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Kidney Transplant Educational Resources

Kidney Transplant

Absorption - the degree and pace at which a drug enters the bloodstream from the small intestine

Acute Tubular Necrosis (ATN) - reversible kidney damage resulting in delayed kidney function

Allocation - The process of determining how organs are distributed. Allocation includes the system of policies and guidelines, which ensure that organs are distributed in an equitable, ethical and medically sound manner.

Allograft - a graft between two individuals who are of the same species (i.e. human) but have genetic differences

Anemic - low red blood cell count

Antacid - a drug that aids in protecting the digestive system and relieves heartburn and digestive discomfort

Antibody - a protein produced by the body to eliminate foreign substances, such as bacteria

Anti-rejection Drugs - see immunosuppressants

Antigen - a substance that triggers an immune response. This response may be the production of antibodies which try to inactivate or destroy the antigen of a transplanted organ

Arteriogram (angiogram) - an x-ray of the arteries taken with the aid of a dye

Atherosclerosis - a build up of fats in the lining of the arteries that may interfere with the flow of blood

Bacteria - small germs that can cause disease

Biopsy - the removal and examination of tissue sampling for diagnosis

Bladder - the part of the urinary tract that receives urine from the kidneys and stores it until urination

BUN (blood urea nitrogen) - a waste product normally excreted by the kidney. BUN values represent how well the kidneys function

Cadaveric Donor - an individual who has recently died of causes that do not affect the function of an organ to be transplanted

Cardiac Catheterization - a procedure in which a small tube is guided through a vein or an artery into the right or left side of the heart to check the function of the heart and the coronary arteries

Cardiologist - doctor who studies and treats diseases of the heart

Catheter - a tube, generally small and flexible, inserted into the body, to infuse medications, monitor organ function and drain fluid

Cellcept® - an immunosuppressive drug used to prevent the rejection of the transplanted organ. Also known by its chemical name myophenolate mofetil

Cholesterol - fat substance found in animal meats, dairy products and produced by the liver. A high level of cholesterol in the blood is a risk factor for developing heart disease.

Coagulation - blood clotting

Corticosteroids - a category of immunosuppressive medications that includes prednisone and prednisolone

Creatinine - a substance found in blood and urine; it results from normal body chemical reactions; high blood creatinine levels are a sign of depressed kidney function

Crossmatch - a test in which donor and recipient blood samples are mixed together. A "positive" crossmatch shows the donor and recipient are incompatible. A "negative" crossmatch shows there is no reaction between the donor and the recipient which means that the donor and recipient are compatible and the transplant may proceed.

Cyclosporine - drug that helps keep the body from rejecting a transplanted organ. Brand names include Neoral® and Gengraf®

Detoxify - to change a harmful substance into a safer form

Diabetes - a disease in which patients have high levels of sugar in their blood

Dialysis - the process of cleansing and achieving chemical balance in the blood of patients whose kidneys have failed.

Diastolic - the bottom of two blood pressure numbers which measures blood pressure in the arteries when the heart is at rest

Donor - person who gives an organ to be transplanted in another person

Echocardiogram - a diagnostic test that uses reflected sound wave (ultrasound) to see images of the heart, and provides information regarding the heart’s structure and function

Edema - excess fluid in body tissues caused by fluid leaking from blood vessels

Electrocardiogram - a recording of the electrical activity of the heart

Electrolyte - refers to the dissolved form of a mineral such as sodium, potassium, magnesium, chlorine, etc.

Enzyme - a protein made in the body and capable of changing a substance from one form to another

Fluid Retention - condition in which the body stores excess fluid

Gastroenterologist - a physician who specializes in the care of the digestive tract

Glucose - a type of sugar found in the blood

Graft - a transplanted organ or tissue

Hemodialysis - a method of dialysis in which blood is purified by circulating through an machine outside the body

Histocompatibility - the examination of antigens in a patient often referred to as "tissue typing" or "genetic matching". Tissue typing is routinely performed for all donors and recipients in kidney and pancreas transplantation to help match the donor with the most suitable recipients in an effort to decrease rejection of the transplanted organ.

