If you have polycystic kidney disease (PKD) and have reached end-stage renal disease (ESRD), you may need a kidney transplant.
Here’s what to expect and how to navigate the process.
How to get a new kidney?
There are two ways to get a new kidney. You can get a donation from a deceased donor or a living donor.
With a deceased donor, you put yourself on a waiting list to receive a kidney from a deceased person. With a living donor, you arrange to use a kidney from a living person.
How long does it take?
If you are expecting a deceased donor, it may take a few years before a kidney is available to you. It’s about 3 to 5 years of waiting.
Your wait may be longer, depending on your age and health. If you have a sensitized immune system from transplants, blood transfusions or previous pregnancies, it may be more difficult to find a suitable donor, so you may have to wait longer.
“My biggest advice for anyone in need of a transplant is to seek out a living donor,” says Niraj Desai, MD, surgical director of kidney and pancreas transplantation at Johns Hopkins Medicine. “It’s a very difficult thing to ask someone to do, but there are programs we have to promote living donation.”
Johns Hopkins Medicine has a program called Live Donor Champion, which helps match donors and recipients. You can also try the National Kidney Registry, which uses a large database to match living kidney donors with recipients.
With a living donor, the process can go quickly. “Living donor transplants can often take place within weeks to months of the start of the transplant evaluation,” says Linda Wright, DrNP, transplant expert for the American Nephrology Nurses Association.
What are the criteria for getting a new kidney?
“The list is long, but these are some of the biggest categories of things we’re looking for,” says Desai.
- No major heart disease
- No current cancer diagnosis
- If you have had cancer in the past, adequate proof of no recurrence
- Appropriate social support
- Body mass index of 35 to 40 or less
- No major progressive neurological disease
- No major untreated psychiatric illness
How are the kidneys distributed?
Kidneys are awarded through a point system run by an organization called the United Network for Organ Sharing (UNOS). Using this computer system, UNOS takes each kidney from a deceased donor and matches it with potential recipients using a point system.
“These points are based on certain medical factors, how long they’ve been on the waiting list or when they started dialysis, how closely they match the donor, and how close they are geographically to the location of the donor. donor,” says Wright. .
Children are given special priority. You may be given priority if you have a sensitized immune system or if you have been an organ donor in the past.
How can I prepare for my transplant?
“The most critical thing is to stay on top of your health needs and maintain an active lifestyle,” says Desai. Try to follow a healthy diet and exercise regularly.
Before a transplant, you will have medical evaluations and tests. While you are waiting for a kidney, you can repeat them to stay up to date. Be sure to follow that, says Wright.
Stay in close contact with your transplant coordinator to find out the status of your assessment and your status on the waiting list.
“Keep your transplant center informed of any changes in your health, insurance, or social status,” says Wright. Don’t forget to share phone number or address changes so they can reach you quickly if an organ is available.
What happens during the transplant?
When you are ready for your transplant, you will be in the hospital for a few days.
Before the surgery, you will have general anesthesia. Your doctor may also prescribe other painkillers.
During surgery, your surgeon will make an incision in your lower abdomen. This is where they will put the new kidney, then they will connect it to your blood vessels and your bladder.
Your new kidney will start working immediately. It may take a few days to fully work. You may need dialysis for a few weeks to help it reach full functioning.
How is the recovery going?
“Hospital recovery takes less than a week,” says Desai. You may be able to leave the hospital 3 to 5 days after your surgery. “It still takes several weeks for the house to return to a normal state.”
At first, you may not be able to drive or lift anything over 5-10 pounds. About 2 to 3 months after your transplant, you may be able to return to work.
You will see your doctor regularly after your surgery. “You can expect frequent lab tests and transplant center appointments for the first few months after the transplant,” says Wright.
Your doctor will also prescribe immunosuppressive drugs to prevent your body from rejecting your new kidney. You will take this medicine for the rest of your life.
What should I ask my doctor?
If you are considering a kidney transplant, share your questions and concerns with your doctor. If you don’t understand something, ask them to explain it better.
Ask questions such as:
- How can I keep my kidney working as long as possible while waiting for a transplant?
- How can I make the most of my chance to receive a transplant?
- How to remain a good candidate while waiting for a kidney?
- What kind of medicine will I need?
- How can I avoid infection after my transplant?