What is Deceased-Donor Kidney Transplant? Purpose, Procedure & Results

A deceased-donor kidney transplant is a life-saving surgery where you receive a healthy kidney from someone who has died and previously agreed to donate their organs. This procedure offers hope when your own kidneys can no longer filter waste and excess fluid from your blood effectively.

The journey involves careful matching between you and the donor kidney to ensure the best possible outcome. While waiting for a compatible organ can feel overwhelming, understanding the process can help you feel more prepared and confident about this important treatment option.

What is a deceased-donor kidney transplant?

A deceased-donor kidney transplant replaces your failing kidney with a healthy one from someone who has died. The donor kidney comes from individuals who made the generous decision to donate their organs after death, giving others a second chance at life.

Your new kidney will be placed in your lower abdomen, typically on the right side. Surprisingly, your own kidneys usually stay in place unless they're causing specific problems. The transplanted kidney connects to nearby blood vessels and your bladder, where it begins filtering your blood and producing urine.

This type of transplant differs from living-donor transplants because the kidney comes from someone who has passed away. The organ must be carefully preserved and transported quickly to maintain its function for the recipient.

Why is a deceased-donor kidney transplant done?

Your doctor recommends this transplant when your kidneys can no longer keep you healthy on their own. End-stage kidney disease means your kidneys function at less than 10% of their normal capacity, making dialysis or transplantation necessary for survival.

Several conditions can lead to this point, and understanding them helps explain why transplant becomes the best option. The most common reasons include:

• Diabetes-related kidney damage (diabetic nephropathy)
• High blood pressure causing kidney scarring
• Polycystic kidney disease with enlarged, cyst-filled kidneys
• Glomerulonephritis, which damages the kidney's filtering units
• Autoimmune diseases like lupus affecting kidney function
• Inherited kidney disorders present from birth
• Kidney damage from medications or toxins

A successful transplant often provides better quality of life than long-term dialysis. Many people feel more energetic and can return to activities they enjoyed before kidney disease progressed.

What is the procedure for deceased-donor kidney transplant?

The transplant surgery typically takes 3 to 4 hours and happens as an emergency procedure once a matching kidney becomes available. You'll receive general anesthesia, so you'll be completely asleep throughout the operation.

Your surgeon makes an incision in your lower abdomen to access the area where your new kidney will be placed. The process involves several careful steps to ensure the best outcome:

1. The surgeon places the donor kidney in your lower right abdomen
2. Blood vessels from the new kidney connect to your existing blood vessels
3. The kidney's ureter (tube carrying urine) attaches to your bladder
4. Your surgeon tests the connections to ensure proper blood flow
5. The incision is closed with sutures or staples

The new kidney often begins producing urine immediately, though sometimes it takes days or weeks to start working fully. Your medical team monitors you closely during this critical period to ensure everything functions properly.

How to prepare for your deceased-donor kidney transplant?

Preparing for transplant involves both getting on the waiting list and staying ready for the call when a kidney becomes available. The evaluation process ensures you're healthy enough for surgery and likely to benefit from the transplant.

Your transplant team will guide you through comprehensive testing that examines your overall health. This preparation phase typically includes:

• Blood tests to check organ function and infection status
• Heart tests like EKG and echocardiogram
• Lung function tests and chest X-rays
• Cancer screening appropriate for your age
• Dental examination to identify any infections
• Psychological evaluation to assess readiness
• Financial counseling about transplant costs

Once approved, you'll join the national waiting list through the United Network for Organ Sharing (UNOS). Stay reachable at all times because you'll need to get to the hospital within hours of receiving the call.

Keep your health as stable as possible while waiting. Continue dialysis treatments, take prescribed medications, and maintain good nutrition to ensure you're in the best condition for surgery when the opportunity arrives.

How to read your kidney transplant results?

After transplant, your medical team monitors specific blood tests to check how well your new kidney is working. The key marker is your creatinine level, which should decrease significantly compared to before transplant when your kidney function improves.

Your doctors track several important measurements to ensure your transplant stays healthy. These tests help detect any problems early when they're most treatable:

• Creatinine levels (should be 0.6-1.2 mg/dL in healthy kidneys)
• Blood urea nitrogen (BUN) indicating waste removal
• Glomerular filtration rate (GFR) measuring kidney function percentage
• Protein levels in urine tests
• Immunosuppressive medication levels in your blood

Normal results vary from person to person, and your new kidney may not function exactly like a healthy native kidney. Your transplant team will explain what numbers are appropriate for your specific situation and adjust medications accordingly.

How to maintain your transplanted kidney?

Protecting your new kidney requires lifelong commitment to medications and healthy lifestyle choices. Your immune system naturally wants to reject the transplanted organ, so immunosuppressive drugs are essential to prevent this rejection.

