You’ll meet with the surgeon to talk about your surgery before you have your kidney transplant surgery. This happens whether you get your kidney from a deceased donor or a living donor. They’ll review your health records and your test results to decide if surgery is a good option for you at that time. The surgeon will talk to you about what your risks are with the surgery, what to expect from surgery, and how long it will take to recover. The surgeon will ask you to sign a consent form to do the surgery. You can ask any questions you have before you sign the consent form. You’ll be able to talk with the surgeon after the surgery as well.
During a kidney transplant, the donor kidney is placed inside your body, in your lower abdomen (belly). The donor kidney’s blood vessels are joined to your blood vessels and the donor kidney’s ureter (a tube that takes urine from the kidney to your bladder) is joined to your bladder. The transplant surgery takes about 3 to 6 hours.
Your own kidneys usually aren’t removed, so you’ll have 3 kidneys after the surgery. This isn’t like other organ transplants (heart, liver, or lung) where a person’s own organ is removed to make room and replaced.
Possible risks with transplant surgery
Transplant is a major surgery and has all the risks of any surgery. Bleeding, blood clots, and infection are a few examples of problems (complications) that could happen. Even though complications from transplant surgery
don’t happen very often, it’s important for you to know what could happen.
Some examples of complications that could happen are:
- bleeding that leads to needing a blood transfusion – up to 2 out of 10 recipients may need a blood transfusion
- blockage of blood flow to the new kidney – about 1 in 100 recipients will need another surgery to repair the blockage
- urine leak – up to about 5 in 100 recipients may need another surgery to repair a urine leak
- infection within a few days of your surgery – less than 5 in 100 recipients develop an infection
- lymphocele (a collection of fluid around the transplanted kidney) – about 5 in 100 recipients may need to have surgery to drain this fluid
Remember, your surgeon will talk to you about possible risks specific to you based on your health history.
What to expect after your surgery
Knowing what to expect after your surgery can help you have fewer fears and help prepare you for what you may notice and need to do after surgery.
Tubes and drains
When your surgery is over, you’ll have some tubes attached to you, outside and inside of your body. Examples of tubes you may have are listed here.
Drains from your incision
You’ll have an incision (cut) where the surgeon placed your new kidney. The incision is closed with stitches (sutures), staples, or glue and tape. It’s usually covered with a dressing.
You may have a thin plastic tube called a drain from the incision. This drains the fluid that can build up as your body heals from the surgery and prevents it from collecting around the new kidney. This drain is only temporary. When it’s no longer needed, it will be removed.
The sutures or staples are removed a few weeks after the surgery, and it will take up to 6 weeks for the incision to heal.
Intranvenous catheter
You’ll have an
intravenous catheter (IV), usually in your arm to give you fluids and medicines before, during, and after your transplant surgery. The IV is usually taken out when you’re eating and drinking well, you don’t need IV medicines anymore, and before you leave the hospital.
Central venous catheter
A central venous catheter (CVC) (also known as a Central venous access device, CVAD) is a tube put into a large vein in your neck when you’re in the operating room. A CVC allows your healthcare team to give you fluids, medicines, collect blood for blood tests, and to check if you are getting enough fluids. If you have a CVC, it’s usually taken out within a few days of having your surgery.
Urinary catheter
An indwelling urinary catheter (often called a Foley catheter) is a tube that drains urine from the bladder. It helps keep your bladder from getting too full so that the new ureter stays attached to your bladder and heals properly. This tube stays in for at least 5 days, but it can be longer. It’s usually removed before you leave the hospital. Sometimes, depending on how your new kidney is doing, you may need to go home with the catheter. If this happens your healthcare team will show you how to look after this before you leave the hospital.
Ureteric stent
A ureteric stent is a tube that runs from the kidney through the ureter and into the bladder. It helps to keep the ureter open while it heals. The stent is removed about 6 to 8 weeks after the transplant. Most often this is done as a day procedure in an outpatient clinic or at the hospital.
Peritoneal dialysis catheters and dialysis lines
You may already have a peritoneal dialysis catheter or dialysis line to help filter your blood from before the surgery. These are kept in until your new kidney starts to work well and then can be removed. Your healthcare team will coordinate getting these lines removed once its’ safe to do so.
Start moving soon after surgery
It’s important for you to get moving soon after surgery to help you recover more quickly. Your healthcare team will help you to get up and walk quite soon after surgery. Sometimes even the same day. A physiotherapist on the transplant unit is available to help with getting you moving.
You may be asked to wear special stockings or leg pumps while you’re in bed, to keep the blood moving in your legs and help prevent blood clots. You may also receive medicines to assist in the prevention of blood clots after surgery.
Deep breathing and coughing exercises
Your healthcare team will show you how to do deep breathing and coughing exercises. These exercises help to expand your lungs and remove mucus that may have collected there. If you have trouble breathing deeply on your own, your healthcare team will show you how to use a device called an
incentive spirometer to help you take deep breaths.
When you cough, it’s important to support or splint your incision so it doesn’t hurt or make your pain worse. Your healthcare team will show you how to do this with a small pillow or folded blanket.
Tests
Many of the tests that will be done after your surgery are the same as the ones you had before your surgery. These tests are done to see how well your kidney is working. You’ll have:
Changes in bladder control
If you’ve been on dialysis for a long time, your bladder isn’t used to working as hard to store urine. This may cause you to have problems with bladder control after your transplant.
If this happens, your transplant team will work with you on ways to get better bladder control. In some cases, you may need to have pelvic floor physiotherapy to help you get control of your bladder.
Swelling in the scrotum
It isn’t unusual for some males to get a build-up of fluid inside their scrotum in the first few days after the transplant surgery. This will usually go away within a few days. Talk to your healthcare team if this becomes too uncomfortable.
Your hospital stay
Most adults who have a kidney transplant will stay in the hospital for 5 to 10 days. Children stay in the hospital for 10 to 14 days in most cases after transplant surgery. How long you stay in the hospital will depend on how well your new kidney is working and if you have any complications.
While you’re in the hospital, you won’t be able to have many visitors. You’ll have a higher risk of getting an infection when you start taking medicine that stops your immune system from attacking your new kidney. During this time, your visitors need to carefully follow all infection prevention precautions. They’ll have to wash their hands and wear personal protective equipment (PPE) when required by the unit. It’s important that you protect yourself from anyone who is sick. Ask your visitors not to bring any fresh flowers or plants.
Children who receive a transplant are often admitted to the pediatric intensive care unit (PICU) for a few days after surgery. If you’re an adult transplant recipient, you may need to go to the intensive care unit (ICU) depending on how sick you are at the time of your transplant. In the ICU your healthcare team can watch you more closely and give you the specialized care you need.
You can find out more about the ICU at
Intensive Care: A guide for you and your family.
Avoid heavy lifting
To help your incision heal and your new kidney start working, you’ll want to be careful about lifting anything heavy.
Don’t lift more than 4.5 kg (10 lb.) for the first 6 weeks after surgery. This is about the same weight as a 4-litre jug of milk. Your healthcare team will also talk to you about other activities you’ll need to be careful with.
