A kidney transplant involves surgically removing a diseased kidney and replacing it with a healthy kidney from a living or deceased donor. The reasons for a kidney transplant include kidney failure from conditions like diabetes or polycystic kidney disease. For a deceased donor kidney, the recipient must be placed on the organ transplant waiting list. Extensive testing is done to evaluate a recipient's eligibility and find a matching donor kidney. The risks of surgery include bleeding, infection and organ rejection. Post-surgery, the patient is monitored closely as they recover in the hospital and as an outpatient during follow-up visits.

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Cameron Ellis
Allyson Puskar
English III
29 April 2013
Kidney Transplant Process
For someone considering a kidney transplant, it is important to understand all steps of the
process. A kidney transplant is a surgical procedure performed to replace a diseased kidney with
a healthy kidney from another person. The body takes nutrients from food and converts them to
energy. After the body has taken the food that it needs, waste products are left behind in the
bowel and in the blood. The reasons for this procedure would be repeated urinary infections,
kidney failure caused by diabetes or high blood pressure, polycystic kidney disease or other
inherited disorders, such as glomerulonephritis, which is inflammation of the kidney‟s filtering
unit. The risks of the procedure consist of: bleeding, infection, blockage of the blood vessels to
the new kidney, leakage of urine or blockage of urine in the ureter. In order to receive a kidney
from an organ donor who has died (cadaver), a recipient must be placed on a waiting list of the
United Network for Organ Sharing (UNOS). Extensive testing must be done before an individual
can be placed on the transplant list (Kidney Transplant Procedure). When asked about the
procedure, Kimberly Ellis stated, “The doctors started off with withdrawing blood to check for
the blood type. Then urine samples were needed. Doctors then said that the kidney was a match.
Then got set up for a renal procedure to check which kidney to remove.”
Kidneys for transplant come from a living donor or a deceased (cadaver) donor. When a
kidney is transplanted from a living donor, the donor‟s remaining kidney enlarges to take over
the work of two. As with any major operation, there is a chance of complications. But kidney

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donors have the same life expectancy, general health and kidney function as others. Potential
barriers to living donors are age (one must be eighteen years old unless the person arean
emancipated minor), uncontrollable hypertension, history of pulmonary embolism or recurrent
thrombosis, bleeding disorders, uncontrollable psychiatric illness, morbid obesity, uncontrollable
cardiovascular disease, or HIV infection. After surgery, the patient will be transferred to the
recovery room. Once the anesthesia has worn off, the patient will be transferred back to the
transplant unit. The amount of time a patient is in the hospital after kidney transplant surgery
varies. It can be as little as two days, barring complications. The kidney function will be closely
monitored for the first several months after you leave the hospital. The follow-up visits will be
more flexible when: wound is healed, kidney functions normal, medication dose is adequate.
About the healing process after surgery, when asked, Kimberly Ellis stated, “Two and a half
months.”At this time, the patient also may have your blood tests done at a location closer to your
home. „Were there any infections, blockages, or internal bleeding while healing, when asked,
Kimberly Ellis stated, “No there were not.”Exercise and diet after transplant are very important
factors in feeling healthy again. It is very unhealthy for the patient, the new kidney and general
will-being to put on excessive weight. Exercise for transplant patients has been shown to:
increase endurance, increase muscle strength, enhance bone remodeling, and reduce the need for
ant-hypertension medication. The process of matching donor organs to patients waiting for
transplantation is based on a point system. Points are given for several factors: time on the
waiting list, antibody level (PRA), common antigens with the donor tissue type, location of the
donor. (Roberts) (Ellis)
One of the most common complications following a kidney transplant is rejection.
Rejection is your body‟s way of not accepting the new kidney. Although rejection is most

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common in the first six months after surgery, it can occur at any time. It is vital for the patient to
be aware of the possible signs of kidney rejection- fever over 100 degrees; “Flu-like” symptoms,
such as chills, aches, headache, dizziness, nausea and /or vomiting; new pain or tenderness
around the kidney; sudden weight gain greater than two to four pounds within a twenty four -
hour period, and significant decrease in urine output(Roberts). Kimberly Ellis stated, That the
kidney was accepted for about three days then the recipients body tried rejecting it and had to go
on an anti-rejection medication.
Kimberly Ellis stated, the medications that were prescribed after the procedure were a
narcotic and an antibiotic. Kimberly Ellis stated, the effects of the pain medication that were
prescribed were that she was physically impaired and relaxed.Doctors may test a kidney for
rejection by doing a kidney biopsy. A kidney biopsy is a procedure in which a small sample of
kidney tissue is removed and tested. A kidney biopsy is usually performed on an outpatient base.
„What surgical instruments were used during the procedure, when asked, Kimberly Ellis stated,
“Doctors used a scalpel, scissors, swabs, body glue, and internal stitches.”The actual biopsy
generally takes twenty to thirty minutes. The patient will be required to lie flat for two hours
following the procedure to prevent bleeding. Kimberly Ellis stated, “It took over an hour to
prepare for the surgery and the surgery took five hours.” If rejection develops, the patient‟s
physician will prescribe medications to treat rejection and prevent continued complications. In
order to control the rejection, the patient may need to be admitted to the hospital, or the patient
may receive care in an outpatient setting. The medications used to treat a kidney rejection
episode are strong drugs. The first few doses could cause the following side effects: fever, chills,
headaches, nausea, vomiting, weakness, diarrhea, and general flu-like symptoms. This graph
shows what kind and what percent of donors donate their kidney to help someone who needs it.

