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Kidney Transplant

FAQs for Kidney Recipients

  1. What are the two kinds of transplants?
  2. Who cannot get a kidney transplant?
  3. When is the best time to get a transplant?
  4. What medications will I have to take afterward?
  5. Who pays for the costs of transplant and other medications?
  6. Where should my family stay while I’m in the hospital for my transplant?
  7. What happens during transplant surgery?
  8. How long will I be in the hospital
  9. What risks are there for a kidney patient?
  10. How successful are kidney transplant surgeries?
  11. What would happen if my kidney transplant didn’t work? Would I die?
  12. What can patients do if they want a transplant but don’t have a living donor?
  13. How does the waiting list work?
  14. How long is the average wait for a kidney on the waiting list?
  15. Is the waiting list fair?
  16. Is there a difference between having a living or deceased donor transplant?
  17. Which kind of transplant happens faster?
  18. Can a person live longer with a transplant compared to staying on dialysis?
  19. How long does a transplanted kidney last?
  20. How does a person’s quality of life change if they get a transplant?

What are the two kinds of transplants?
Kidneys for transplant may come from a person who has died (a deceased donor), or from a healthy living person, like a family member or a friend who offers to donate a kidney (a living donor).

Who cannot get a kidney transplant?
Many patients assume they are too old for transplant but if you are otherwise healthy, age is not a factor in determining your transplant eligibility. However, there are some other factors that prevent patients from getting a kidney transplant:
  • Current life expectancy of less than 5 years
  • Recent cancer (other than most skin cancers)
  • Uncorrectable heart disease
  • Untreatable psychiatric illness
  • Missing dialysis appointments or signing off the machine early
  • Active substance abuse (alcohol or drugs)
  • Lack of health insurance or Medicare/Medicaid coverage
You and your transplant doctor will discuss your eligibility during the transplant evaluation process.

When is the best time to get a transplant?
In general, the sooner you get a kidney transplant, the better.  The transplant team and your nephrologists will determine the best time for you.

What medications will I have to take afterward?

Anti-rejection medications are taken as long as you have your transplanted kidney.  Following transplant, patients usually take:
  • Three types of medication to prevent kidney rejection
  • Decreased doses of medications over time
  • Medications for other health issues (blood pressure, insulin, etc.)
Who pays for the costs of transplant and other medications?
Each patient’s insurance coverage is different. Medicare/Medicaid and private health insurance pays for some or all of:
  • Evaluation/testing of the recipient and donor
  • Surgery of the recipient and donor
Review your personal financial and insurance situation with the Barnes-Jewish Hospital financial coordinator who will be part of your transplant team.

Possible out-of-pocket costs
  • Parking, hotel, gas, childcare, Medicare/insurance co-pays or deductibles, etc.
  • Transplant drug costs for the first year are generally the highest.
  • Typically covered at 80 percent by Medicare Part B for three years (longer if you qualify for Medicare due to age or disability)
  • Monthly drug costs will vary and can range from $0 to $3,500 per month.
Where should my family stay while I’m in the hospital for my transplant?
Accommodations for family members or friends are available on the Barnes-Jewish Hospital campus and in the surrounding area. The transplant social workers will be happy to help find short or long-term accommodations that will meet your needs and budget. Representatives can also direct you to places to eat on and off the hospital campus. For off-campus lodging assistance and to receive special rates, call (314) 362-5301 or toll-free (800) 551-3492 Monday through Friday, 8 a.m. to 5 p.m.

What happens during transplant surgery?

Shortly before going into surgery, medicine is given to the patients to help them relax. A general anesthetic is then given. The donor and recipient are in adjacent operating rooms.  The transplant surgeon removes the kidney from the donor and prepares it for transplant into the recipient.. There, the surgeon connects the renal artery and vein of the new kidney to the recipient’s artery and vein. This creates blood flow through the kidney, which makes urine. The ureter, or tube coming down from the donor kidney, is sewn into the bladder.  Usually, the new kidney will start working right away. Sometimes, it takes several days for the donor kidney to “wake up.”

