A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly.
The kidneys are two bean-shaped organs located on each side of the spine just below the rib cage. Each is about the size of a fist. Their main function is to filter and remove waste, minerals and fluid from the blood by producing urine.
When your kidneys lose this filtering ability, harmful levels of fluid and waste accumulate in your body, which can raise your blood pressure and result in kidney failure (end-stage kidney disease). End-stage renal disease occurs when the kidneys have lost about 90% of their ability to function normally.
Common causes of end-stage kidney disease include:
People with end-stage renal disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
At Mayo Clinic, health care professionals trained in many medical specialties work together as a team to ensure favorable outcomes from your kidney transplant.
Having all of this subspecialized expertise in a single place, focused on you, means that you're not just getting one opinion — your care is discussed among the team, your test results are available quickly, appointments are scheduled in coordination, and your transplant care team works together to determine what's best for you.
Why it's done
A kidney transplant is often the treatment of choice for kidney failure, compared with a lifetime on dialysis. A kidney transplant can treat chronic kidney disease or end-stage renal disease to help you feel better and live longer.
Compared with dialysis, kidney transplant is associated with:
Some people may also benefit from receiving a kidney transplant before needing to go on dialysis, a procedure known as preemptive kidney transplant.
But for certain people with kidney failure, a kidney transplant may be more risky than dialysis. Conditions that may prevent you from being eligible for a kidney transplant include:
Only one donated kidney is needed to replace two failed kidneys, making living-donor kidney transplantation is an option.
If a compatible living donor isn't available, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor.
How long you have to wait for a deceased donor organ depends on the degree of matching or compatibility between you and the donor, time on dialysis and on the transplant waitlist, and expected survival post-transplant. Some people get a match within several months, and others may wait several years.
At Mayo Clinic, surgeons perform more than 650 kidney transplants a year, including numerous complex surgical procedures at campuses in Arizona, Florida and Minnesota. As a three-site institution, Mayo Clinic has one of the largest living-donor kidney transplant and paired kidney donor programs in the United States.
Our experts have pioneered many procedures, including living-donor kidney transplants and kidney transplant before dialysis is needed. The Mayo Clinic kidney transplant team has extensive experience in the most complex types of kidney transplantation, including ABO incompatible, positive crossmatch and paired donation kidney transplants.
Mayo Clinic in Rochester, Minn., is ranked as the best hospital in the nation for diabetes and endocrinology for 2021-2022 by U.S. News & World Report. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for diabetes and endocrinology by U.S. News & World Report.
Kidney transplantation can treat advanced kidney disease and kidney failure, but it is not a cure. Some forms of kidney disease may return after transplant.
The health risks associated with kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and side effects of taking medications (anti-rejection or immunosuppressants) needed to prevent your body from rejecting the donated kidney.
Deciding whether kidney transplant is right for you is a personal decision that deserves careful thought and consideration of the serious risks and benefits. Talk through your decision with your friends, family and other trusted advisors.
Complications of the procedure
Kidney transplant surgery carries a risk of significant complications, including:
Anti-rejection medication side effects
After a kidney transplant, you'll take medications to help prevent your body from rejecting the donor kidney. These medications can cause a variety of side effects, including:
Other side effects may include:
How you prepare
Choosing a transplant center
If your doctor recommends a kidney transplant, you'll be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.
When you consider transplant centers, you may want to:
You may also consider:
After you've selected a transplant center, you'll be evaluated to determine whether you meet the center's eligibility requirements for a kidney transplant.
The team at the transplant center will assess whether you:
The evaluation process may take several days and includes:
After your evaluation, your transplant team will discuss the results with you and tell you whether you've been accepted as a kidney transplant candidate. Each transplant center has its own eligibility criteria. If you aren't accepted at one transplant center, you may apply to others.
What you can expect
Before the procedure
Finding a match
A kidney donor can be living or deceased, related or unrelated to you. Your transplant team will consider several factors when evaluating whether a donor kidney will be a good match for you.
Tests to determine whether a donated kidney may be suitable for you include:
Additional factors your transplant team may consider in finding the most appropriate donor kidney for you include matching age, kidney size and infection exposure.
Living kidney Donation
Finding a willing living kidney donor is an alternative to waiting for a compatible deceased-donor kidney to become available.
