Kidney transplant surgery

Kidney transplant surgery is a procedure to replace a failing kidney with a healthy kidney from a deceased or living donor. Penn Medicine’s kidney transplant team is ready at all times to perform a transplant when a donor kidney becomes available. 

Kidney transplantation is a treatment for people with advanced kidney disease. Your care for kidney transplantation at Penn Medicine begins with a thorough kidney transplant evaluation to determine if a transplant is the right treatment for you.  

General criteria for a kidney transplant include: 

• Late-stage chronic kidney disease or end-stage kidney failure 
• Receiving dialysis or nearing the need for dialysis 
• Life expectancy of five years or more 

If a kidney from a deceased donor becomes available, we’ll call and ask you to come to the hospital right away. If you’re receiving a kidney from a living donor, you and the donor can schedule the transplant at a time that works for both of you. 

When you arrive at the hospital, we check you in and perform some quick medical tests to ensure you’re healthy enough for transplant. Your loved ones are welcome to wait with you until we take you into surgery, and we’ll keep them updated throughout the process. 

Kidney transplantation typically takes two to four hours. We use the most advanced minimally invasive techniques for kidney transplantation, using only a small incision in your lower abdomen. You’ll have general anesthesia to ensure you’re asleep and comfortable during the procedure.  

Your surgeon may remove your failing kidney if it’s causing complications. Most of the time, we leave your native kidney in place. After placing the donor kidney, we connect it to blood vessels and your bladder. Then your surgeon closes the incision with stitches. The small incision and minimally invasive approach typically lead to less pain during healing and a shorter recovery time. 

When surgery is complete, we move you to your hospital room, where you’ll wake up after the anesthesia wears off. Your family is welcome at every point during recovery from kidney transplant surgery. 

After surgery, you’ll have a catheter draining urine from your body, and your team will be monitoring your new kidney carefully for urine production. If your kidney is from a living donor, it will produce urine right away. A kidney from a deceased donor takes time to “wake up” and may not produce urine for a few weeks. If this happens, you’ll receive dialysis until the new kidney begins functioning properly. 

Right after transplant surgery, you start taking immunosuppressant medications to prevent organ rejection and infection. During your three- to seven-day stay in the hospital, we test the function of your new kidney frequently and watch closely for signs of rejection. Education sessions with our team will teach you how to take your medication and follow a kidney-friendly diet.  

All major surgeries come with general risks such as bleeding, blood clots, and infections. Other complications specific to a kidney transplant procedure include: 

• Fluid build-up: Lymph fluid may fail to drain properly (lymphocele) from the surgical site or urine may back up in your abdomen (urinoma). 
• Urine leakage: If the tube connecting your new kidney to your bladder detaches from your bladder, urine may leak around your kidney. 
• Primary non-function: Sometimes a new kidney never functions properly after transplant. We monitor you closely for signs of primary non-function. 
• Organ rejection: If your immune system recognizes the transplanted kidney as foreign to your body, it will attack the kidney. We watch you closely for signs of rejection. 

The first kidney transplant at Penn Medicine took place in 1966. In the decades since, we’ve performed thousands of transplants and earned a national reputation as leaders in the field, with particular expertise in living kidney donation, and dual-organ (kidney-heart and kidney-pancreas) transplants. This experience translates to excellent results—above the national average—for even the most high-risk cases.  

At the Penn Transplant Institute, our focus is on making sure you get the best care before, during, and after kidney transplant surgery—and for the rest of your life. Your family is part of our family, and we’re here whenever you need us.