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Kidney Transplants

What is a kidney transplant?

A kidney transplant is a surgery in which a surgeon replaces your kidney with a healthy donor kidney. This healthy kidney then does the job that your diseased kidneys can no longer do. A kidney transplant is a treatment for advanced CKD or ESKD.

The surgeon puts the donor kidney into the lower part of your belly and connects the kidney to your bladder.

The kidney can come from someone who has died (called a deceased donor) or someone who is alive (called a living donor) that donates a kidney to you. 

A kidney from a living donor can help you avoid the waiting list for a deceased donor kidney. Living donor kidneys are also more likely to work better and for a longer period of time after the transplant than a deceased donor kidney. 

Evidence shows that a kidney transplant is the best treatment for ESKD. Compared to staying on dialysis, a kidney transplant can help you live longer and have a better quality of life. 

What happens to my own kidneys?

Your own kidneys are usually left where they are unless they are causing you problems, such as pain or infection. If that happens, the surgeon may decide to remove your own kidney or kidneys. 

What if I do not want to get a kidney transplant?

It is okay to not want a kidney transplant. If you do not want a transplant, you will need to continue to get dialysis. However, sometimes people don’t want a transplant because they don’t know enough about it, such as how it could help them or how the process works.  

We encourage you to learn about kidney transplants from your doctor before deciding if a kidney transplant is right for you.

The kidney transplant process

The kidney transplant process has many steps. The main steps are:

  1. Get referred to a kidney transplant program
  2. Get education about kidney transplants
  3. Go through the kidney transplant program’s evaluation process
  4. Complete any testing required by the transplant center to be placed on the waiting list
  5. Wait on the transplant list until a kidney becomes available
  6. Get a kidney transplant

How do I get referred to a kidney transplant program?

Your primary care physician, dialysis unit, or kidney doctor (nephrologist) will place the referral. However, you may also contact the transplant center yourself. 

When should I get referred?

In general, everyone with advanced kidney disease should be considered for a kidney transplant. A good time to start the transplant process is when your eGFR is between 20-25. eGFR is a measurement of how well your kidneys are working, based on a blood test.

You can get referred and start the transplant process before you are on dialysis, which can:

  • Give you more time for the evaluation process
  • Give you time to find a living kidney donor, if you choose
  • Possibly allow you to get a kidney transplant before you need to go on dialysis

What happens during the evaluation process?

After being referred for a kidney transplant, the next step is the evaluation. During this step, members of the kidney transplant program will talk with you and do many tests. The goal of the evaluation is to make sure you are healthy enough to:

  • Survive the kidney transplant surgery
  • Benefit from a transplant
  • Take good care of your new kidney

It is possible you may not be able to go through the evaluation process due to:

  • Having an active infection 
  • Having cancer
  • Actively using street drugs or prescription medicines that are not prescribed to you
  • Having serious medical conditions that raise the chance of dying during the transplant surgery 
  • Not being interested in getting a kidney transplant

If possible, you may be able to treat or resolve these issues and continue to go through the evaluation process.

What will I learn during kidney transplant education?

During your initial education about kidney transplants, you will learn about: 

  • Why a kidney transplant is preferred over dialysis 
  • Detailed steps of the evaluation process 
  • How long the kidney transplant waiting list is in your area 
  • Things you may need to do to be placed on the waiting list for a kidney transplant, such as lose weight or stop smoking

How will I pay for a kidney transplant?

Before the evaluation process, it is important to review your insurance coverage with a social worker and transplant financial advisor, who your transplant center will provide for you. They may be able to answer questions specific to your situation. 

Medicare will cover about 80% of the costs of being evaluated for a kidney transplant, the transplant operation, post-transplant care, and anti-rejection medicines. Medicaid may cover much or all of the remaining costs, if you are disabled. If you have private insurance, they may cover some additional costs as well. 

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This content was developed independently by AST and supported by a financial contribution from Sanofi