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Kidney transplant surgery lasts about three to four hours. During surgery, the transplanted kidney is placed in the pelvis near one of your hip bones. The surgeon connects the blood vessels from the transplanted kidney to the blood vessels in the pelvis.
The ureter (urine drainage tube) from the transplanted kidney is connected to your bladder so urine can be excreted. A stent (a flexible, narrow tube) is inserted into the ureter going into the bladder to keep the connection open. This stent will be removed six weeks after surgery by a procedure called a cystoscopy. This procedure is done as an outpatient procedure in the transplant clinic.
Seven to ten days after surgery, the staples are removed in the transplant clinic. Tape called “steri-strips” will then be applied. Do not peel these strips off; they will fall off gradually. The surgical incision usually heals completely in six weeks. Call the transplant team if your incision is red, warm, draining, swollen, or more tender than usual.
You will be given a post-transplant patient handbook upon discharge.
Delayed Function
After a transplant, most patients have immediate function of their new kidney. However, up to 25% of patients may experience “delayed function”. Before your kidney is transplanted, it is preserved in a cold solution that keeps the kidney at a very low temperature. There is no blood flow, and it is, in effect, “asleep”. The transplant team strives to keep this preservation period as short as possible. After surgery, the blood supply is restored. It may take your kidney several days, or even weeks, to “wake up” and start working. During this time, your creatinine may not decline, and you may not make much urine. If this is the case, dialysis may need to be resumed temporarily. Almost all of the time, delayed function resolves. In the meantime, lab tests, scans, ultrasounds, and/or biopsies may be performed to monitor for rejection or other causes of less than optimal function. If you have delayed function, this does not mean that your kidney will never work. Your kidney may just need extra time to heal and adjust.
Testing your New Kidney
After your kidney transplant, several tests are performed to determine how well your new kidney is functioning. Blood tests are performed frequently. If your creatinine rises, a renal ultrasound may be performed. This test is used to diagnose complications such as a leakage of urine or lymphatic fluid, fluid build-up in the kidney due to a blockage, or problems with blood flow into the kidney. If the ultrasound is normal, other tests such as a renal scan or renal biopsy may be done. The most reliable measure of your kidney function is the creatinine. It is a byproduct of muscle use and is filtered out by the kidney. This tells the transplant team how well your kidney is excreting waste products.
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