Patients with end-stage kidney disease are carefully monitored through Froedtert Hospital’s Kidney Transplant and Nephrology Clinic. For many of these patients, external cleansing of the blood through dialysis provides adequate treatment. When dialysis or other treatments are no longer effective options, a transplant may be recommended.
A “pre-emptive transplant” may also be recommended if a kidney from a living donor is available. In a pre-emptive transplant, recipients avoid dialysis and related procedures, receiving a new kidney earlier in their treatment when they are generally healthier. According to the National Kidney Foundation, research has found that appropriate patients who receive a transplant earlier in their disease process are more likely to experience better outcomes.
Preparing for Kidney Transplant Surgery
The transplant team provides comprehensive care before, during and after a kidney transplant to make sure patients and their families are fully prepared and that their experience goes smoothly. Prior to the transplant, the team works with patients to reduce possible medical, social and psychological risk factors that may impact their outcomes. Patients and their family members receive education about end-stage kidney disease and the kidney transplant process to enhance their success and long-term outcomes after kidney transplant.
Living and Deceased Kidney Donor Options
Transplants can be done using a kidney from a deceased donor or from a living donor. Living donor kidney transplants are the preferred method of transplant as they generally offer better long-term outcomes and shorter wait times.
Transplants using kidneys from deceased donors are also successful, but this approach requires patients to be placed on a waiting list, and it can take months and sometimes many years before a donated kidney is available. Once a kidney is available, several hours may pass between the time the kidney is identified and the time the transplant is actually performed. The transplant surgery is still planned, but due to the uncertain timing, it is done on an emergency basis.
Kidney Transplant Surgery
For transplant recipients, the kidney transplant surgery generally lasts about three or four hours and involves the following steps:
- Prior to surgery, patients are given general anesthesia that allows them to sleep through the procedure.
- Once the anesthesia is in effect and the patient is asleep, the transplant surgeon makes an incision in the lower abdomen.
- The donated kidney is then placed in the patient’s abdomen and attached to the new blood supply and the ureter to the bladder.
- The original kidney will be left in place unless the patient has had repeated infections, uncontrollable hypertension or problems with urine backup.
- Once all of the connections to the new kidney are made, the surgeon closes the incision and the patient is moved to a recovery area.
Kidney Transplant Recovery and Follow-Up Care
Following surgery, patients receive care in our dedicated transplant intensive care unit (TICU). Nurses staffing the TICU are specially trained to care for kidney transplant patients. Patients will stay in the hospital for a few days. The initial recovery time after the surgery is four to eight weeks. However, living with a new kidney requires a life-long commitment to a healthy diet and physical activity routine, along with a strict regimen of medications.
Medications, primarily antirejection drugs (immunosuppressants), protect the new organ from rejection. In any organ transplant procedure, the recipient’s body may consider the new organ a foreign object and try to eliminate or reject it. To protect the new organ, patients must take these medications the rest of their lives.
Because excellent follow-up care is critical to maintain and enhance a transplant patient’s long-term survival, Froedtert Hospital offer a multidisciplinary Kidney Transplant Clinic to provide a central location to continue care. Our goal is to optimize each patient’s kidney function and overall health after kidney transplant. Dedicated post-transplant coordinators work with our patients to coordinate their transplant follow-up care.
For More Information
Learn more about the patient experience through the Transplant Center.
FAQ and Resources
Do I need a referral for kidney transplantation at Froedtert Hospital?
Most of our patients are referred by their nephrologists as they approach the need for transplant or dialysis. If this is your situation, once we receive the referral, our office will contact you to make an appointment and complete a medical intake questionnaire with you. You may call us at 800-272-3666 to request more information.
What happens during my first appointment?
During your initial appointment, a transplant surgeon, nurse coordinator, social worker, registered dietitian, financial liaisons and a pharmacist will meet with you to evaluate you as a candidate for transplant. If you are appropriate for transplant, we will schedule you to begin the medical testing process.
How do I proceed for a living versus deceased donor transplant?
Options for a living donor versus a deceased donor transplant will be discussed at the time of your initial consultation.
Do I need to find my own living donor?
We encourage all of our patients to look for potential donors from among family, friends and acquaintances. Some patients have received kidneys from neighbors, church members or people in the community who heard of their need for a kidney. The Living Donor Kidney Exchange, available as part of the End-Stage Kidney Disease and Kidney Transplant Program, provides those who need a kidney transplant with significantly improved access to potential compatible donors.
When do I get placed on the transplant waiting list?
When tests are complete, your candidacy will be discussed at a meeting of the transplant review committee. This committee is composed of transplant surgeons, nephrologists, coordinators and other transplant professionals. After approval by the committee and authorization from an insurance carrier, a patient can be placed on the transplant wait list.
How long do I need to wait for a transplant while on the list?
The allocation or distribution of deceased donor kidneys is a complex system. There are many factors that are considered when a kidney becomes available. These include blood type, length of time on the list, medical urgency and other factors. For more information on waiting times for transplantation, visit the United Network for Organ Sharing.
What are my responsibilities while on the waiting list?
Your responsibilities include keeping the transplant office informed of changes in your address, phone numbers, dialysis centers and your medical condition. You will also need to remain “transplant ready” through periodic testing.
What are the risks of having a transplant?
The risks and possible complications of transplant are similar to those associated with any surgical procedure. During education sessions and consultation, these issues are discussed.
What should I anticipate when I get called in for a transplant?
When a patient is called in, he or she will be asked to report to the hospital as soon as possible. The patient can expect to be prepared for surgery by having a history and physical, lab work, chest X-ray and EKG. The final crossmatch is done at this time to determine if the transplant will proceed. The crossmatch results take a few hours to obtain before a final decision is made to go forward.
What are the side effects of the medications?
Antirejection medications are designed to suppress, or disable, a person’s immune system so that the transplanted organ will not be rejected. This can make patients vulnerable to infection. An upset stomach is also a common side effect. Your care team will work with you to closely monitor dosages and side effects, making all adjustments possible to help you feel as healthy as possible.
Where else can I learn more?
- Visit the National Kidney Foundation to learn more about kidney disease, transplantation, education, advocacy, resources and much more.
- The United Network of Organ Sharing (UNOS) provides information about the transplantation and donation process, living donation and various national, regional, state and center-specific data reports. The Scientific Registry of Transplant Recipients website also provides national and local transplant center data.
- UNOS sponsors Transplant Living, a patient education website about life before and after transplant.
- Data specifically about kidney transplant at Froedtert Hospital is available through the Scientific Registry of Transplant Recipients website.
- You can also learn more by visiting the websites of our Transplant Center partners, Children’s Wisconsin, Versiti Blood Center of Wisconsin and the Medical College of Wisconsin.
Transplant and the COVID-19 Vaccine
Transplant patients may be at a higher risk of severe COVID-19, and we have seen worse outcomes if they do get it. Due to the increased risk, we recommend transplant patients get the vaccine.