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Coming Back for Your Kidney Transplant at
University of Minnesota Medical Center
If you need to contact the transplant unit before you arrive (night or day), call 612-273-3062.
Deceased donor transplants
Living donor transplants
The transplant operation
Possible complications after transplant
The Transplant Unit
Deceased donor transplants
If you will receive a kidney from a deceased donor, you will get a call from a doctor at University of Minnesota Medical Center. Calls like this can come any time, day or night, so be sure to answer your phone.
When a kidney is available, we may call two patients. We do this to make sure the organ can be used and time is not lost. We will tell you if you are the first or second choice for this transplant.
The doctor will ask you to come to the hospital as quickly (and safely) as possible. Please be sure to:
- Get the doctor’s name and phone number.
- Say what time you expect to arrive at the hospital.
- Tell the doctor if you have recently had a surgery, illness, infection or health problem.
- If you have diabetes:
--Ask what to do to prevent low blood glucose (sugar).
--Ask what to do about insulin, if you take any. - Follow the doctor’s orders about when to stop eating and drinking.
- Bring a support person with you to the hospital.
If your arrival time changes or other problems occur, call 612-273-3000 . Ask us to page the on-call transplant surgeon.
Once you arrive at the hospital, please stop at the Admissions Department. They will direct you to the Transplant Unit. Once you are admitted, we will prepare you for surgery.
- You will have a chest X-ray, ECG, blood tests and urine tests.
- You may need enemas to clean out your intestines.
- You will be told how to take a shower using special soap.
- The anesthesiologist (doctor in charge of your anesthesia) will discuss the medicines he or she will give you during surgery.
- We will insert an IV (intravenous) line to give you fluids and medicines.
Your support person or family can stay with you until it is time to go to the operating room. We will then direct them to the waiting area on the third floor. After your surgery, the doctors will meet them there.
Living donor transplants
If you will receive a kidney from a living donor, we will give you a date for your surgery. This will happen after both of you have been approved for transplant.
The day before surgery:
- You will come to the Transplant Center for day-long evaluation. This will include blood tests, an EKG and other tests.
- We will do a final crossmatch test to make sure you can still receive the donor’s kidney.
- You may begin drugs to prevent your body from rejecting the new kidney.
- We will assess your need for dialysis.
- You will learn about your medicines, surgery and how to prepare.
- We will tell you which of your medicines (if any) to take the night before, or morning of your surgery.
The day of surgery:
Please arrive at 5:30 a.m. and go to the Same Day Admission Unit (3C).
We will insert an IV (intravenous) line. This allows us to give you fluids and medicines during the surgery. The anesthesiologist (doctor in charge of your anesthesia medicine) will also come to see you.
Your family can stay with you until it is time to go to the operating room. We will then direct them to the waiting area on the third floor. After your surgery, the doctors will meet them there.
The transplant operation
Your transplant surgery will take about four hours. The surgeon will place the new kidney in your lower abdomen (belly area), on the right or left side. Your incision (surgical cut) will be about 6 to 8 inches long.
After your new kidney is in place, your surgeon will watch for signs that it is healthy and has a good blood supply. We will update your family at this time.
The Transplant Unit
After you leave the operating room, we will bring you to the recovery room.
- When you are fully awake, we will move you to your bed on the transplant unit. You may be in a single or double room, depending on your needs and the availability of rooms.
- Some patients will stay in the intensive care unit (ICU).
- If you had a living donor, you will not share a room with this person. Your care needs are very different.
You may be slow to wake up after surgery. We will give you medicine to control pain and help you relax.
If your kidney came from a deceased donor, it might not work right after surgery. You may need several dialysis treatments to help your body while your kidney is beginning to work. This may take up to two weeks, or rarely, longer. We will draw blood tests daily to see how your kidney is working.
While you are on the Transplant Unit, you will learn about your medicines and how to take care of yourself at home. You will need to go to two different classes. Your nurse will schedule these for you. You will also receive a handbook for patients. This provides general information and a place to write your lab results.
Your nurse will work closely with you as you learn. By the time you go home you will know how to take your medicines, record your lab values, check your blood pressure and more. Once you go home, you will need to keep track of your lab values. You must know how they should be reported to the transplant office.
Possible complications after transplant
While some problems might appear right after surgery, others may show up weeks, months and even years later. Most of the time your local doctor can treat any problems that occur. In some cases, you may need to return to the Transplant Center.
Surgical problems
Surgical problems, though rare, may occur during or right after surgery. They include:
- Bleeding
- Kinked or narrow blood vessels
- A lymphocele (a build-up of fluid around the kidney)
All of these problems require treatment. They may lead to a longer stay in the hospital.
Blockage in your urinary system
If your urine is blocked from leaving the body, you may have a nephrostomy tube. This is a tube that drains urine from your kidneys. You may have a tube for several weeks or months. Your surgeon will tell you when it should come out.
Infection
Call your transplant coordinator if you have any signs of infection such as:
- Fever over 101°F (38.3°C) (under the tongue), with or without chills
- High white blood cell count
- Pain or redness at the incision or drain site
- Cold or flu symptoms
Most infections can be treated with medicine from your kidney doctor or family doctor. For severe infections, you may need to return to the Transplant Center.
Rejection
A rejection may occur at any time. It is most likely to occur in the first three to six months after transplant.
You may have no symptoms if a rejection begins. It is found with blood tests. You must have blood tests three times a week for the first month after your transplant. In time you will need blood tests less often: about once a month for the rest of your life.
You may have the blood tests at your local clinic. Have the clinic fax us your test results. If you don’t, we will not know how your kidney is working or if you might be having a rejection or some other complication. You may need a biopsy to check for rejection.
If you are having a rejection, it is vital to catch it early. This improves the chances that the problem can be treated. We will adjust your medicines. You may need to come to The Transplant Center.
The risk of rejection lessens with time, but it never goes away. As this risk decreases, so will your doses of anti-rejection medicines. As your medicines decrease, most of the side effects will decrease as well.
If you ever stop taking your medicines, your body will likely reject your new kidney. You will probably lose your kidney, become very sick, and you may even die.
High blood pressure
This is very common. It is more likely to occur in the first three months after surgery. Your doctors will use medicines to treat your blood pressure.
Blood in the urine (hematuria)
The color of your urine may range from pink to bright red. You may also have blood clots in the urine. This may be due to infection, rejection or the stitches used during surgery.
Diabetes
The medicines you are taking may cause diabetes. If this happens, you will have to watch your diet and test your blood sugar often. You may need diabetes pills or insulin shots.
Cancer
Taken over many years, your anti-rejection drugs may increase your risk of cancer, especially skin cancer. For this reason, you should cover up before going out in the sun or use a sun block (at least SPF 15). Do not use tanning beds.
Your anti-rejection medicines may also increase your risk of lymphoma, a more serious form of cancer. You should see your doctor for a yearly exam.
Return of your kidney disease
Several types of kidney diseases can come back after a transplant, including:
- MPGN (membranoproliferative glomerulosclerosis)
- FSGS (focal segmental glomerulosclerosis)
Please discuss any concerns with your transplant surgeon.
