Kidney Transplantation: Introduction FeedbackA general introduction to Kidney Transplantation.Source: NHS Choices, 31 Jan 2014
A kidney transplant is the transfer of a healthy kidney from one person (the donor) into the body of a person who has little or no kidney function (the recipient).
The main role of the kidneys is to filter waste products from the blood and convert them to urine. If the kidneys lose this ability, waste products can build up, which is potentially dangerous and can be life threatening.
This loss of kidney function, known as end stage chronic kidney disease or kidney failure, is the most common reason for needing a kidney transplant.
It is possible to partially replicate the functions of the kidney using a blood filtering procedure known as dialysis, but this can be both inconvenient and time-consuming so a kidney transplant is the treatment of choice for kidney failure whenever possible.
Who can have a kidney transplant?
Most people who need a kidney transplant are able to have one, regardless of their age, as long as:
- they are well enough to withstand the effects of surgery
- the transplant has a relatively good chance of success
- the person is willing to comply with the recommended treatments required after the transplant – such as taking immunosuppressant medication and attending regular follow-up appointments
Reasons why it may not be safe or effective to perform a transplant include having an ongoing infection (this will need to be treated first), heart disease, liver failure, cancer that has spread to several places in your body (metastatic cancer), and AIDS (the final and most serious stage of an HIV infection).
However, people who have HIV that is being effectively controlled with medication can often have a kidney transplant.
Unlike many other types of organ donation, it is possible to donate a kidney while you are alive because you only need one kidney to survive. This is known as a living donation.
People who want to be considered as a kidney donor are tested very carefully to ensure they are a suitable donor and are fit for the operation needed to remove a kidney.
Ideally, living donations will come from a close relative because they are more likely to share the same tissue type and blood group as the recipient, which reduces the risk of the body rejecting the kidney. However donations from those who are not blood relatives are sometimes possible.
Kidney donations are also possible from people who have recently died. This is known as deceased kidney donation. However, this type of kidney donation has a slightly lower chance of long-term success.
Read more about donating a kidney.
Waiting for a kidney
People who need a kidney transplant, but do not have a suitable living donor, will have to wait until a suitable deceased donor kidney becomes available. This will ideally be from a donor with the same tissue type and blood group as the recipient, to reduce the risk of the body rejecting the kidney.
On average, the waiting time for a deceased donor kidney transplant is about three years. Waiting times are so long because the demand for donated kidneys in the UK is far higher than the available supply of donors.
From April 2012 to April 2013, around 3,000 kidney transplants were carried out in the UK, but there were still more than 6,000 people on the waiting list for a kidney by the end of this period.
Kidney donors are particularly required from people of non-white ethnic origin because rates of kidney disease are especially high in people of South Asian, African and Caribbean ethnic origin, but there are not many donors from these communities.
Read more about the kidney transplant waiting list.
The transplant procedure
If you receive a kidney from a living donor, this will be a carefully planned operation.
If you are waiting for a deceased donor kidney, the transplant centre will contact you if a suitable kidney becomes available. This can happen at any time of the day or night. Staff at the centre will check you don't have any new medical problems and will ask you to go to the centre, where final checks will be performed to be sure it is right for the transplant to go ahead.
You will then have surgery to insert the new kidney and connect it to your blood vessels and bladder. The new kidney will be placed in the lower part of your abdomen (tummy). Your own kidneys will usually be left in place.
A kidney transplant is a major surgical procedure with a wide range of potential risks. In the short term, these risks include blood clots and infection. Longer term problems, which include diabetes and an increased risk of infections, are usually related to the immunosuppressant medication that needs to be taken continuously to reduce the chance of rejection.
Because of the risk of further problems, people who have had a kidney transplant require regular check-ups for the rest of their life.
Living with a kidney transplant
Having a healthy lifestyle after a kidney transplant goes a long way to minimising the risk of complications.
Therefore, it’s recommended that you:
- stop smoking if you smoke
- eat a healthy diet
- lose weight if you are overweight or obese
- take steps to reduce your risk of developing infections
Read more living with a transplant.
How long do kidney transplants last?
There are a number of factors which affect how long a transplanted kidney may last. These include whether or not the kidney came from a living donor, how well the kidney is matched in terms of blood group and tissue type, the age of the person receiving the donation, and the overall health of the person receiving the donation.
Overall, average kidney survival times are:
- 1 year – 85-95%
- 5 years – 70-80%
- 15 years – 50-60%
If you have a kidney transplant that fails, you are usually suitable for another transplant from either a living or deceased donor.