High Blood Pressure or Hypertension - Occurs when the force of the blood pushing against the walls of the blood vessels is higher than normal because the blood vessels have either become less elastic or have gotten smaller. Hypertension causes the heart to pump harder to move blood through the body. It can cause kidney failure and heart disease if not treated.

Immune Response - any defensive reaction to foreign material by the immune system

Immune System - the body’s natural defense system against foreign substances such as viruses, bacteria, some types of cancers, and transplanted organs or tissue

Immunosuppressive agents - drugs that help treat or prevent the immune system from rejecting an organ or tissue transplant

Imuran® - an immunosuppressive drug used to help prevent the rejection of a transplanted organ. Also known by its chemical name, azathioprine

Incompatible - no match or similarity between donor or recipient blood type or organs

Insulin - substance produced by the pancreas that helps the body absorb blood sugar from the blood into cells to produce energy

IV (Intravenous) - refers to giving medicines or fluids directly through a vein

IV Catheter - a small needle with a hollow tube inserted into a vein and used to give medicines or fluids

Kidney - one of the two kidney-bean-shaped organs located on both sides of the spine, just above the waist. Their function is to remove the body’s waste materials and maintain fluid balance through the production of urine

Lab Draw - process of taking blood or urine for laboratory analysis

Living Related Donor (LRD) - a blood relative who donates an organ

Match - the compatibility between recipient and donor; the closer the match between the donor and recipient, the greater potential for a successful transplant

Nephrologist - a physician who studies the kidney and treats kidney disease

Non-compliance - failure of patients to follow the instructions and recommendations of their medical team, such as not taking medicine as prescribed or not showing up for clinic visits

Organ Preservation - methods used to preserve organs while they are out of a donor’s body and to be transplanted to a recipient.

Organ Procurement and Transplantation Network (OPTN) - The purpose of the OPTN is to improve the effectiveness of the nation's organ procurement, donation and transplantation system by increasing the availability of and access to donor organs for patients with end-stage organ failure. Administered by UNOS (United Network Organ Sharing), it provides a unique public-private partnership that links all of the professionals involved in the donation and transplantation system.

Organ Procurement Organization (OPO) - An organization designated by the Centers for Medicare and Medicaid Services (CMS) that is responsible for the procurement of organs for transplantation and the promotion of organ donation. OPOs serve as the vital link between the donor and recipient and are responsible for the identification of donors, and the retrieval, preservation and transportation of organs for transplantation

Organ Rejection - an attempt by the immune system to reject or destroy what it recognizes to be a "foreign" presence

Panel Reactive Antibody (PRA) - a way of measuring the immune system activity within the body; PRA is higher when more antibodies are being made

Potassium - a mineral essential for body function

Prednisone - medication used to limit rejection; taken by recipients of a transplanted organ or tissue

Prograf® - See tacrolimus

Psychiatrist - physician who diagnoses and treats mental disorders

Rapamycin (Rapamune®) - medicine that belongs to a group of medicines known as immunosuppressive agents used to lower the body's natural immunity and prevent organ rejection in patients who receive kidney transplants

Rejection - an immune response against grafted tissue in which a recipient’s body rejects tissue or organ transferred from a donor

Shingles - a herpes virus infection that usually affects a nerve, causing pain in one area of the body

Sodium - a component of table salt (sodium chloride); an electrolyte that is the main salt in blood

Status - indicates the degree of medical urgency for patients awaiting heart or liver transplants

Survival Rates - indicate how many patients or grafts (transplanted organs) are alive or functioning at a set time post transplant

Systolic - the top of the two blood pressure numbers, which measures the maximum blood pressure reached as blood is pumped out of the heart chambers

Tacrolimus - a drug the helps keep the body from rejecting a transplanted organ. Brand name is Prograf®

Thrush - a fungus infection in the mouth

Triglycerides - a form of fat that the body makes from sugar, alcohol, and excess calories

Tissue Typing - a blood test performed prior to transplantation to evaluate the closeness of tissue match between the donor and recipient

Ultrasound - device that uses ultrasonic waves to outline the shape of various tissues and organs of the body

UNOS (United Network for Organ Sharing) a national agency that maintains a national computerized transplant waiting list and helps locate donor organs

Urethra - a tube that drains urine from the bladder to the outside

Ureters - tubes that drain urine from the kidneys to the bladder

Urinary Tract Infection (UTI) - an infection of one or more parts of the urinary tract

Virus - a germ that causes infection

Waiting List - After a patient has concluded evaluation by the transplant physician, he/she is added by the transplant center to a national waiting list. Lists are specific to both geographic area and organ type. Each time a donor organ becomes available, UNOS generates a list of potential recipients based on factors that include genetic similarity, organ size, medical urgency, and time a patient has been on the waiting list

What are the advantages of a kidney transplant compared to dialysis?

