

After kidney transplant surgery, you'll spend a week or two in the hospital as you recover. Your health care team will watch you to make sure there are no complications from the surgery, such as bleeding or infection.

You'll also learn what medicines you need to keep your body from rejecting the new kidney. These are called immunosuppressants. Taking them can make you more likely to get infections, especially in the days right after surgery. So be sure to stay away from sick people. Everyone at home should wash their hands well and often.

For the first couple of months after surgery, you'll need to see the doctor a lot to make sure your new kidney is working normally. If you get a fever or soreness in the area of the transplant, tell a doctor right away. These could be signs that your body isn't accepting the new kidney or that you have an infection.

But with surgery and immunosuppressant medicines, the success rate of kidney transplants is very high.

What Else Should I Know?

In about 3–6 months, there's a good chance you'll be back to doing most of the things you enjoyed before your kidneys failed. You may have to cut back on rough contact sports, though. Sports like football, hockey and wrestling can lead to injuries that could damage the new kidney.

If you have questions about whether a sport is a good idea for you, talk to your doctor before you start playing. A kidney shield (a piece of plastic worn under your clothing) can protect the transplanted kidney and allow you to play some sports. 

Ease back into activities while you recover. Eating well, taking your medicines at the correct times, keeping a healthy body weight, and following up with your transplant team will help keep your new kidney healthy.

Dealing With Feelings

Living with a chronic condition like kidney failure can be frustrating. Things like dialysis, time spent waiting for a donor kidney, surgery, and taking medicines can add stress. Some people feel depressed or anxious. It can be a lot to deal with!

Immunosuppressant therapy can be especially hard for teens because it does have some side effects. The medicines you'll take to stop your body rejecting the kidney can cause acne, weight gain, mood swings, and trouble sleeping. If you notice side effects, talk to your doctor to see if anything can help. But never change or stop taking a medicine without talking to your doctor or nurse.

If it seems like the stress of living with kidney failure or having transplant surgery is more than you can handle, talk to someone. A parent is best, since your mom or dad will probably be going through it all with you.

But some teens find help by talking to a therapist or joining a support group. Online resources include the National Kidney Center's Facebook page and Transplant Living. You also can ask the transplant team if the hospital has (or knows of) a support group for teens who've had kidney transplants.