Kidney Transplant Surgery
At the time of surgery, the transplant physician will check for fever, infections or other serious conditions that, if present, may prevent surgery. You will undergo several blood tests as well as a chest X-ray and EKG. Dialysis may also be necessary. After these preparations, you will be taken to the operating room where after receiving a general anesthetic, you will quickly fall asleep. The transplant surgeon will place an intravenous (IV) catheter into one of your large veins to administer medications, monitor pressures and retrieve blood for laboratory tests.
After you are asleep, the site for your incision will be shaved clean to prevent infection and a Foley catheter will be inserted in the bladder. The surgeon will then make an eight- to 10-inch curved incision, just above your groin on either the right or left side. After placing the donor kidney in your abdomen, the surgeon will sew the artery and vein of the transplanted kidney to blood vessels in your pelvis. The new kidney's ureter (the tube carrying urine from the kidney to the bladder) will be attached to your bladder.
If you still have one or both of your diseased kidneys, they will not be removed because they usually cause no further harm. The surgical procedure should take two to three hours.
Living Donor Transplant Surgery
In the case of living donor transplants, the donor kidney is removed from the donor immediately prior to the transplant recipient's surgery. In most cases, one's own kidneys are left undisturbed. The surgical procedure will take from three to four hours. Following surgery, you will have a catheter from your bladder to drain urine and help your bladder heal. The catheter is usually removed after four or five days. Following removal, you will be able to pass urine as you did before the onset of kidney disease.
After Surgery
Following surgery, you will recover in the medical-surgical intensive care unit (MSICU), a specialized area of the hospital where close monitoring will be in effect for 24 hours. Once your vital signs and the function of the transplanted kidney have stabilized, you will be transferred to the regular nursing floor where our team of specialists will continue to provide postoperative care.
Medications required for good kidney function are carefully individualized. The transplant nephrologist heads this post-transplant team which includes transplant nurses, a transplant social worker and a dietitian. The average hospital stay for a kidney transplant recipient at California Pacific is between four to seven days. The living kidney donor is usually hospitalized for five days while living laparoscopic nephrectomy donors are typically hospitalized for three days.
After discharge from the hospital, you will be asked to return to the California Pacific Medical Center transplant clinic in San Francisco for regular follow-up visits. You can also be followed at one of the outreach clinics located in the East Bay (Berkeley), Central Valley (Clovis and Modesto), Sacramento (Roseville) and the South Bay. We will arrange for ongoing laboratory work at facilities near your home.
The frequency of clinic visits will depend on your individual needs. As recovery progresses, the visits will become less frequent. We will slowly integrate our care with that given by your own nephrologist or primary care physician in order to ensure a smooth and continuous transition. We will eventually ask to see you only once a year. However, the transplant team remains on constant standby and is always available to care for you and consult with your own doctor, should that become necessary.