The most important advantages are that your overall quality of life improves significantly after a kidney transplant and typically you will live a longer and healthier life following a transplant. Taking transplant medications are much less time consuming than being on dialysis three times week or even doing peritoneal dialysis at home or doing at-home hemodialysis. All of those are very time consuming.

Generally, we find patients have better energy and a better appetite when they have a kidney transplant. There are very few dietary restrictions when you have a kidney transplant versus dialysis. You have more time available for your family. It’s easier to maintain a job and you have more time available for travel. Patients on dialysis and with kidney transplant are at higher risk of heart disease. But that risk goes down significantly with a kidney transplant.

Presented by Dr. Melissa Isbell, nephrologist with Renal Associates and a former Chief of Staff at Methodist Specialty and Transplant Hospital.


How do I qualify for a kidney transplant?

To receive a kidney transplant there are several requirements that need to be met. And these are requirements that are established nationally and by our program. At the Texas Transplant Institute, we help patients through every step of the process to ensure they are a good candidate for kidney transplantation and have great results.

Presented by Dr. Melissa Isbell, nephrologist with Renal Associates and a former Chief of Staff at Methodist Specialty and Transplant Hospital.


What are the advantages of live donor transplantation?

There is little doubt that transplantation is the preferred method for treatment for failing kidneys. Dialysis helps patients survive, however, people get sick very quickly on dialysis. With a kidney transplant people can live longer and healthier.

Presented by Matt Kapturczak, M.D., physician with the San Antonio Kidney Disease Center, medical director of the kidney and pancreas transplant program at the Texas Transplant Institute and vice chief of staff at Methodist Specialty and Transplant Hospital.


How do I approach someone about being a kidney transplant donor?

Approaching a friend or family member about donating a kidney can be very difficult. A living kidney donation is a precious gift that only the donor can decide in their heart of hearts to help somebody and to improve and prolong their life.

Presented by Matt Kapturczak, M.D., physician with the San Antonio Kidney Disease Center, medical director of the kidney and pancreas transplant program at Texas Transplant Institute and vice chief of staff at Methodist Specialty and Transplant Hospital.


How does the kidney waitlist work?

The patient needs to work very closely with their nephrologist and primary care providers. They need to make sure they are up to date on their age-appropriate cancer screening tests including colonoscopy, PSA, mammogram, chest X-rays, etc. If there is any change in the patient’s health status, it’s important to notify the folks at the Texas Transplant Institute immediately.

Presented by Irfan Agha, M.D., transplant nephrologist at the Texas Transplant Institute.


What do you recommend for patients who are waiting for a transplant off the list?

We encourage patients to identify a living donor from among their family, friends and social circle. If you have a live donor, a transplant can sometimes happen very quickly. If an appropriate live donor is not available, then the patient will have to wait for an appropriate deceased donor to become available.

Presented by Irfan Agha, M.D., transplant nephrologist at the Texas Transplant Institute.


Is it safe to donate a kidney to someone?

We have complete processes in place to ensure the safety of each donor. The donor evaluation includes a thorough work up that includes medical, surgical and psychological evaluations. Because of this comprehensive work up, we are able to eliminate high risk donors and include the only donors who meet the requirements.

Presented by Fadi Abouzahr, M.D., nephrologist at the Texas Transplant Institute.


What is the evaluation process to qualify to donate a kidney?

A potential kidney donor must be 18 years old or older and able to consent for themselves. They should be free of any active medical disease.

Presented by Fadi Abouzahr, M.D., nephrologist at the Texas Transplant Institute.


What types of medication are needed after a kidney transplant?

