Kidney transplant

Coronavirus: kidney and transplant update

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What is a kidney tranplant

A kidney transplant operation is when a healthy kidney from one person is placed in the body of another person with kidney disease. The person receiving the kidney is called the recipient. 

A kidney can either be donated by someone who has died or from a living person.

Not all patients are suitable to have a transplant. For those people who are suitable a transplant will, in most cases, give you a better quality of life than dialysis. Your kidney team will discuss transplantation with you during your clinic visits. You may need to have several tests and medical examinations to help decide whether you are suitable for a transplant.

You will not be put into the transplant waiting pool or put forward for a living donor kidney transplant until you have been assessed as being suitable by one of our transplant surgeons.

Having a kidney transplant

• Having a kidney transplant – video transcript

  Chris: Hi, my name is Chris Callaghan. I'm a transplant surgeon at Guy's Hospital. I'm involved with kidney transplantation, also pancreas transplantation.

  A transplant is when an organ is removed from one person and put into another person's body.

  A transplant can either come from someone who's passed away, a deceased donor, or from a living donor.

  Transplants can be a heart, a lung, a kidney or a pancreas or other organs and for some patients with diabetes and kidney failure, a kidney and pancreas transplant might be suitable.

  For most patients with kidney failure, a kidney transplant is the best option.

  If you have kidney failure then we would hope that a kidney transplant would not only prolong your life but give you a better quality of life and give you the best chance of having the type of lifestyle that you had before you developed kidney disease.

  Although kidney transplantation is the best option for most patients with kidney disease, it's not always the right option for all people.

  There are risks and benefits that come along with kidney transplantation and it's important that your treatment options are raised with you as soon as possible once you have the diagnosis of kidney disease.

  The kidney team will discuss the risks and benefits of transplantation with you as soon as possible so that you can make a decision about what's best, not just for you, but also for your family.

  Cheryl: Hello my name is Cheryl. I donated my kidney to the kidney sharing scheme and this is my husband George.

  George: My name is George, I'm Cheryl's husband. I'm a recipient of a kidney from the kidney sharing scheme which means I am a kidney transplant patient. I was diagnosed with chronic kidney failure three years ago. As a result of that I went on to dialysis.

  Cheryl: When we found out that George needed a transplant the doctor told us about the different options that we could take. One was for him to be on the deceased list. The other option was for family to donate. So I agreed, I said that I would do that. I had to be worked up for that, so they gave me lots of tests but we found out that our blood groups weren't compatible. So the other option that they told us we could do was what's called the shared scheme. Basically what that meant was they would have a pool of people and then every few months they would look at those pool of people and see whose blood groups matched. I wasn't concerned. I wasn't worried. I knew it was something that I wanted to do. So for me personally there weren't any concerns.

  George: It's a big operation. I didn't realise how big it is, so it does take a lot out of you, but the whole process for us was a positive experience.

  Cheryl: Anyone considering doing the kidney sharing scheme is to go ahead and do it. For us it was the quickest, it was the best way. We were very, very informed at all times, lots of communication, so I would say yes go ahead and do it.

  Christian: Hi, I'm Christian. I'm 25 years old, and five and a half months ago I had a kidney transplant from a deceased donor. I waited for six years for a kidney and it was quite nervous at some times. You'd always have to figure out who was calling the phone.

  It was actually on New Year's Day that I got the phone call, so I didn't really expect it at all. I thought it was just a relative or someone calling to say Happy New Year. It was quite early in the morning so it woke me up. When I realised the importance of the call I grabbed everything I could and quickly ran to the hospital.

  The team at Guy's Hospital where I had my transplant on Richard Bright Ward were really helpful. What seemed to me a really panicky situation, having to quickly run in and not knowing whether or not I'd have my transplant, they seemed able to calm me down, and very good standard of care I think at Guy's Hospital.

  Previously when I was on dialysis, work was really hard to either get into or keep focused and just six months after transplant I'm ready, going in for interviews for the career choice that I really wanted to do.

  At the moment I feel really great. It's hard to believe that only six, seven months ago I needed to be hooked up to a machine just in order to have a decent standard of life.

  To other people waiting for a kidney, I would say I really hope you get one soon. It makes all the difference in your life. And to those who are debating whether to go on the list or not, there's obviously only one choice really that it should be to have a kidney transplant.

  Jillian: Hello my name is Jillian. I'm 45 years old and I had a kidney-pancreas transplant four years ago at Guy's and St Thomas'.

  I've been diabetic since the age of 18 which had affected my kidneys over the years and gradually they just became less and less functional, and I'm finding I'm very tired all of the time so that was really difficult.

  The people at Guy's and St Thomas' suggested to me that I could just have a kidney transplant, but also have a kidney and pancreas transplant and gave me lots of help and support in terms of making the decision.

  It was a really nice feeling for me to have a choice in terms of my future and the different routes that I could take and it was fully up to me to decide whether I just wanted to have a kidney transplant or the kidney and pancreas transplant. They gave me loads of leaflets, videos, I went along to a transplant education day. For me I came to the decision quite quickly and easily. For me the advantage is being not having to be a diabetic anymore after 23 years was not just going to be amazing for me but also my family and my friends.

