Kidney Transplant

What you should know

Kidney transplant is surgery to replace a damaged kidney with a new kidney from a donor (another person). The kidneys are 2 bean-shaped organs found under the ribs on each side of the upper abdomen. The kidneys remove wastes and other unwanted chemicals from your body. The body disposes of these wastes in your urine.


Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may bleed more than expected or get an infection after surgery. Nerves, blood vessels, muscles, intestines, and other organs may get damaged. You may have problems with your ureter or bladder, which may cause urine to leak. You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Your condition may get worse during surgery, and may become life-threatening. Your body may reject the new kidney.

  • Without a kidney transplant, you will need dialysis for the rest of your life.

Getting Ready

Weeks before your surgery:

  • Your caregiver may suggest that you have counseling about your surgery and condition. He may talk to you or your family about your expectations, benefits, and possible outcomes of the surgery.

  • Tell your caregiver about all other diseases or health conditions you have. These include diabetes, cancer, bleeding disorders, or heart problems. Your caregiver may need to treat you before your surgery to prevent possible problems. He may also start you on dialysis treatment or need you to continue dialysis until your surgery.

  • Tell your caregiver if you know or think you might be pregnant.

  • You may need blood and urine tests to check if you and your donor have compatible blood types or other matching factors. You may also need an EKG, echocardiogram (echo), or stress tests. Imaging tests, such as x-rays, CT scan, MRI, ultrasound, or arteriography, may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

  • Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Ask if you should get vaccines to prevent some infections. These should be completed at least 4 weeks before your surgery. Ask your caregiver which vaccinations are right for you.

  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

  • Write down the correct date, time, and location of your surgery.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

  • Bowel preparation: You will need to clean out your bowel to get ready for this surgery. Your caregiver may ask you to do one or more of the following:

    • You may need medicine called an enema. This is liquid put into your rectum to help empty your bowel. Ask your caregiver how to do this.

    • You may be given 8 to 12 (eight-ounce) cups of special bowel prep medicine to drink. Drink 1 eight-ounce cup of bowel prep medicine every 10 minutes until you pass clear fluids. Ask your caregiver for more information about this medicine.

The day of your surgery:

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.

  • Bowel preparation:

    • Do not eat or drink anything on the morning of your surgery. Your bowel needs to be totally empty during your surgery. If you need to take medicines, you may have them the morning of your surgery with few sips of water.

    • You may need an additional enema, using warm water, the morning of your surgery.

    • You may also be asked to drink 4 to 8 (eight-ounce) cups of special bowel prep medicine. This may need to be done if you drank the bowel prep medicine the night before.

  • If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

  • You may be given medicine to help you relax. Your abdomen, side, and genital areas will be cleaned. An endotracheal (ET) tube connected to a breathing machine may be put into your mouth. This goes down the windpipe to keep your airways open and help you breathe during your surgery. A catheter may be inserted to drain your urine.

  • Your caregiver will make an incision on your abdomen. He will attach your new kidney by stitching the blood vessels of the new kidney to your blood vessels. The ureter of the new kidney will be attached to your bladder. Your damaged kidneys will be left in place unless they are causing problems such as infection or high blood pressure. Thin rubber tubes will be put near the kidney to drain blood from your incisions. Your incisions will be closed with stitches or surgical tape and covered with bandages.

After your surgery:

  • You will be taken to the recovery room or an intensive care unit (ICU). The ET tube may be removed after you are awake and can breathe well on your own. Caregivers will watch you closely to make sure you are okay. A caregiver may remove the bandages soon after your surgery to check your wound and drains.

  • You will have several tubes in place, which might make it hard to move. All of these tubes are important to help your caregivers know about any problems. The drains are taken out when the incision stops draining. Do not get out of bed until your caregiver says it is okay.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever.

  • You have a skin infection or an infected wound on or near your abdomen.

  • You have questions or concerns about your surgery.

Seek Care Immediately if

  • You have more pain or have trouble urinating.

  • Your signs and symptoms get worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Kidney Transplant (Precare)

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