6. Prepare for transplant, have the surgery and recover.
After you have been approved for a transplant you now have to wait for the big day. As we shared earlier your wait time could be a few months or several years. One of the best ways to prepare for a transplant is to try to get yourself in the best health possible. This seems pretty obvious, but this will help remove issues with the surgery, help you recover faster and help your organ last longer.
It is important for you to:
- Eat healthy and exercise regularly
- Take all of your medications
- Make all of your doctor’s visits and other appointments
- Stop smoking at least a month in advance
It is important to keep in close contact with your transplant team and alert them if anything major changes with your health. This includes updating emergency contact numbers and letting them know of out of state travel or other event s that could stop you from being ready right when an organ becomes available.
As you get closer to your surgery date it will be important to have your hospital bag and transportation secured. A few days before your surgery, the transplant center and/or hospital team will work with you to do pre-admission testing and give specific instructions for the night before surgery. These instructions normally include items such as not eating or drinking after midnight on the eve of surgery, removing jewelry and any last minute paperwork or verification.
The day of the surgery, you will have the chance to go over any last questions, sign paperwork and start anesthesia. The surgery itself normally takes 2-4 hours and the surgery is called heterotopic, which means that your new kidney will be put in a slightly different part of your body than your original kidneys.[1] This is because your kidneys will normally remain in your body unless they are causing major issues for your body.
If you are receiving a donation from a living donor, you will be in two close operating rooms and surgeons will use a laparoscopic surgery technique to remove the donor organ. This technique uses small incisions and a tiny camera to remove the donor kidney. The donor kidney is then removed through an approximately 3-4 inch incision in the abdomen. The donor organ is then inserted you’re your body artery that carries blood to your kidney and the vein that takes the blood away are connected and the ureter (connecting tube) of the donor organ is connected to your bladder to remove waste in the form of urine. Unless there are medical setbacks, recovery for the donor is pretty quick with 1-2 days of hospitalization, a couple weeks of recovery before heading back to work and follow up appointments at strategic dates in the future such as 6 months, 1 year and then annually.[2]
In the case of a deceased organ you will not have as much time to plan and you will need an additional test to ensure the donor organ is a match. Here they will do a cross match test to see if your body will react to the new organ. If your body doesn’t have a reaction, then you will be taken into surgery. Just like the process of the living donor, your surgeons will connect the blood supply to your new kidney and make the connection to your bladder for waste removal. You will then be stitched back up and taken to recovery.
Your recovery as the kidney recipient will be a bit longer than the donors. After the effects of the anesthesia wears off, many patients say that they immediately feel better and some begin to urinate right away. The typical recovery in the hospital is right around a week. During recovery, your doctors will be looking for signs of infection and making sure that your new kidney is working properly. No matter how good the match is your body will still see the new kidney as something that doesn’t belong and immunosuppressive drugs are needed to stop the body’s natural reaction. Once your doctors determine that you are healing correctly and you are let go from the hospital, the real caring process begins.
[1] University of California San Francisco. Phases of Transplant. Retrieved from http://transplant.surgery.ucsf.edu/conditions--procedures/kidney-transplantation.aspx.
[2] University of Maryland Medical Center. Living Donor Kidney Frequently Asked Questions. Retrieved from http://www.umm.edu/transplant/kidney/qanda.htm#9.
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