Kidney Transplant

Why should I consider a kidney transplant instead of dialysis?

Dialysis is a lifesaving treatment, but it does only about 10 percent of the work a functioning kidney does. It’s also hard on the rest of the body, which can lead to other health problems. Patients who opt for kidney transplant live about 10 to 15 years longer than those who stay on dialysis. And most will say their quality of life improved after transplant.

Am I a good candidate?

Your candidacy depends on your physical health, emotional well-being, and ability to manage your care plan. Our team will conduct a thorough evaluation and consult with your referring nephrologist to determine if transplant is your best option.

When is the best time to get a transplant?

You can have a good outcome if you have a transplant after you’ve been on dialysis, but having a transplant before you need dialysis gives you the best possible outcome. At this point your health is stable, which can improve your immediate outcome after surgery as well as your long-term prognosis. Even if you’ve been on dialysis for a while, you can still be a good candidate.

How do I get a kidney?

You can receive a kidney from a deceased donor or a living donor. Living donors give patients the best chance of a successful outcome, and in some cases patients can get a new kidney before needing dialysis. Studies show kidneys from living donors function longer and patients live longer. You can undergo the transplant when it’s convenient, rather than an urgent operation when a deceased donor kidney becomes available.

How do I get a living donor?

Sometimes a relative, friend, even a stranger will donate a kidney. We recommend you talk about the option with others. Any healthy person over 21 years old may be a living donor candidate. A candidate must undergo a thorough medical evaluation to determine general health and condition of the kidneys. This is a big decision, and our team is available for confidential discussions.

What kind of surgery does a living donor need?

The surgery, called a nephrectomy, is done under general anesthesia. Most nephrecomties can be done laparoscopically, which is minimally invasive and results in a quicker recovery time.

If I don’t have a living donor, what happens?

You will be listed with the United Network for Organ Sharing (UNOS). UNOS is supervised by the federal government and maintains the national organ transplant waiting list. All procurement organizations and transplant centers belong to UNOS and operate according to UNOS policies. Midwest Transplant Network (MTN) is the regional procurement organization for Saint Luke’s Hospital of Kansas City. UNOS ensures equal access for all patients on the waiting list. Your medical information will be entered onto the waiting list and UNOS will notify our transplant team when an organ is available.

How long will I wait on the national waiting list?

Many factors affect how long you remain on the list. The median waiting time at Saint Luke’s Hospital is among the region’s and nation’s shortest. However, the wait can last for many months and up to several years depending upon multiple factors. There is no guarantee when or if a deceased donor kidney will become available.

What are my options if I have diabetes?

Some patients with Type 1 diabetes and early signs of kidney disease might be eligible for a pancreas transplant. Those who already have kidney failure or are about to require dialysis might be candidates for a simultaneous kidney/pancreas transplant, whether the donated kidney is from a deceased or living donor.

What medications must I take?

You will need antibiotics right after surgery to prevent infection. You also will need to take immunosuppressant drugs for as long as you have a functioning donor kidney to minimize your risk for tissue rejection. At some point you might need medications to treat blood pressure or prevent fluid retention.

What if I reject the new kidney?

We can successfully reverse most rejection episodes, especially when caught early. Your transplant team will closely monitor you through frequent blood tests in the first three months to assess your body’s reaction. You will need ongoing monitoring throughout the life of your kidney, even if you don’t reject it. The most important thing you can do to help prevent rejection is to take your immunosuppressive medications as prescribed.

How often do I need to return to the transplant clinic?

You will need lifetime care after a kidney transplant, and frequent care in the first six months. Some of these visits can be done at your local clinic. In time, we will share your follow-up care with your referring nephrologist.

Can I exercise after a transplant?

Yes! You need to build back your endurance and strength. You will need to start slow, but you can in time resume your usual activity. Your team will discuss an exercise plan based on your physical limitations after surgery.

How do I pay for a transplant?

The financial aspect of transplant can be incredibly stressful. Our transplant financial coordinator and social worker will map out a plan, taking into consideration your coverage and finances. If you’re uninsured, our team will explore potential resources to develop a workable plan. Our ultimate goal is to help you better manage your illness, surgery, and long-term recovery.

