Kidney Transplant Procedures

Living Donor Transplant

A date will be scheduled for your surgery. Generally, you and your donor will be admitted to the hospital the day of the surgery. One week prior to surgery, you and your donor will come to Emory for a final medical examination. Preoperative testing will include a chest x-ray, EKG, blood work, and a health history and physical exam to make sure neither you nor your donor have developed any new medical problems. At this time, you and your donor will have blood drawn for a final cross match test. This test makes sure you do not have any antibody sensitivities against your donor that could cause immediate rejection of the kidney.

Deceased Donor Transplant

When a donor kidney becomes available, a transplant coordinator will call you at the numbers you have provided. If you receive a message from us, please call back immediately since we have a limited amount of time to contact you before moving on to the next suitable candidate on the list.

The coordinator will let you know that a potential donor kidney is available will ask some basic health screening questions over the phone, to make sure you are still able to be transplanted. If you have a fever, nausea, vomiting, recent heart problems or surgery, it may not be safe for you to be transplanted at that particular time. Once you are instructed to come to the hospital, it will be important that you come here as soon as possible. Be sure to keep your directions to the hospital handy so that you will be prepared to find Emory whenever you receive the call.

The first call you get does not always mean the transplant will occur. The coordinator will explain to you that the surgeon must examine the organ before giving the final approval for your transplant. You will also have your blood tested against the donor to make sure you are not sensitized against this donor, a situation which would result in rejection of the kidney.

When you arrive at the hospital, your coordinator will direct you to the check-in location. This will be a hectic time, with nurses and doctors preparing you for surgery. Some final testing will be done to make sure you are healthy enough for surgery. These tests may include chest x-ray, EKG, blood and urine tests, and a health history and physical exam. Depending on the results of your blood tests and the timing of your last dialysis, you may be dialyzed at Emory Hospital before your transplant.

Kidney Transplant Surgery

Kidney transplant surgery lasts about three hours. After arriving in the operating room, you will be given general anesthesia and put to sleep. The surgeon will make an incision on one side of your lower abdomen (usually the right side for first transplants) and the donor kidney will be placed in your pelvic area where it will be well protected. The blood vessels from the kidney will be connected to your large blood vessels. A small incision is made in the top of your bladder, and the ureter (the tube that connects the kidney and the bladder) will be stitched to your bladder. This allows the urine from your new kidney to flow down to your bladder.

A ureteral stent is usually placed during the transplant surgery. A stent is a hollow plastic tube that is inserted inside the ureter to help keep it open while it heals. You will be informed if you receive a stent during surgery so you can receive the appropriate follow-up. Staples or dissolvable stitches will be used to close the incision.

Kidney-Pancreas Transplant Surgery

All kidney-pancreas transplants at Emory are performed using organs from deceased donors. Therefore, the waiting list and pre-transplant period will be similar to that described above for kidney recipients.

After arriving in the operating room, you will receive general anesthesia and be put to sleep. The surgeon will make an incision in the center of your abdomen from just below your breast bone to your pubic bone. The donated kidney will be placed in the left lower part of your abdomen in a protected area. The blood vessels of the kidney will be connected to your large blood vessels nearby. The ureter (the tube that connects the kidney to the bladder) will be stitched to your bladder so that urine can flow from the kidney, through the ureter, to your bladder.

During the same operation, the donor pancreas will be transplanted. The pancreas is also placed in the lower part of your abdomen. Blood vessels are connected to supply blood flow to the pancreas. A section of the donor small intestine, called the duodenum, is removed along with the donor pancreas. This section of donor intestine is sewn onto your small intestine so that the digestive enzymes secreted from the pancreas will empty into your intestine. Once the pancreas is in place, the incision is closed using staples and a sterile dressing is placed over the incision.