Kidney Transplantation: Guidance FeedbackThe most relevant search results for Kidney Transplantation from producers of guidance information.
- British Transplantation Society, 31 January 2011
- National Institute for Health and Care Excellence, 12 December 2011
Guidelines for the prevention and management of cytomegalovirus disease after solid organ transplantation [PDF]British Transplantation Society, 01 August 2010
- Organ donation for transplantation
- The Renal Association
- The Renal Association, 05 February 2011
Information for the public
Kidney Transplantation: Information for the public FeedbackThe most relevant search results for Kidney Transplantation, from Department of Health accredited producers of patient information.
TA99 Renal transplantation - immunosuppressive regimens for children and adolescents: understanding NICE guidance [PDF]National Institute for Health and Care Excellence, 25 April 2006
TA85 Renal transplantation - immuno-suppressive regimens (adults) (review): understanding NICE guidance [PDF]National Institute for Health and Care Excellence, 22 September 2004
- National Institute for Health and Care Excellence, 09 November 2012
- NHS Choices, 14 May 2012
- NHS Choices, 31 January 2014
Kidney Transplantation: Ongoing Research FeedbackThe most relevant search results for Kidney Transplantation, from research trials.
An investigation into the treatment of the donor kidney to see if this improves the recovery of the kidney after transplantationUK Clinical Trials Gateway, 03 August 2012
Standard Versus Prolonged-release Tacrolimus Monotherapy After Alemtuzumab Induction in Kidney TransplantationUK Clinical Trials Gateway, 10 December 2008
- UK Clinical Trials Gateway, 18 May 2007
- UK Clinical Trials Gateway, 21 March 2012
A Study to Determine Pharmacokinetics of Children Receiving Modigraf (Tacrolimus Granules) Following Solid Organ TransplantationUK Clinical Trials Gateway, 09 June 2011
- UK Clinical Trials Gateway, 31 July 2012
- UK Clinical Trials Gateway, 19 September 2011
Safety & Efficacy of Eculizumab to Prevent AMR in Living Donor Kidney Transplant Recipients Requiring DesensitizationUK Clinical Trials Gateway, 19 July 2011
- UK Clinical Trials Gateway, 16 February 2012
- UK Clinical Trials Gateway, 07 June 2010
Kidney Transplantation: Evidence Uncertainty FeedbackThe most relevant search results for Kidney Transplantation, highlighting areas where further research is needed.
Patient level factors associated with benefit of kidney transplantation for outcomes other than mortalityUK Database of Uncertainties about the Effects of Treatments, 27 July 2012
- UK Database of Uncertainties about the Effects of Treatments, 23 August 2012
- UK Database of Uncertainties about the Effects of Treatments, 14 October 2013
- UK Database of Uncertainties about the Effects of Treatments, 20 May 2009
- UK Database of Uncertainties about the Effects of Treatments, 21 September 2010
What are the benefits and harms of immunosuppressive regimens containing TOR-I when compared to other regimens as initial therapy for kidney transplant recipients?UK Database of Uncertainties about the Effects of Treatments, 23 September 2010
- UK Database of Uncertainties about the Effects of Treatments, 22 September 2010
Is rituximab therapy associated with a higher rate of relapse in kidney transplant patients with post-transplant lymphoproliferative disorder?UK Database of Uncertainties about the Effects of Treatments, 07 December 2009
Do calcium channel blockers prevent acute tubular necrosis (ATN) in cadaveric kidney transplant recipients?UK Database of Uncertainties about the Effects of Treatments, 21 September 2010
- UK Database of Uncertainties about the Effects of Treatments, 07 December 2009
Kidney Transplantation: Medicines FeedbackAppropriate medicines information for Kidney Transplantation supplied by Datapharm, a leading source of trusted, credible information about medicines.