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The Cadaver is at twenty two percent, the Living is at twenty five percent, the Non Living is at
fifteen percent, the Donated is at thirty eight percent, but overall it all comes out to 100 percent
and that‟s what matters. (Roberts) (Ellis)
According to Kimberly Ellis, some physical difficulties after the procedure were, “There
was not any lifting over three pounds and no pulling on anything for about four months.”
Study results published in the New-England-Journal of Medicine, show that three -year
graft survival is significantly greater in all transplanted kidneys machine perfused in the Life-
Port Kidney Transporter compared to those stored in a traditional box of ice (static cold storage)
(ninety one percent vs. eighty seven percent, p=0.04). The graft survival difference at three years
was most pronounced for kidneys from expanded criteria donors (eighty six percent vs. seventy
six percent, p=0.01). Expanded criteria donors are those over the age of sixty or those over fifty
with health conditions such as high blood pressure, stroke or poor kidney function. Over the past
Living
25%
Donated
38%
Non living
15%
Cardiver
22%
Living Donors

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decade, kidney donations from expanded criteria donors have increased considerably and today
comprise nearly half of the deceased donor kidneys transplanted in the US and EU. (New-
England-Journal of Medicine)
When the results are analyzed by donor type, they show that three-year graft survival
after machine perfusion compared to static cold storage was also significantly superior for
kidneys donated after brain death (ninety percent vs. eighty six percent, p=0.02).
Machine-perfused kidneys with delayed graft function (DGF) - a delay in the recovery of renal
function that requires dialysis within the first week after transplantation - had better three -year
graft survival (seventy seven percent) than cold stored kidneys with DGF (sixty two percent).
"It is very interesting to see that the benefits in graft survival seen in this landmark study at one
year with machine perfusion persist after three years compared to traditional cold storage
methods," said lead author Cyril Moers, University Medical Center Groningen, The Netherlands.
"Since a growing number of organs available for transplantation come from older donors or from
people with more complex medical conditions, it is particularly welcome that machine perfusion
offers significant improvements for 3-year graft survival in kidneys from these donors and is a
real step forward in kidney transplantation. (Gruner)
The Machine Preservation Trial was a landmark, investigator-driven study, run by an
independent scientific steering committee across the Netherlands, Belgium and the German federal
state of North Rhine Westphalia, in collaboration with the Deutsche Stiftung Organtransplantation
and Euro- transplant International Foundation (the international organ exchange organization
for Austria, Belgium, Croatia, Germany, Luxembourg, The Netherlands and Slovenia) as the central
trial assistance desk. Principal investigators were RutgerPloeg (Oxford, United Kingdom and
Groningen, The Netherlands), Andreas Paul (Essen, Germany) and Jacques

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Pirenne(Leuven, Belgium).The study was the first large randomized, prospective trial to compare
machine perfusion with traditional cold static storage.(Gruner)
Three-year follow-up data were collected on all 672 recipients of consecutive kidneys donated
after brain death or after cardio-circulatory death in the main data set, as well as 164 recipients of
kidneys donated after cardio- circulatory death in the extended data set. One kidney from each of the
336 pairs included was randomly assigned to machine preservation trial showed that transplanted
kidneys preserved and transported in the lifeport kidney transporter had a forty eight percentage to
fail within a year compared to those transported in the traditional box of ice. (New England Journal
of Medicine)
The LifeportKidney Transporter is designed to provide a sealed and sterile environment
from the time of donation until the time of transplantation. Lifeport gently infuses a specifically
formulated solution through-out the kidney, or referred to as Machine Perfusion. Machine Perfusion
is and important contrast to the traditional method of storing and transporting kidneys in a box of ice
(Gruner). When asked, Kimberly Ellis stated, “It felt wonderful to be able to give, or donate, an
organ and would certainly do it again if needed too.”

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Works Cited
Ellis, Kimberly.Personalinterveiw. June.3 2013
Gruner, Linda. “Elseiver”, New Tools Can Better Predict Successful Kidney Transplant
Outcomesn.d. Web. 26 April. 2013.
http://www.elsevier.com/about/press-releases/research-and-journals/new-tools-can-
better-predict-successful-kidney-transplant-outcomes
“Kidney Transplantation Procedure”.HealthLibrary.John Hopkins Medicine, n.d. Web. 28 Feb.
2013.
http://www.hopkinsmedicine.org?health/test_procedure/urology/kidney_transplantation_
procedure92,p07708/
New-England-Journal of Medicine.“Processing of kidneys”, n.d. Web. 29 May 2013.
http://new-england-journal-of-medicine.process.of.kidneys.com
Roberts, John P. “Professor and chief, division of transplantation surgery”.UCSF Division of
Transplant Surgery Kidney Transplantation, n.d. Web. 28 Feb. 2013.
http://transplant.surgery.uscf.edu/conditions--procedures/living-donor-kidney-
transplantation.aspx