Evaluation, surgery & recovery

If you’re considering a kidney transplant, you may have many questions about the process of evaluation, surgery, and recovery. Here, we will answer some of those questions.

What should I do if I want to pursue transplant?
How do patients start a transplant evaluation?
  1. Call a transplant center to schedule your evaluation to complete tests to make sure you’re healthy enough for a major surgery. To find a transplant center, visit OPTN (Organ Procurement and Transplantation Network) at optn.transplant.hrsa.gov.
  2. Fill out all the transplant medical forms. If you are unsure how to fill out the forms, ask someone you trust to help you.
  3. Go to the transplant center for your medical appointments. This may take several visits.
How long does a transplant evaluation take?

Your evaluation can take a few months to a year, depending on your health and how quickly your center can schedule your tests. Any serious health problems that are not related to kidney disease will need to be cleared up before your transplant can happen.

Stay in contact with your transplant team until you know if you are able to get a transplant. If you’re not eligible, they may tell you how you could become eligible. For example, you may find out you have to lose weight before you’ll be eligible for a transplant.

What tests do patients need for a transplant evaluation?

The transplant team will give you medical and psychological tests to make sure a transplant will be safe for you. Your doctors may:

  • Check your blood pressure, heart rate, and how well your lungs work.
  • Do a colonoscopy to test for colon cancer (for those over age 50).
  • Take blood and urine samples.
  • Possibly do a stress test to check your heart.
  • Do a breast exam and a Pap smear to test for cervical cancer (for women).

You can get all of these tests without having to stay overnight in the hospital. The team will also make sure you have a support system, such as family and friends who can help take care of you after the transplant.

A member of the transplant team will look at your insurance coverage and help you figure out the costs for your transplant and medicines to make sure you can afford them.

What is transplant surgery like?
How long does the surgery take?

The surgery takes about 3–5 hours. The entire process from waiting before surgery to waking up in the recovery room takes 4–8 hours.

During the surgery:

  1. You will be under general anesthesia, which will put you to sleep and prevent pain.
  2. A machine will help you breathe.
  3. Doctors make a cut in your belly.
  4. They place the donated kidney into your body through this cut (doctors won’t take out the failed kidneys most of the time).
  5. They connect your new kidney to your bladder.
  6. The new kidney starts making urine, often during the surgery or soon after.
  7. A tube will help drain urine from your bladder for a few days after surgery.
How painful is the surgery?

You will likely feel the most pain in the first week after surgery. You’ll take medicines for your pain.

Many patients say they start feeling better quickly because they have a working kidney.

What is recovery like after the transplant and how long does it take?

You’ll stay in the hospital for a few days to a week. After leaving the hospital, you’ll return to the clinic about 2–3 times a week while your body heals. Over time, you’ll start to feel better and be able to do more.

You’ll likely be able to return to your normal activities within a month after your transplant.


What happens after the transplant?

Getting a transplant is not a cure for kidney disease. After your transplant, you’ll need to:

  • Visit your doctors regularly.
  • Continue taking some of the medicines you took before the transplant.
  • Take new medicine to prevent your new kidney from failing and to prevent infection for however long the kidney lasts.
  • Have your kidney function and blood pressure checked regularly.

Your transplant team will explain everything that you’ll need to do before you leave the hospital. Follow all of their directions for the best result.


Risks & benefits

There are risks to all surgeries. There are medical, emotional, and financial risks to a kidney transplant. A kidney patient can change their mind about getting a transplant at any time.

What are the medical risks of getting a transplant?

Like other surgeries, you’ll have scars, pain, and feel tired and weak afterwards. More serious problems are rare, such as:

  • Less than 5% of patients (less than 1 in 20 patients) have these problems after surgery:
    • Problems from being put to sleep, such as confusion, pneumonia, stroke, or heart attack
    • Infection
    • Fever
    • Bleeding and blood clots
  • The risk of death is less than 3 in 10,000 patients—this is much less than 1% of patients.

Your surgical team does everything they can to prevent or avoid these problems.

What are the emotional risks of a transplant?

After the transplant, you may feel overwhelmed learning how to care for your kidney. If the kidney isn’t working well, you may feel upset or angry.

You might also worry about the costs of the medicines or the cost of insurance. Getting a kidney transplant may make it harder to get or afford health, disability, or life insurance.

Who pays for the costs of a transplant?

The costs of the medical tests and surgery for kidney transplants are covered by Medicare or private health insurance. However, you might have to take vacation time from work or pay for childcare, gas, meals, parking, or hotels.

If you are worried about your insurance or other costs, speak with your financial counselor at the transplant center to see if there are resources to lower your out-of-pocket costs.

Will Medicare pay for my anti-rejection medicines?

After a kidney transplant, you will need to take medicines for as long as the kidney lasts to prevent your body from rejecting the kidney. These medicines can be expensive, but Medicare covers most of them for 3 years after your transplant surgery.

If you’re 65 or older and have Medicare, Medicare will continue to cover the cost of the medicines for the life of the transplant. If you’re under age 65 and get Social Security Disability for medical issues other than kidney failure, you also may get medicines covered past the 3 year period.

The financial counselor at your transplant center can help you figure out the future costs of your transplant, medicines, and how to pay any costs your insurance doesn’t cover.

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The doctors and other experts of Explore Transplant can help you make an informed decision that’s right for you.
What are the side effects of taking anti-rejection medicines?

Depending on which type of medicines you use, you may have side effects such as:

  • Tremors (shaky hands)
  • Problems sleeping
  • Weight gain
  • Hair growth
  • Nausea
  • Headaches

They can also give you a higher chance of other health problems such as:

  • Cancer (especially skin cancer, so you should avoid the sun and wear sunblock)
  • Diabetes
  • High blood pressure
  • High cholesterol

You can talk to your doctor about any side effects and possibly changing your medicines.

What would happen if my kidney transplant fails?

If your kidney starts to fail, your transplant team can change your medicine to try to slow or stop your body from rejecting it. This is why it’s important to stay in contact with your transplant center and go to your appointments.

If your kidney transplant stops working, you will go on dialysis. You may also be able to get another transplant.

Check out My Transplant Coach for help making your treatment decision