Kidney transplant

Get tested at a transplant center

At the transplant center, you’ll meet members of your transplant team. You’ll have tests to make sure you’re a good candidate for transplant.

Tests will include blood tests and tests to check your heart and other organs—to make sure you’re healthy enough for surgery. Some conditions or illnesses could make a transplant less likely to succeed, such as cancer that is not in remission, or current substance abuse.

You’ll also have tests to check your mental and emotional health. The transplant team must be sure you’re prepared to care for a transplanted kidney. You’ll need to be able to understand and follow a schedule for taking the medicines you need after surgery.

In a process called cross-matching, the transplant team tests the donor’s blood against your blood to help predict whether your body’s immune system will accept or reject the new kidney.

If a family member or friend wants to donate a kidney and is a good match, that person will need a health exam to make sure he or she is healthy enough to be a donor. If you have a living donor, you don’t need to be on a waiting list for a kidney and can schedule the surgery when it’s best for you, your donor, and your surgeon.

Testing and evaluation at the transplant center may take several visits over weeks to months.

Who is on my transplant team?

A successful transplant involves working closely with your transplant team. Members of the team include:

You—you are an important part of your transplant team.
Your family members—this may include your spouse, parents, children or any other family member you would like to involve.
Transplant surgeon—the doctor who places the kidney in your body.
Nephrologist—a doctor who specializes in kidney health and may work closely with a nurse practitioner or a physician’s assistant.
Transplant coordinator—a specially trained nurse who will be your point of contact, arrange your appointments, and teach you what to do before and after the transplant.
Pharmacist—a person who tells you about all your medicines, fills your prescriptions, and helps you avoid unsafe medicine combinations and side effects.
Social worker—a person trained to help you solve problems in your daily life and coordinate care needs after your transplant.
Dietitian—an expert in food and nutrition who teaches you about the foods you should eat and avoid, and how to plan healthy meals.

How do I know my new kidney is working?

Blood tests help you know your donor kidney is working. Before you leave the hospital, you’ll schedule an appointment at the transplant center to test your blood. The tests show how well your kidneys are removing wastes from your blood.

At first, you’ll need regular checkups and blood tests at the transplant center or from your doctor. As time goes on, you’ll have fewer checkups.

Your blood tests may show that your kidney is not removing wastes from your blood as well as it should. You also may have other symptoms that your body is rejecting your donor kidney. If you have these problems, your transplant surgeon or nephrologist may order a kidney biopsy.

What are the possible problems after a kidney transplant?
The donated kidney may start working right away or may take up to a few weeks to make urine. If the new kidney doesn’t start working right away, you’ll need dialysis treatments to filter wastes and extra salt and fluid from your body until it starts working.

Other problems following kidney transplant are similar to other pelvic surgeries and may include

bleeding
infection, especially a bladder infection
hernia
pain or numbness along the inner thigh that usually goes away without treatment
Transplant rejection is rare right after surgery and can take days or weeks to occur. Rejection is less common when the new kidney is from a living donor than when it’s from a deceased donor.

What are the symptoms of transplant rejection?

Transplant rejection often begins before you feel any changes. The routine blood tests that you have at the transplant center will reveal early signs of rejection. You may develop high blood pressure or notice swelling because your kidney isn’t getting rid of extra salt and fluid in your body.

Your health care provider will treat early signs of rejection by adjusting your medicines to help keep your body from rejecting your new kidney.

Transplant rejection is becoming less common. However, your body may still reject the donor kidney, even if you do everything you should. If that happens, you may need to go on dialysis and go back on the waiting list for another kidney. Some people are able to get a second kidney transplant.

Your Kidneys & How They Work

Why are the kidneys important?
How do my kidneys work?
How does blood flow through my kidneys?
Clinical Trials
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of your spine.

Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder. Your bladder stores urine. Your kidneys, ureters, and bladder are part of your urinary tract.

Illustration of a human torso showing the kidneys, ureters, bladder, and urethra.
You have two kidneys that filter your blood, removing wastes and extra water to make urine.
Why are the kidneys important?
Your kidneys remove wastes and extra fluid from your body. Your kidneys also remove acid that is produced by the cells of your body and maintain a healthy balance of water, salts, and minerals—such as sodium, calcium, phosphorus, and potassium—in your blood.

Without this balance, nerves, muscles, and other tissues in your body may not work normally.

Your kidneys also make hormones that help

control your blood pressure
make red blood cells
keep your bones strong and healthy
Watch a video about what the kidneys do .

How do my kidneys work?

Each of your kidneys is made up of about a million filtering units called nephrons. Each nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process: the glomerulus filters your blood, and the tubule returns needed substances to your blood and removes wastes.

Drawing of a nephron showing that a blood vessel from the renal artery leads to the glomerulus before branching across the u-shaped tubule and leading to the renal vein.
Each nephron has a glomerulus to filter your blood and a tubule that returns needed substances to your blood and pulls out additional wastes. Wastes and extra water become urine.
The glomerulus filters your blood
As blood flows into each nephron, it enters a cluster of tiny blood vessels—the glomerulus. The thin walls of the glomerulus allow smaller molecules, wastes, and fluid—mostly water—to pass into the tubule. Larger molecules, such as proteins and blood cells, stay in the blood vessel.

The tubule returns needed substances to your blood and removes wastes
A blood vessel runs alongside the tubule. As the filtered fluid moves along the tubule, the blood vessel reabsorbs almost all of the water, along with minerals and nutrients your body needs. The tubule helps remove excess acid from the blood. The remaining fluid and wastes in the tubule become urine.

How does blood flow through my kidneys?

Blood flows into your kidney through the renal artery. This large blood vessel branches into smaller and smaller blood vessels until the blood reaches the nephrons. In the nephron, your blood is filtered by the tiny blood vessels of the glomeruli and then flows out of your kidney through the renal vein.

Your blood circulates through your kidneys many times a day. In a single day, your kidneys filter about 150 quarts of blood. Most of the water and other substances that filter through your glomeruli are returned to your blood by the tubules. Only 1 to 2 quarts become urine.

Drawing of one kidney with the artery bringing in blood with wastes, a vein carrying the filtered blood out of the kidney, and the ureter carrying wastes (urine) to the bladder.
Blood flows into your kidneys through the renal artery and exits through the renal vein. Your ureter carries urine from the kidney to your bladder.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you .