Kidney Transplant: How it Works

How does one get a kidney transplant?

Getting a kidney transplant is a complex process that involves several steps. Here’s an overview of the process:

Step 1: Evaluation

1. Referral: A patient with end-stage renal disease (ESRD) is referred to a nephrologist or transplant center by their primary care physician.
2. Initial evaluation: The patient undergoes a thorough medical evaluation, including:
   • Medical history
   • Physical examination
   • Laboratory tests (e.g., blood work, urine analysis)
   • Imaging studies (e.g., CT scan, MRI)
3. Kidney function assessment: The patient’s kidney function is assessed using creatinine levels, estimated glomerular filtration rate (eGFR), and other tests.

Step 2: Waiting list registration

1. Waiting list: The patient is added to the national transplant waiting list, managed by the Organ Procurement and Transplantation Network (OPTN).
2. Priority level: The patient is assigned a priority level based on their medical urgency and the amount of time they’ve been waiting for a transplant.

Step 3: Matching process

1. Matching algorithm: The United Network for Organ Sharing (UNOS) uses an algorithm to match donors and recipients based on factors like blood type, size, and tissue type.
2. Matching decisions: The transplant center reviews the matches and makes decisions about which match is best for the patient.

Step 4: Transplant surgery

1. Surgery preparation: The patient undergoes pre-surgery testing, including blood tests, imaging studies, and other evaluations.
2. Surgery: The transplant surgeon performs the surgery, typically involving a laparoscopic or open procedure to remove the diseased kidney and implant the new kidney.
3. Recovery: The patient recovers in the hospital for several days before being discharged.

Step 5: Post-transplant care

1. Immunosuppression: The patient takes medications to suppress their immune system to prevent rejection of the new kidney.
2. Follow-up care: Regular follow-up appointments with the transplant team are crucial to monitor kidney function, detect any complications, and adjust immunosuppression medications as needed.
3. Lifestyle changes: Patients must make lifestyle changes, such as avoiding certain medications, foods, and activities, to reduce the risk of rejection and infection.

Important notes

• Kidney transplantation is a complex procedure that requires careful planning, evaluation, and treatment.
• Patients must be committed to following their post-transplant care plan to ensure successful outcomes.
• Living donation is an option for some patients who do not have a compatible deceased donor match.

It’s essential to consult with a nephrologist or transplant center to learn more about the process and determine if a kidney transplant is right for you.