Kidney transplant - Medicines Information
- Advagraf (a brand of Tacrolimus Monohydrate)
- Antithymocyte immunoglobulin (rabbit)
- CellCept powder
- Dexamethasone sodium phosphate
- Medrone (a brand of Methylprednisolone)
- Methylprednisolone sodium succinate
- Mycophenolate mofetil (a generic version of Cellcept)
- Mycophenolate mofetil hydrochloride (a generic version of Cellcept Powder)
- Mycophenolate sodium
- Myfortic (a brand of Mycophenolate Sodium)
- Neoral (a brand of Ciclosporin)
- Prednisolone Sodium Phosphate
- Prograf (a brand of Tacrolimus Monohydrate)
- Prograf Infusion (a brand of Tacrolimus)
- Rapamune (a brand of Sirolimus)
- Sandimmun (a brand of Ciclosporin)
- Simulect (a brand of Basiliximab)
- Solu-Medrone (a brand of Methylprednisolone Sodium Succinate)
- Tacrolimus monohydrate
- Thymoglobuline (a brand of Antithymocyte Immunoglobulin (Rabbit))
- Results are currently sorted by relevance (Sort results by: date)
- Results 1 - 10 (of 67)
Mycophenolate versus azathioprine for kidney transplantation: a 15-year follow-up of a randomized trial.
...Mycophenolate versus azathioprine for kidney transplantation: a 15-year follow-up of a...azathioprine (AZA) early after kidney transplantation. However, the...cancer incidence, and estimated kidney function were compared on an intention...
Cochrane Central Register of Controlled Trials, John Wiley & Sons Ltd, 01 July 2012 - Publisher: Transplantation
...interest Index terms Kidney transplantation is the treatment of choice...preventing acute rejection after kidney transplantation, and tacrolimus treated...Subject Headings (MeSH) *Kidney Transplantation; Cyclosporine [*therapeutic...
Cochrane Database of Systematic Reviews, 19 October 2005 - Publisher: John Wiley & Sons, Ltd
Target of rapamycin inhibitors (TOR-I; sirolimus and everolimus) for primary immunosuppression in kidney transplant recipients
...initial therapy after renal transplantation: preliminary results of...kidneys [abstract]. Transplantation 2004;78(2 Suppl...initial therapy after renal transplantation: preliminary results of...patient receiving marginal kidneys [abstract]. American...sirolimus vs cyclosporine in kidney transplantation: renal...
Cochrane Database of Systematic Reviews, 19 April 2006 - Publisher: John Wiley & Sons, Ltd
...The British Transplantation Society • Department...Health • National Kidney Federation • National Kidney Research Fund NICE...for the National Kidney Research Fund...Surgeon & Head of Transplantation, Guy's and St Thomas...
National Institute for Health and Care Excellence, 22 September 2004 - Publisher: NICE - Publication type: Full Guidance
...those who receive kidneys from live donors...following renal transplantation can be categorised...Surgeons • British Kidney Patient Association...Society • British Transplantation Society • Department of Health • Kidney Alliance NICE...
National Institute for Health and Care Excellence, 25 April 2006 - Publisher: NICE - Publication type: Full Guidance
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease
...damage to the kidneys. In 2002, the US Kidney Disease Outcomes...early chronic kidney disease. Nephrology Dialysis Transplantation 2007;22...early chronic kidney disease. Nephrology Dialysis Transplantation 2007;22...
Cochrane Database of Systematic Reviews, 05 October 2011 - Publisher: John Wiley & Sons, Ltd
...tacrolimus and cyclosporin in kidney transplantation (Webster 2005). Both cyclosporin...in this review and in the kidney transplantation meta-analysis...and cyclosporin in liver and kidney transplantation. He has received grants...
Cochrane Database of Systematic Reviews, 18 October 2006 - Publisher: John Wiley & Sons, Ltd
British Association of Dermatologists' guidelines for the safe and effective prescribing of azathioprine 2011.
...G. Guidelines for kidney transplantation in patients with HIV...Carlson LL et al. Kidney and liver transplantation...enzyme inhibitors. Transplantation 1993; 56:585...transplant recipients. Kidney Int 1996; 50:973–8. 165 Ford LT...
British Association of Dermatologists, 19 September 2011
...of dialysis or kidney transplantation. Surrogate...Nephrology Dialysis Transplantation 1992;7 Suppl...glomerular diseases. Kidney International...American Journal of Kidney Diseases 1995...Nephrology Dialysis Transplantation 1992;7 Suppl...
Cochrane Database of Systematic Reviews, 18 October 2004 - Publisher: John Wiley & Sons, Ltd
...Centre for Kidney Research, Westmead...Emergency and Organ Transplantation, Bari, Italy...Saudi Journal of Kidney Diseases & Transplantation 2011;22(5...Dialysis and Transplantation Association.European Kidney Research Organisation...
Cochrane Database of Systematic Reviews, 12 December 2012 - Publisher: John Wiley & Sons, Ltd
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