How long will I be in the hospital?

Patients typically spend from three to seven days in the hospital following kidney transplant surgery.

What risks are there for a kidney patient?
Death from surgery: less than 1 percent, same as any major surgery; surgical complications: infection, fever, bleeding, blood clots; kidney failing in first year (5-10 Percent ).

How successful are kidney transplant surgeries?

Most transplanted kidneys start working immediately, but some start working slowly and you may need dialysis for one to three weeks after surgery. Nationally, 1 – 2 percent of transplants fail immediately, and 25 percent of patients on average in the nation require dialysis after surgery.

What would happen if my kidney transplant didn’t work? Would I die?

No. If the transplant doesn’t work, you can:
  • Start or resume dialysis
  • Pursue another transplant
What can patients do if they want a transplant but don’t have a living donor?
Patients who do not have a living donor can wait on a nationwide waiting list to get a deceased donor transplant.

How does the waiting list work?
The government and the United Network for Organ Sharing (UNOS) manage the nationwide kidney transplant waiting list. Patients who want a deceased donor kidney are evaluated by their transplant center. If a patient is healthy enough for a transplant, their medical information is added to the list. When a donor becomes available, that person’s medical information is also added to the list.. The computer then matches the kidney with someone on the waiting list based on blood type, how well they match the donor and the length of time on the waiting list.

How long is the average wait for a kidney on the waiting list?

At Barnes-Jewish Hospital, most patients wait for three to five years for a kidney from the deceased donor waiting list. Every year, about 10,000 people nationally donate their kidneys.  There are still over 80,000 people on the waiting list. Because of the lack of kidneys, this waiting time keeps increasing. Sometimes a matching kidney is never found. If you want to get a kidney from a deceased donor, the most important thing to do is to get on the list right away to begin gaining time. Another way to decrease your waiting time is to explore living donor transplants.

Is the waiting list fair?
National rules have been set up to make sure that everyone has an equal chance of receiving a kidney from the waiting list. Matching is based on blood type, how well they match the donor and the length of time on the waiting list.  Your income, race and age do not prevent you from receiving a kidney, nor do they move you up/down on the list.

Is there a difference between having a living or deceased donor transplant?
Yes. Living donor transplants last longer than deceased donor transplants because a living donor kidney is removed from a healthy donor in the operating room and transplanted right away. Living donor transplants last on average for 15-20 years and deceased donor transplants last for 10-15 years. Some transplants have been known to last much longer.

Which kind of transplant happens faster?
If a living donor is available, a living donor transplant happens faster, often within one year. With a deceased donor transplant, most patients have to wait 3-5 years until a kidney is available from the list.

Can a person live longer with a transplant compared to staying on dialysis?
Yes. Patients who have a transplant generally live longer than patients who stay on dialysis.  The transplanted kidney works 24 hours a day to remove 50-85% of the total waste your body generates.  Dialysis on the other hand only removes 15% of total waste and only when on the dialysis machine.

How long does a transplanted kidney last?

Kidney transplants are very successful with more than 95 percent of kidney transplants done at Barnes-Jewish still working after one year. Living donor transplants last on average for 15-20 years and deceased donor transplants last for 10-15 years.  If a transplant fails, a patient can begin or return to dialysis and/or pursue another transplant.

How does a person’s quality of life change if they get a transplant?
Most patients say that having a kidney transplant improves the quality of their lives. Patients say that they feel better and have more energy to spend time with their family, do their hobbies, travel and go back to work. Patients also say they have more time, since they do not have to spend hours in treatment with dialysis each week.  They are also very satisfied that renal dietary restrictions are removed once they are transplanted.

For additional information or to begin a kidney transplant evaluation, call .

Dan Brennan, MD

Nephrologist, Barnes-Jewish & Washington University Transplant Center

 
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St. Louis, MO 63110
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