Kidney Transplant Surgery: What to Expect

Medically Reviewed by Carmelita Swiner, MD on July 03, 2023
4 min read

When your kidneys aren’t working the way they should, waste and extra fluids build up in your body. Dialysis is one way to treat this problem, but you could also choose to have a kidney transplant. This could give you more freedom with your daily schedule. It may also give you more energy and help you feel better. And, survival rates are higher after a kidney transplant.

Still, it’s a complex surgery. Here’s what you should know before you decide it’s right for you.

If your doctor thinks a transplant is an option for you, they’ll put you in touch with a local transplant center. That’s a hospital that does organ transplants. You’ll then have exams, X-rays, and scans to make sure you’re healthy enough to go through the transplant process.

There are two different ways you can get a healthy kidney. The first is through what’s known as a “living donor.” This might be a family member or close friend who is willing to give you one of their kidneys. Or, it could be a stranger who’s willing to give you one of theirs. The second way you could get a kidney is from a deceased organ donor.

Either way, your blood and tissue will need to be tested to make sure yours matches that of the donor. This raises the chances that your immune system will accept the donor kidney and not try to attack it.

If you have a living donor, you’ll be able to schedule the date of your transplant surgery. Getting a kidney from a deceased organ donor may take much longer. You’ll be placed on a waiting list. Then, when a kidney is ready, you’ll receive a call telling you to get to the hospital right away.

A kidney transplant often takes 3 hours, but can last as long as 5.

You’ll be given anesthesia so you stay asleep the whole time. Then once you’re “under,” the surgeon will make an opening in your abdomen, just above your groin. Your own kidneys won’t be removed unless they’re infected or causing pain, but the donor kidney will be put in. Its blood vessels will be attached. Then, the surgeon will connect the ureter (the tube that carries urine from your kidney) to your bladder.

The opening will be closed with stitches, special glue, or staples. A small drain may be put into your abdomen to get rid of any extra fluid that’s built up during the surgery. Your surgeon will also insert a tiny tube called a stent into your ureter to help you pee. This will be removed 6 to 12 weeks later during a simple procedure.

If your damaged kidney is removed, you have the option of giving it to a kidney research group. Doctors will study it to learn more about kidney disease and hopefully get closer to a cure. If this interests you, you’ll need to tell your transplant doctor ahead of time.

You may be able to get out of bed and walk around the day after your transplant. Most people stay in the hospital for 5 days or less.

Although you should start to feel much better in about 2 weeks, you won’t be able to drive or lift heavy objects for about a month. Your doctor will probably advise you to take off work for 6 to 8 weeks.

To stop your body from rejecting the donor kidney, you’ll need to take a special medication every day. At first, you may also have to visit your doctor 2 to 3 times each week to make sure your body is healing the way it should. Over time, these visits will become much less frequent.

You’ll recover faster if you stay active. Your doctor will tell you what exercises are safe to do and for how long. Many people start with walking and stretching, then slowly build up to longer and more intense workouts. But contact sports, like soccer and football, will be off limits, since you could harm your donor kidney.

Giving up smoking and alcohol are key to staying healthy. You may also think about talking to a dietitian about healthy meal planning. You’ll be able to eat more fruits and vegetables and drink more liquids than someone on dialysis. But you’ll also need to choose foods that can keep your blood pressure low and blood sugar stable.

Having a kidney transplant puts you at risk for health problems like high blood pressure and diabetes. You’re also more likely to get infections. This could occur at the site of your incision. Or, it could be a yeast infection or a virus that affects your whole body, like shingles.

There’s also a chance your body could start to attack (reject) the donor kidney. If so, you could experience:

If you notice any of these signs, you’ll need to call your doctor right away. But many people who have a kidney transplant do very well.