Family members are often the most likely to be compatible living kidney donors. But successful living-donor transplants are also common with kidneys donated from unrelated people, such as friends, co-workers or religious congregation members.
Paired donation is another type of living kidney donation if you have a willing kidney donor whose organ is not compatible with you or does not match well for other reasons. Rather than donating a kidney directly to you, your donor may give a kidney to someone who may be a better match. Then you receive a compatible kidney from that recipient's donor.
In some cases, more than two pairs of donors and recipients may be linked with a nondirected living kidney donor to form a donation chain with several recipients benefitting from the nondirected donor's gift.
If a compatible living donor isn't available, your name will be placed on a waiting list for a deceased-donor kidney. Because there are fewer available kidneys than there are people waiting for a transplant, the waiting list continues to grow. The waiting time for a deceased-donor kidney is usually a few years.
Whether you're waiting for a donated kidney or your transplant surgery is already scheduled, work to stay healthy. Being healthy and as active as you're able can make it more likely you'll be ready for the transplant surgery when the time comes. It may also help speed your recovery from surgery. Work to:
Stay in touch with your transplant team and let them know of any significant changes in your health. If you're waiting for a donated kidney, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag handy, and make arrangements for transportation to the transplant center in advance.
During tha Procedure
Kidney transplants are performed with general anesthesia, so you're not awake during the procedure. The surgical team monitors your heart rate, blood pressure and blood oxygen level throughout the procedure.
During the surgery:
After the procedure
After your kidney transplant, you can expect to:
After a successful kidney transplant, your new kidney will filter your blood, and you will no longer need dialysis.
To prevent your body from rejecting your donor kidney, you'll need medications to suppress your immune system. Because these anti-rejection medications make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications.
It is important to take all your medicines as your doctor prescribes. Your body may reject your new kidney if you skip your medications even for a short period of time. Contact your transplant team immediately if you are having side effects that prevent you from taking your medications.
After your transplant, skin self-checks and checkups with a dermatologist to screen for skin cancer and keeping your other cancer screening up-to-date is strongly advised.
Kidney transplant success rates
Survival rates among kidney transplant recipients in U.S. transplant centers can be found online at the Scientific Registry of Transplant Recipients website.
If your new kidney fails, you can resume dialysis or consider a second transplant. You may also choose to discontinue treatment. If you decide to discontinue treatment, your doctor can give you medicines to help relieve your symptoms. This decision depends on your current health, your ability to withstand surgery and your expectations for maintaining a certain quality of life.
Coping and Support
It's normal to feel anxious or overwhelmed while waiting for a transplant or to have fears about rejection, returning to work or other issues after a transplant. Seeking the support of friends and family members can help you cope during this stressful time.
Your transplant team can also assist you with other useful resources and coping strategies throughout the transplant process, such as:
Diet and nutrition
After your kidney transplant, you may need to adjust your diet to keep your new kidney healthy and functioning well. You'll have fewer dietary restrictions than if you were receiving dialysis therapy before your transplant, but you still may need to make some diet changes.
Your transplant team includes a nutrition specialist (dietitian) who can discuss your nutrition and diet needs and answer any questions you have after your transplant.
Some of your medications may increase your appetite and make it easier to gain weight. But reaching and maintaining a healthy weight through diet and exercise is just as important for transplant recipients as it is for everyone else to reduce the risk of heart disease, high blood pressure and diabetes.
You may need to keep track of how many calories you consume or limit foods high in sugar and fat.
Your dietitian will also provide you with several healthy food options and ideas to use in your nutrition plan. Your dietitian's recommendations after kidney transplant may include:
Your dietitian may also recommend:
Once you recover from your transplant surgery, exercise and physical activity should be a regular part of your life to continue improving your overall physical and mental health.
After a transplant, regular exercise helps boost energy levels and increase strength. It also helps you maintain a healthy weight, reduce stress, and prevent common post-transplant complications such as high blood pressure and cholesterol levels.
Your transplant team will recommend a physical activity program based on your individual needs and goals.
Soon after your transplant, you should walk as much as you can. Gradually, start incorporating more physical activity into your daily life, including participating in at least 30 minutes of moderate exercise five days a week.
Walking, bicycling, swimming, low-impact strength training and other physical activities you enjoy can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine.