NewYork-Presbyterian, in cooperation with the Rogosin Institute, established the first kidney transplant program in New York. We’ve since developed the largest kidney transplant programs in the country at NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian/Columbia University Irving Medical Center.
Our kidney transplant centers are home to two of the biggest living donor kidney transplant programs, with expanded living donor kidney options that make this lifesaving operation accessible to more people. Our world-renowned organ transplant physicians are able to achieve excellent outcomes while caring for this very complicated and complex patient population.
What is a Kidney Transplant?
A kidney transplant is a surgical procedure that involves placing a healthy donor kidney into a patient who does not have functioning kidneys. The donor kidney can be either from a living or deceased donor.
A kidney transplant is typically done to treat kidney failure (end-stage renal disease or ESRD). Some patients with kidney failure caused by diabetes may be eligible to receive a kidney and pancreas transplant at the same time. In these circumstances, the pancreas transplant helps protect the new donor kidney from diabetic damage that is often done for type 1 and some type 2 diabetes.
What Conditions are Treated with a Kidney Transplant?
Healthy kidneys filter waste from the blood and help it leave the body through urine. They also help maintain blood pressure and control electrolyte and acid-base balance. When kidneys aren’t functioning properly, people can develop complications like high blood pressure, anemia, electrolyte imbalances, and kidney failure, which is life-threatening.
Kidney transplants are used to remove the need for dialysis and treat many conditions, including:
- Kidney failure due to diabetes or high blood pressure. Diabetes can lead to high blood sugar levels, which damage the kidney’s filtering abilities, ultimately leading to kidney failure.
- Congenital kidney defects. These defects could include hydronephrosis, or swelling in the kidneys, or vesicoureteral reflux, which causes backflow of urine from your bladder to your kidneys. Other congenital kidney defects include renal hypoplasia or polycystic kidney disease (PKD).
- Lupus. Lupus is an autoimmune disease that can cause kidney disease, or lupus nephritis. Lupus nephritis can lead to kidney failure.
- Chronic glomerulonephritis, a condition that involves inflammation to the kidney’s filtering function, known as the glomerulus. Waste and excess fluid builds up inside the body when the kidneys lose function in this condition.
NewYork-Presbyterian can connect you with a team of experienced specialists who can address all treatment options available for your specific condition.
How is a Kidney Transplant Surgery Performed?
Kidney transplant recipients need to understand all the steps involved before undergoing the operation. Some key points of the kidney transplant procedure to consider include:
- Pre-operative testing. To make sure you meet all the criteria to be a transplant candidate, you’ll undergo various tests at the transplant center first. These may include blood tests, as well as checkups on your heart and other organs to ensure you’re healthy. You may also receive a mental health evaluation to ensure you’re ready to take on self-care and adhering to medication after a transplant surgery.
- Matching you with a donor. The transplant team will then seek to find a donor match for you, based on whose blood is a match with yours. Wait times can last from a few months to years depending on whether the donor is living or deceased.
- Living donor transplants can be done once the kidney donor and the recipient are cleared to proceed. If you are undergoing a living donor kidney transplant, the donor will need to undergo testing and then an operation to remove the kidney.
- Deceased donor kidney transplants have an average wait time of 4-6 years, depending on blood type and degree of sensitization. A patient’s wait time begins when the patient is listed for transplant or their dialysis start date, whichever is earlier.
- Recipient operation. Kidney transplant surgery takes about two to four hours, during which the surgeon connects the new transplanted kidney to your blood vessels and bladder. In most cases, they place the new kidney into the body and do not remove the damaged kidneys. Damaged kidneys are only removed if they are prone to infections or cause other complications.
- Post-transplant period. After the surgery, the recipient is closely monitored to ensure the kidney is functioning, and the body is not rejecting the organ. The patient will be placed on anti-rejection medication.
After the procedure, patients who undergo the surgery will generally spend about four days in the hospital but should plan for a week. Longer stays may be required if the kidney does not work immediately (known as “delayed graft function”) or if there are other surgical complications. After discharge, patients will continue to have frequent checkups with their doctor and adhere to immunosuppressant medication for the rest of their life.
Living donor kidney program
NewYork-Presbyterian is a leader in living donor kidney transplants. Our NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian/Columbia University Irving Medical Center programs were founded in 1963 and 1970, respectively. Patients and their families travel from around the world for our expertise and record of providing transplants quicker than other local centers.
Over the years, our transplant teams have revolutionized the kidney donation operation — pioneering and perfecting the minimal invasive -access kidney donation procedure (laparoscopic nephrectomy), which leaves only a three-inch incision mark, and three smaller ½-inch marks at the site. We also pioneered innovative ways to match patients with a living kidney donor faster and better, such as paired donation, swaps, chains, and incompatible donor-recipient pairs.
Risks to Consider
It’s important to be aware of a kidney transplant’s possible risks and complications before undergoing the surgery. Like any organ transplant, the new kidney may be rejected by your body – a normal reaction to implanted foreign tissue.
At NewYork-Presbyterian, we use plasmapheresis and medication regimens that help reduce rejection of the kidney. Potential complications of kidney transplantation include:
- Wound issues
- Blood clots
- Lack of function in the donated kidney
Preparing for a Kidney Transplant
In the weeks and days before the kidney transplant procedure, you will want to take preparatory steps to ensure you’re in the best state for surgery. Preparing for a kidney transplant can include:
- Avoiding blood thinners for a week or more before surgery
- Eating light meals until noon the day before surgery, then switching to clear liquids
- Drinking enough water and clear liquids to stay hydrated before surgery
- Making sure you have a bowel movement the night before or morning of surgery, or taking a laxative if needed
Keep in mind that the preparatory steps above can vary depending on a patient’s condition and dialysis status. Be sure and follow your transplant team’s specific instructions.
What to Expect After a Kidney Transplant
Once your surgery is finished, you will spend a few days in the hospital recovering, where the transplant team will monitor your new kidney to make sure it’s working properly and not being rejected by your body. Your care team may provide you with fluids and painkillers to help with post-operation pain.
Your new kidney could take some time to begin working, filtering waste in your body and producing urine. It is common for kidney recipients to experience “delayed graft function,” and dialysis may be required after transplantation. You’ll also begin taking immunosuppressants or medications that prevent your immune system from attacking the new kidney, which you will continue to take for the rest of your life.
In the weeks following a kidney transplant, you will need to be frequently monitored by your doctor at checkups, which may include blood tests and medication adjustments. Your doctor may have more specific instructions for you on how to take care of yourself post-transplant, but generally speaking you will need to make sure you take all your medications as prescribed, and attend your frequent checkups.
Kidney transplants are about 95% successful in the first year after surgery, meaning the new kidney will be functioning properly within that year.
Certain medical and psychosocial conditions can make a kidney transplant unsafe. These include active infections, untreated cancers, ongoing substance abuse disorders, and uncontrolled psychiatric illness.
People who undergo a kidney transplant generally have a longer life expectancy than patients who stay on dialysis, depending on the type of kidney transplant. Living donor kidneys last 19 years on average, while deceased donor kidneys last an average of 12 years. Some patients undergo more than one kidney transplant in their lifetimes.
Kidney transplants in the U.S. can cost up to $442,500, depending on the hospital, your insurance, and the price of immunosuppressant drugs following the surgery.
Receive a Kidney Transplant at NewYork-Presbyterian
If you are in need of a kidney transplant, the experts at NewYork-Presbyterian are here to help. When you arrive at our center, our specialists will assess your health and guide you through your individualized treatment plan.
Your team includes a dedicated transplant coordinator and transplant surgeons, nephrologists, gastroenterologists, endocrinologists, critical care specialists, nurses and nurse practitioners, pharmacists, psychiatrists, nutritionists, physical therapists, social workers, and financial counselors.
Throughout the transplant process and beyond, we partner closely with you, the transplant recipient, and your referring physicians while helping you and your family navigate any emotional, financial, and practical concerns. Our transplant teams are here for you before, during, and after your transplant — for life.