If you’re nearing the need for dialysis and would like to explore getting a transplant, start the discussion with your nephrologist. Your doctor will discuss the transplant process with you, which generally starts with being referred to a transplant center for further evaluation. You will undergo comprehensive medical tests to determine if you’re a viable candidate. If you are, then the search for a donor can begin.
How do I find a match for a kidney transplant?
There are two types of organ donors: a living donor and a non-living, or cadaver, donor. Compatibility between a patient and the donor reduces the chances of organ rejection and can contribute to a more successful transplant. Additionally, because medication to help prevent organ rejection is so effective, donors don’t always have to be genetically similar to the recipient.
If you don’t have a potential living donor, you will be placed on the waiting list for a cadaver organ and will need to register for the national transplant waiting list at Gift of Life. The wait for a transplant can vary greatly depending on the type of donation you receive, your geographic location and current health.
Know someone who would like to donate a kidney? The National Kidney Registry and Gift of Life can provide extensive information on donor match programs.
How long is kidney transplant surgery?
You’ll be scheduled for surgery as soon as an appropriate organ match has been identified. In most cases, your surgeon will leave your kidneys in place and simply place the new, healthy kidney in a different location in your abdomen. You will remain in the hospital for several days after the surgery and be monitored for any complications.
What are potential kidney transplant complications?
While your age and health conditions prior to the transplant surgery can affect the risk of complications, there are three common post-transplant concerns.
- Rejection: Medication will be prescribed to help ensure your body accepts the new kidney.
- Functionality: In some cases, the newly transplanted kidney begins working right away, while in others it may require dialysis for a few days before it starts functioning normally.
- Organ lifespan: The average life span for a donated kidney is 10 to 15 years. When a transplant fails, a patient may opt for a second transplant or return to dialysis.
When do I go from dialysis to kidney transplant?
If your kidneys are failing, a kidney transplant may be a treatment option for you. The balance of risks and benefits varies depending on your age and other health problems. If you want a kidney transplant, you must contact a transplant center and ask for a transplant evaluation. It is not automatic. Only a transplant team can tell you that you are definitely eligible (or not eligible) for a transplant.
You can contact the Main Line Health Kidney Transplant Program when it seems likely that you will need dialysis within two to three years. Most kidney transplants are successful—more than 90 percent of transplants are still working one year later. Recent studies have found that the odds of good results are somewhat better with a “preemptive” transplant, done before dialysis is needed. Preemptive transplant requires a willing living kidney donor—probably a relative, spouse or friend.
If you do not have a living donor, you can ask to be placed on a national waiting list to receive a cadaver kidney from someone who has recently died—usually in an accident. After your evaluation is complete and you are placed on the list, credit for waiting time begins when your glomerular filtration rate (GFR) drops to 20 mL/min or lower. Longer waiting times—often years—are common for kidney transplants from cadaver donors.
Can I get on the kidney transplant waiting list before I start dialysis?
Yes, you may want to be evaluated for a transplant before you start dialysis. After your evaluation is done and you get on the waiting list, credit for waiting time starts when your kidney function drops to less than about 20 percent. This is measured by a GFR of 20 mL/min or less. Longer waiting times—often years—are very common for kidney transplants from cadaver donors.
Will my kidney doctor automatically put me on a kidney transplant waiting list?
No. Your kidney doctor will not automatically put you on the transplant waiting list. If you want to be evaluated for a transplant, ask your doctor for a referral to a transplant center. Contact your private insurance to help determine which centers are contracted with your plan.
Who pays for kidney transplant costs?
If you want to get a kidney or kidney-pancreas transplant, your employer health plan may cover it (and Medicare would be secondary). If your plan does not cover a transplant, Medicare will pay 100 percent of the hospital charges, and 80 percent of Medicare’s allowable rate for outpatient care like doctors’ fees. Medicare will also pay for a living kidney donor to be evaluated, but your donor may have costs that aren’t covered like travel or time off of work. Transplant requires costly anti-rejection drugs, too. If your employer health plans covers drugs, these will be paid for. If not, Medicare covers 80 percent of these drugs for three years (longer for people who are elderly or disabled).
Can anyone give me a kidney, whenever I want?
In the past, only a close relative, such as a parent or sibling could give you a kidney. Now more distant relatives, spouses and even friends and neighbors can be donors. If you have a willing living kidney donor, you will both need to be evaluated for general health and to see if your blood type and immune system are matched closely enough with the donor. How close the match needs to be depends on the rules and protocol of each transplant center.
If I have a kidney transplant, will I be able to stop taking pills and seeing doctors?
No. A kidney transplant is a treatment, not a cure, for kidney disease. When you have a transplant, you must take pills to suppress your immune system for the life of the transplant. These pills keep your body from rejecting your new kidney. You will also need to see doctors regularly to monitor your health and your transplanted kidney.
If my kidney transplant fails, can I go back to dialysis?
Yes. You may be able to go back to either hemodialysis or peritoneal dialysis, depending on your medical history.
I am in stage 4 kidney disease and can’t have a transplant. Can I do dialysis for the rest of my life?
The questions, “How long can someone live?” and, “How well can someone live?” are very common when you need to go on dialysis and you’re scared. Yes, dialysis is something you can do for the rest of your life. Some people have done dialysis for 30 years or more without getting a transplant. How long you can live on dialysis and how well you can do will depend on a number of things, including:
- How healthy you are, other than kidney disease
- How positive your attitude is (optimists live longer, depression can be treated)
- Whether you receive good quality medical care and dialysis
To request more information about the Main Line Health Kidney Transplant Program at Lankenau Medical Center call 484.476.8485.