medicines have resulted in very good success rates for kidney transplants from deceased donors. However, there are more people who need kidneys than there are donor kidneys. Therefore, you remain on a waiting list (sometimes for several years) until a suitably matched kidney becomes available. Did you know that one healthy kidney is enough to remove wastes and excess fluid from the blood? You are born with two, but you only need one! FACT WWW.KIDNEY.ORG 9 Only a transplant center can place you on the national waiting list. It is important to follow your prescribed treatment carefully while waiting for a new kidney. What are “preemptive” transplant and early transplant? When your kidneys fail, it may be possible to get a transplant and avoid dialysis (preemptive transplant) or reduce time on dialysis (early transplant). For many recipients, this means they are able to save time and money, and keep working, as well as reap the benefits of better physical health that come with a new kidney. There are a number of factors that must be addressed when considering this option, including finding a suitable living donor, health status of the recipient, time involved in waiting for a transplant, and financial issues, to name just a few. 10 NATIONAL KIDNEY FOUNDATION How do I start the process of getting a kidney transplant? You should ask your doctor about the transplant process. He or she can refer you to a transplant center for evaluation. Or you can find a transplant program by state or region using the website of the Organ Procurement and Transplantation Network (www.optn.transplant.hrsa.gov/ members/search.asp). WWW.KIDNEY.ORG 11 What does the transplant operation involve? The kidney transplant operation involves surgically opening the lower part of your abdomen to place the new kidney inside. The kidney will be put into the right or left side of the lower abdomen, just above the front of your hip bone. The blood vessels of the new kidney are connected to your existing blood vessels, and the ureter (urine tube) is connected to your bladder. The operation usually takes about three to five hours. Diseased kidneys Artery Transplanted kidney Vein Transplanted ureter Bladder 12 NATIONAL KIDNEY FOUNDATION You can expect to feel groggy and sore, as you would after any type of surgery. You can usually begin to eat and drink the next day. There will be a tube (catheter) in your bladder to collect and measure the urine. There will be an intravenous (IV) tube in your arm to supply you with fluids and pain medicine. The IV and catheter will be removed within several days. You may be out of bed within a day or two. In many cases, the new kidney begins to work right away. In other cases, it may take a while for the new kidney to work. Your failed kidneys are typically not removed. When can I go home? Most patients can leave the hospital in two to five days. Once you are home, the most important work begins: the follow-up. For your transplant to be successful, you have to be followed carefully and your medications will need to be adjusted. This is done to watch for rejection. You may need to have blood tests several times a week just after the transplant. Over time, follow-up visits and blood tests are required less often. However, you will still need to have your kidney function and medications checked from time to time. You must WWW.KIDNEY.ORG 13 take your medications exactly as prescribed by your transplant team. In addition, you must become familiar with the signs of rejection so you can report them promptly and be treated early. What is rejection? The most important complication that may happen after transplant is rejection of the kidney. The body’s immune system guards against attack by all foreign matter, such as bacteria. This defense system will recognize an organ transplanted from someone else as “foreign” and act to fight or reject this foreign “invader.” You will need to take antirejection medications (also called immunosupressants) every day to prevent rejection of your new kidney. Most patients take three types. The major one is usually a medication like cyclosporine, tacrolimus, sirolimus, or everolimus. You may also need to take a steroid, such as prednisone, and a third medication, such as mycophenolate or azathioprine. Additional treatment may be needed if a rejection episode occurs. Regular checkups at your transplant center will help find and treat signs of rejection. 14 NATIONAL KIDNEY FOUNDATION What are side effects of antirejection medications? Antirejection medications have a large number of possible side effects because the body’s immune defenses are lowered. Fortunately, these side effects are usually controllable for most patients. If side effects do occur, changing the dose or type of medication can often lessen them. It is important to talk to your doctor about this. Some of the most common side effects include: •lowered kidney function •high blood pressure •heart problems •diabetes •bone weakness •weight gain •increased risk of infections and cancer IMPORTANT REMINDER You must not take any medicine or nutritional supplement that is not approved by a transplant physician because of the risk of interaction with your immunosuppressive (antirejection) medications. WWW.KIDNEY.ORG 15 What other types of