Taking medications exactly as prescribed is the most important thing you can do for your transplant. These powerful drugs require careful monitoring because they affect your entire immune system:

• Anti-rejection medications taken at the same times daily
• Blood pressure medications to protect kidney function
• Medications to prevent infections and bone disease
• Regular blood tests to monitor drug levels

Healthy lifestyle choices support your transplant's long-term success. This includes eating a balanced diet, exercising regularly as approved by your doctor, avoiding exposure to infections, and protecting your skin from sun damage since immunosuppressive drugs increase cancer risk.

What is the best outcome after kidney transplant?

The best outcome means your new kidney functions well for many years, allowing you to live an active, fulfilling life. Most people feel significantly better than they did on dialysis, with more energy and freedom in their daily activities.

Success rates for deceased-donor kidney transplants are encouraging, though individual results vary. About 95% of transplanted kidneys work well for the first year, and approximately 85% continue functioning after five years.

Long-term success depends on several factors including your age, overall health, how well you follow medical instructions, and how closely the donor kidney matches your tissue type. Many people return to work, travel, exercise, and enjoy activities that were difficult during advanced kidney disease.

Regular follow-up care with your transplant team helps maintain these positive outcomes. Early detection and treatment of any problems can prevent serious complications and help preserve your kidney function for decades.

What are the risk factors for kidney transplant complications?

Several factors can increase your risk of problems after transplant, though many are manageable with proper care. Understanding these risks helps you and your medical team work together to minimize complications.

Some risk factors you can't change, while others respond to lifestyle modifications and careful medical management. The main factors that affect transplant outcomes include:

• Age (older recipients face higher complication rates)
• Diabetes or heart disease present before transplant
• Previous transplants or blood transfusions
• High levels of antibodies in your blood
• Poor medication compliance after transplant
• Smoking or excessive alcohol use
• Obesity affecting surgical recovery

Your transplant team evaluates these factors during the evaluation process and works with you to optimize your health before surgery. Many risk factors can be improved through lifestyle changes, medication adjustments, or additional medical treatments.

Is it better to have a kidney transplant than stay on dialysis?

For most people with end-stage kidney disease, transplant offers significant advantages over long-term dialysis. Studies consistently show that transplant recipients typically live longer and enjoy better quality of life than those who remain on dialysis.

The benefits extend beyond just survival statistics. Many people find transplant allows them to feel more like themselves again, with increased energy and fewer dietary restrictions than dialysis requires.

However, transplant isn't right for everyone. Some people with serious heart disease, active cancer, or other major health problems may do better continuing dialysis. Your transplant team carefully evaluates whether you're likely to benefit from transplant surgery.

The decision involves weighing the surgical risks against the potential benefits. While transplant requires lifelong immunosuppressive medications with their own risks, many people find this trade-off worthwhile for the improved quality of life.

What are the possible complications of kidney transplant?

Like any major surgery, kidney transplant carries both immediate and long-term risks. Understanding these possibilities helps you recognize warning signs and seek prompt medical attention when needed.

Early complications can occur in the first few weeks after surgery, while some problems may develop months or years later. Here are the main concerns your medical team monitors:

• Acute rejection where your immune system attacks the new kidney
• Infections due to immunosuppressive medications
• Blood clots in the kidney's blood vessels
• Urinary tract infections or blockages
• Wound healing problems at the surgical site
• Side effects from anti-rejection medications
• Increased cancer risk from immune suppression
• Cardiovascular disease progression

Most complications are treatable when caught early, which is why regular follow-up appointments are so important. Your transplant team teaches you warning signs to watch for and provides 24-hour contact information for urgent concerns.

Long-term complications may include chronic rejection, where the kidney slowly loses function over years, or side effects from medications like bone disease or increased infection risk. Regular monitoring helps detect and manage these issues before they become serious.

When should I see a doctor after kidney transplant?

You should contact your transplant team immediately if you experience any concerning symptoms after your transplant. Quick medical attention can prevent minor problems from becoming serious complications.

Some symptoms require urgent medical evaluation because they might indicate rejection or serious infection. Don't hesitate to call your transplant coordinator or go to the emergency room if you notice:

• Fever over 100.4°F (38°C) or chills
• Decreased urine output or changes in urine color
• Swelling in legs, ankles, or around eyes
• Unexplained weight gain (more than 3 pounds in 2 days)
• Pain or tenderness over the transplant site
• Severe nausea, vomiting, or diarrhea
• Difficulty breathing or chest pain
• Severe headache or vision changes

Regular scheduled appointments are equally important for monitoring your transplant's health. These visits typically occur frequently at first, then gradually spread out as your recovery progresses and your new kidney remains stable.

Your transplant team becomes your long-term medical partner, so maintain open communication about any health concerns, medication side effects, or changes in how you feel. Early intervention often prevents minor issues from becoming major problems.