Our Philosophy of Care
At the University of Rochester Medical Center, we believe a kidney transplant is a lifelong commitment for you and for us. We will stay involved with you and your family through the entire transplant process. We get to know you very well and recognize that preparing for and living with a transplant will affect your lifestyle in many ways. We will help you maintain and resume many of your activities and even become involved in new ones.
We are committed to the time, effort, and resources required to make your transplant a success. And our definition of “success” extends far beyond the operating room. It means we’ll work with you to make your life after the transplant as successful as possible.
What Do the Kidneys Do?
The kidneys, a part of the urinary system, are a pair of bean shaped organs in the back of abdomen. They clean the body of excess water, salt and waste products. As blood circulates through the kidneys, it passes through more than a million tiny filtering units within them. These filters produce a liquid waste (urine). Urine flows from the kidneys through a pair of thin tubes, the ureters, to the bladder, where it is stored until a person urinates. The kidneys also produce important hormones that help regulate blood pressure, form bone, and control red blood cell production in bones.
Several diseases and conditions can injure the kidneys and make them fail, that is, stop them from working correctly. When your kidneys fail, harmful wastes build up in your body, your blood pressure may rise, and your body may retain excess fluid and not make enough red blood cells.
Kidney failure can be treated in a number of ways, but if you have advanced and permanent kidney failure, a kidney transplant may be the best treatment option. Your primary doctor will make the referral to the Strong Health Division of Solid Organ Transplantation.
What is a Kidney Transplant?
In a kidney transplant, a healthy kidney from another person is put into your body. This one new kidney takes over the work of your two failed kidneys.
Usually, the healthy kidneys come from someone who has recently died but did not have kidney injury. This is called deceased donor transplantation. However, a healthy kidney can be taken from a living organ donor who may be a family member or friend.
Is a Kidney Transplant Right for You?
A kidney transplant is offered only to people who have irreversible, chronic kidney failure. Usually, other medical or surgical treatments have been tried before a transplant is considered.
Age is not necessarily a factor in deciding if you’re a candidate for kidney transplant. Newborns, infants, children and adults past the age of 70 have all had successful kidney transplants.
What is important is your general health and suitability for major surgery. For example, you can’t have a transplant if you have:
- Cancer in another part of your body
- Serious heart, lung or nerve disease that would make the operation too risky
- An active, severe infection that can’t be completely treated or cured, such as tuberculosis
- An inability to follow your doctor's instructions
Of course, all major surgery carries risks, and a transplant is no exception. The risks associated with surgery in general are:
- Reactions to anesthesia
- Problems breathing
Transplants carry additional problems, such as:
- Rejection (the body considers the transplanted organ to be a “foreign substance” and uses its natural immune system to destroy it)
- Life-long need to take medicines (called immunosuppressive drugs) that prevent rejection by suppressing the immune system; this weaken the body's ability to fight infections
- Finding a healthy organ
However, if your primary doctor recommends a transplant, it probably is he best treatment option for your condition. Kidney transplants do save lives.
If you’re referred to us for a kidney transplant, a five-step process will begin.
The Transplant Process
The information that follows is an edited version of a brochure about kidney transplants at URMC. You can request the complete brochure by calling us at (585) 275-7753.
When you are referred to us for a kidney transplant, a five-step process will begin.
You’ll be contacted when a kidney is available. If your new kidney is from a living donor, both you and the donor will be in surgery at the same time. One team of surgeons will do the nephrectomy (removing the kidney from the donor), while another prepares you to receive the donated kidney.
If your new kidney is from a person who has recently died, your surgery starts when it arrives at the hospital and the results of the cross-match test, described above, are negative (satisfactory).
The surgery can take from 3 to 4 hours or more. You will be given general anesthesia. Your surgeon makes an incision in your lower abdomen and puts the new kidney in place. Then the surgeon connects the artery and vein of the new kidney to your own artery and vein. Your blood will then flow through the new kidney. The ureter from the new kidney will be connected to your bladder. Often, the new kidney will start making urine as soon as your blood starts flowing through it, but sometimes a few weeks pass before it starts working. Unless they are causing infection or high blood pressure, your own kidneys are left in place.
Recovery in the Hospital
You’ll probably stay in the hospital for about a week or so after surgery. Immediately after surgery, you’ll be taken to the Surgical Intensive Care Unit (SICU). After a day or so there, you’ll go to the Inpatient Transplant Unit where you’ll take medicines to prevent infections and rejection of your new kidney. Your doctor will check for bleeding and other problems.
You’ll also be prepared for your return home. You’ll be given a schedule for follow-up visits and routine blood draws, and a 24-hour phone number for emergencies or other problems. You’ll learn how to deal with the medicines you’ll be taking and their side effects, recognize rejection symptoms, plan proper diets and generally take responsibility for your recovery at home. The transplant coordinator, social worker, and psychiatrist are all available when needed. The social worker will help arrange your discharge needs, such as rehabilitation or long-term placement, chemical dependency counseling, and transportation home. You’ll also be offered a referral to a community health nurse who can help you at home.