Kidney Transplant

A transplant places a single healthy kidney from a donor into your body. The donor is either a living person, usually a close relative or spouse, or somebody who has died and whose family has consented to donation. In India both routes are governed by law, and living donation requires approval from an authorisation committee before anything is scheduled.

The new kidney goes into the lower abdomen, low on one side, above the groin. It is not put where your own kidneys sit. That position keeps the vessels short, sits the kidney close to the bladder and just under the skin where it can be felt and scanned easily. Your own kidneys are almost always left where they are.

One kidney is enough. A transplanted kidney typically begins producing urine on the table or within a day or two.

The operation is the shorter part of this. What follows it is a lifelong course of medicines that hold your immune system back from attacking the new kidney, taken every day without a missed dose, along with regular clinic visits and blood tests.

This is a major Inpatient operation under general anaesthetic, so you are fully asleep throughout. With a living donor the date is planned well in advance and both operations run in adjacent theatres.

Your surgeon makes a curved cut in the lower abdomen on one side, about fifteen to twenty centimetres long, and works outside the abdominal cavity itself. The artery and vein of the new kidney are stitched to the vessels supplying your leg, the clamps come off and the kidney takes up blood, and the ureter is then joined to your bladder over a fine internal tube called a stent, which is removed a few weeks later in a short procedure.

The operation takes three to four hours. A urinary catheter and usually a drain are in place when you wake.

You go to a protected room or a transplant unit. The catheter stays for around five days, the drain a little less, and the anti-rejection medicines begin immediately, with blood tests every day and a scan of the kidney in the first twenty-four hours. Expect five to ten days in hospital.

The first three months are intensive. Clinic visits and blood tests are twice or three times a week at first, weekly by a month, and monthly by three months, and this schedule is not optional: rejection is detected on blood tests before you would feel anything.

The wound is sore for two to three weeks. Most people are walking the day after surgery, off strong painkillers within a week, and doing light activity at home by three weeks. Avoid lifting anything heavy and avoid driving for six weeks, and expect to feel genuinely tired for two to three months. Return to desk work is usually at two to three months and to physical work later.

Drink the volume of fluid you are told to, weigh yourself daily, record your urine output and your blood pressure, and bring the record to clinic.

The medicines are the rest of your life. Take them at the same times each day, never stop or change a dose on your own, keep a supply ahead, and check with the transplant team before taking any new medicine, including anything bought over the counter or any traditional preparation.