Financial Information

Saint Luke's Kidney Transplant Program will work with you through all of the financial aspects pertaining to kidney transplantation.

How do I qualify for Medicare?

You are entitled by:

• Age—you must be 65 years or older
• Disability—after 24 months of Social Security Disability
• End Stage Renal Disease (ESRD)—coverage would start the first month of peritoneal dialysis training, fourth month of hemodialysis, or the month in which you receive the transplant

When will Medicare terminate?

For patients with ESRD, Medicare stays in effect until 36 months after successful transplant or patient no longer requires dialysis.

How are living donors covered?

It depends on the type of insurance you have. If you have Medicare/Medicaid/TriCare, these providers will pay in full for the donor’s hospital, doctor, and lab charges. Most group health insurance plans provide donor coverage. And charges not covered by the group health plan are submitted to Medicare under Part B.

Do I need prescription drug coverage?

This is the most important part of a transplant. You will need good prescription coverage for life.

What do I do if I don’t have coverage?

Speak with your dialysis social worker or transplant financial specialist to discuss what options are available.

Criteria for kidney transplantation

All patients with chronic kidney disease should be considered for kidney transplantation.

Situations that would prevent you from being a candidate for kidney transplant:

• Current malignancy (cancer)
• Ongoing active substance abuse
• Inability to care for yourself
• Lack of social support (no family or friends to help you)
• Current noncompliance with dialysis or medical treatment plan

If any of these are a problem for you now, and you’re interested in kidney transplantation, you need to take steps to correct them before transplant consideration.

If none of these are an issue, give us a call. We will schedule you and your family for an educational class to learn whether kidney transplantation is right for you.

Transplant evaluation

Scheduled evaluations occur after an educational class. You’ll be seen by group of doctors, nurses, and other health care professionals who are experts in the field of kidney transplantation.

During this evaluation, our experts will look for such transplant risk factors as:

• Active infection
• Serious heart or lung disease
• Obesity
• Past malignancies (cancers)
• Recent/past substance abuse
• Psychosocial disorders
• Past noncompliance with dialysis or medical treatment plan
• Inadequate financial resources

Post-transplant care

Patients who continue their care with a transplant center in conjunction with seeing their own doctors do better and keep their new kidneys longer. Saint Luke's kidney transplant patients receive regular follow-up care at Saint Luke's for several months after transplantation, and we work in a shared care model with your nephrologist. We want to see you at Saint Luke's at least once a year.

Nephrologists specializing in kidney transplants as well as specially trained nurses see patients in our outpatient kidney transplant clinic.

If you are looking for a transplant center to provide post-transplant care, contact us at our Kansas City and Wichita clinics.

Our kidney transplant team

Our kidney transplant team includes:

• Nephrologist
• Transplant surgeon
• Transplant nurse coordinator
• Transplant social worker
• Transplant financial counselor
• Transplant dietitian
• Transplant pharmacist

Each year, more than 4,200 people die waiting for a kidney transplant. Living kidney donation has revolutionized kidney transplantation.

Top 10 benefits of living kidney donations

1. Patient life expectancy doubles.
2. Short- and long-term graft survival rates are significantly better.
3. Living kidneys almost always function immediately.
4. Patients won’t be listed with the United Network for Organ Sharing (UNOS).
5. It eliminates the stress of waiting.
6. Patients can plan for the operation.
7. Patients get to know you.
8. You get the satisfaction of giving the patient a second chance at life.
9. It shortens the wait time for others.
10. It offers the patient a better quality of life.

Recipients who receive a kidney from a living donor generally keep their new kidney longer than those who receive a kidney from a deceased donor. Talk with family and friends about donating a kidney to you.

Take the living donor screener

Before you talk to others about your need for a kidney, you’ll want to educate yourself about living donation.

Download living kidney donation talking points (PDF) and sample letter (PDF).

Additional Resources

• Midwest Transplant Network
• National Kidney Foundation
• Scientific Registry of Transplant Recipients
• Transplant Living
• United Network for Organ Sharing