Kidney transplant evaluation is usually done on an outpatient basis unless you are critically ill and require hospitalization. In addition to meeting with members of the kidney transplant team, during the evaluation you will have appointments with other specialists and undergo a number of pre-transplant tests. The pre-transplant tests, as well as giving a clear picture of the your overall health status, help in identifying potential problems before they occur. They also help in determining whether transplantation is truly the best option and increase the likelihood of success.
Once you have been placed on the transplant list, you may receive a very important call. When a kidney donor becomes available, the on-call coordinator will call you. The coordinator will instruct you:
- When to come to the hospital.
- When to stop eating or drinking.
The Admission Process
Before the surgery you will go to the admitting department unless otherwise instructed. You will then have several pre-operative tests to prepare you for surgery. You will have:
- A chest x-ray,
- An ECG,
- Urine tests,
- Blood tests, and
- A history and physical.
The transplant surgeon will talk with you and your family about the surgery and intra-operative and post-operative risk.
Once you are taken to the operating room, the anesthesiologist will give you medication to put you to sleep during the surgery. At this time your heart rate and rhythm and breathing will be monitored. You will also have a breathing tube placed.
The surgeon will make an incision on the abdomen. He will then place the kidney in and attach the blood vessels that take blood to and from the leg. The ureter will be attached to the bladder, to drain urine from the new kidney. A urinary catheter will be placed to allow the new urine to be drained from the bladder.
Once the surgery is completed you will be taken to the intensive care unit. On this unit they will closely monitor you. The nurses will be monitoring your vital signs, fluid input, and output. Once you are stable, you will be taken to a surgical floor. At this time discharge teaching will begin. The average length of stay in the hospital will be five to seven days.
After your transplant you will be given a kidney transplant owner’s manual prior to discharge. This manual will cover in detail almost everything you need to know about your transplant. Topics that will be covered are:
- Types of infections.
- How to prevent infections.
- Possible viruses after transplant.
- Kidney transplant rejection.
- Post transplant clinic schedule.
- Important labs.
- Clinic schedule.
- What to do in an emergency.
Your assigned post kidney transplant coordinator will cover all this information with you. Your coordinator will be available to you during business hours Monday-Friday. If you have an emergency after business hours, you can contact the on-call transplant coordinator.
Once you return home, we will draw labs twice a week. This will give us information on your kidney function; it is very important that you do these as ordered. You will also follow-up in our transplant clinic as ordered by our physicians.