  Also that having a new pancreas would mean that my new kidney wouldn't be affected any more by the diabetes. For me post-transplant, it was so exciting to see the improvements in my health. It sounds silly but the first time I walked up a hill after the transplant I was literally in tears of joy when I got to the top, just to start feeling normal again.

  The staff at Guy's have just been fantastic. I've always been thoroughly supported, really well looked after and always felt like the decisions that I took were supported by them.

  Chris: For patients with kidney failure and who would like to have a kidney transplant and are suitable for it, a kidney transplant may come from a living donor or a deceased donor.

  For most patients who decide to have a transplant we would suggest that a living donor would be the best option, as these kidney transplants most often work straight away and work for longest in the long run.

  For patients who are unable to find a living donor, a deceased donor kidney is usually the next best option. If you have diabetes and kidney failure and if you meet other specific criteria, then a kidney and pancreas transplant may be the best option for you.

A transplant surgeon talks about the different types of kidney transplants. Patients tell us about their experiences and explain how having a transplant has benefited them. 

Preparing for your operation

Watch our preparing for your operation film to find out what you can expect during your care with us before, during and after an operation and how you can help your recovery after surgery.

• Preparing for your operation – video transcript

  Mr Jonathan Olsburgh (consultant surgeon): In this video we're going to talk about what you can expect during your care with us before, during and after an operation and what steps you can take to assist your recovery and help you to get home as quickly as possible.

  This is often referred to as the enhanced recovery programme.

  These principles apply to any kind of operation. Evidence shows that being prepared for your operation both mentally and physically will help your recovery. You will know what to expect, what you can do to make yourself feel better. This is a key element of enhanced recovery.

  Applying enhanced recovery principles before your operation helps ensure you're better prepared by looking at exercise and diet; if appropriate stopping smoking or reducing alcohol; thinking about your home circumstances and having information on what to expect at each stage.

  Ian Wicks (kidney transplant patient): I spoke to my doctor when I turned out for my regular appointments about what to expect and things like that helped. I'm someone who likes to know information in advance it helps me process it a bit better. Back in the education sessions it was, don't smoke if you smoke, don't drink if you drink.

  Start to manage your diet a little bit differently, which we did, and in terms of the diet I think that was the thing that probably helped the most given guidance on what things would be good for me to eat the things that wouldn't be so good for me to eat. I think having that information and also listening to it is really important.

  Kathryn Chatterton (clinical nurse specialist): When I first meet you I'll be introduced to you by my consultant and then we'll be able to go through before and after what's going to be happening to you during your surgery. You'll also be given the opportunity to ask me any questions and also I'll make sure that you have the appropriate literature for you to have with regards to your surgery.

  Before your surgery you'll attend a pre-assessment clinic or a seminar which will be with a group of patients that are all undergoing the same surgery. Depending on the type of surgery and length of surgery there are a few members of the health care professional team that you may meet.

  You may meet the clinical nurse specialists who will be able to go through any additional questions that you're unsure about regarding your surgery. You will also meet a physiotherapist. They may be able to help you with any exercise to help you for pre and post-surgery and also, perhaps depending on the surgery, a pharmacist.

  Our dietitians can give guidance on nutrition before your surgery and how to look after yourself nutritionally when you're discharged. Some patients may be asked to drink a special carbohydrate drink which will help prepare your body for the operation and will help you with your recovery.

  Anna Mae Salvador (ward manager): The nurses will prepare you for surgery and when you're ready you'll be taken to an anaesthetic room and from there you're going to the operating room. After an operation most patient will wake up in the recovery room where you will be monitored until you're ready to go back to the ward.

  If you have had complex surgery or have complex medical needs you may move to a more specialist unit to be monitored through the initial recovery before being moved to the ward.

  It is important to get up and get moving as soon as you can after your operation. Most patients can start gentle exercises in bed and maybe sit out in a chair with assistance from the nurse on the same day of the operation. Movement will really help your recovery.

  The team looking after you will make sure you start eating and drinking at the right time after your operation, building this up gradually. We will also ask you if you have any pain or nausea and will help you manage this.

  Ian Wicks: I think it was on day one after the operation I should be getting out of bed and sitting up for a little while and I think that gave me the kind of the kick to get up and do it, thinking with that's what I've been told to do that's got to be the right thing to do even if it hurts. So get up, get out of bed and just try and do what the little booklet told me to do.

  I think having like a plan laid out, almost like a diary of what to expect, was really helpful, and I think in some ways you almost want to psychologically to try and beat it a little bit because I think it ran for five or six days, the programme. It was nice to know that I could sit in a chair longer than they expected me to sit in a chair for example. So that was a bit of a challenge almost to try and do better than it was laying out for you.

  Mr Jonathan Olsburgh: The important thing to remember is that every patient we see gets personalised care and is based around giving you the best possible experience and fastest possible recovery. The experience of Ian is an example of enhanced recovery to best support a transplant patient, many of the principles apply regardless of the type of operation you require.

  Ian Wicks: I went home three and a half days after the operation and I felt ready to go.

  Mr Jonathan Olsburgh: We're always happy to answer your questions so please do ask a member of your care team.