Medications after your transplant can be summed up fairly simply: two medications, twice a day is what most of our patients end up on.

Presented by Francis Wright, M.D., transplant surgeon at Texas Transplant Institute.


What is the usual follow-up after a kidney transplant?

Your follow-up after a kidney transplant is a team effort. You’re part of the team. We depend on you to let us know if there are any problems and to be part of your follow-up care. The other members of the team are the entire transplant team here.

Presented by Francis Wright, M.D., transplant surgeon at Texas Transplant Institute.


What function does a kidney serve?

The function of a kidney is to filter the blood in our body. What this kidney does, it filters the toxins that our body creates from the byproducts of our metabolism and so forth.

Presented by Luke Shen, M.D., transplant surgeon at Texas Transplant Institute.


What happens during a kidney donor’s surgery?

The kidney donor surgery is a safe operation. We do it through a laparoscopic technique using a small incision to take the kidney out safely.

Presented by Luke Shen, M.D., transplant surgeon at Texas Transplant Institute.


What is the recovery process for a kidney donor?

The recovery period for a living donor surgery is rather short. Most patients stay in the hospital one to two nights. The pain level is usually described as being comparable to doing a lot of stomach sit ups.

Presented by Luke Shen, M.D., transplant surgeon at Texas Transplant Institute.


What follow up is required for a kidney donor?

We like to see donors back in the clinic about two to three weeks after surgery. After that we would like for them to come back to the clinic at six months, 12 months and two years for follow-up visits. These follow-up visits require us to examine the incisions that we made as well as get laboratory studies to ensure their kidney function remains stable and within normal limits.

Presented by Luke Shen, M.D., transplant surgeon at Texas Transplant Institute.


What is the history of Methodist Specialty and Transplant Hospital’s transplant program?

The history of the program dates back more than 30 years. It was set up by nephrologists and urologists who performed the kidney transplants. Up to 2014, the program has now done nearly 4,000 kidney transplants including nearly 2,000 live donor kidney transplants. The program has really taken off over the years. It’s always been set up as a regional program. About half of our patients come from San Antonio and the other half come from outside San Antonio.

Presented by Adam Bingaman, M.D., Ph.D., transplant surgeon and director of the abdominal transplant program at Texas Transplant Institute.


What sets Methodist Specialty and Transplant Hospital’s kidney transplant program apart from other programs?

In the United States there are about 250 kidney transplant programs. The biggest live donor kidney program is right here at Methodist Specialty and Transplant Hospital in San Antonio. We have developed a program built on four pillars and that is the key to our success. The first pillar is our people.

Presented by Adam Bingaman, M.D., Ph.D., transplant surgeon and director of the abdominal transplant program at Texas Transplant Institute.


What if a kidney donor and recipient are not a match?

Unfortunately, statistically, there’s at least a one in three chance that two random people will not be a match… We formed a dedicated team to address this exact issue. We meet once a week to work on finding matches for patients with willing donors. This team has grown to become the biggest single center program in the United States doing these exchange transplants. In other words, finding a situation where you’re not a match with your donor so maybe somebody else’s donor can match you and your donor can match somebody else.

Presented by Adam Bingaman, M.D., Ph.D., transplant surgeon and director of the abdominal transplant program at Texas Transplant Institute.


What is the most gratifying part of your profession?

Everybody working at the Texas Transplant Institute at Methodist Specialty and Transplant Hospital has a true passion for transplant. We’re here because we want to be here. We’re here because transplant gets us up in the morning… It’s rewarding to be part of a field that can give people their lives back.

Presented by Adam Bingaman, M.D., Ph.D., transplant surgeon and director of the abdominal transplant program at Texas Transplant Institute.


Will I feel better after a kidney transplant?

Undergoing kidney transplantation will help restore kidney function thus eliminating the need for dialysis. Most patients recover strength, and energy, and are expected to be able to live twice as long, as compared to remaining on dialysis.


How will I be evaluated as a kidney transplant recipient?

The process begins with a referral from your physician. Our transplant specialists review your medical records, and contact you and your physician to inform you of expectations and schedule a half-day appointment for a pre-transplant evaluation.


What is the process to find a donated kidney?

After you have completed the evaluation process by the transplant team, and a decision has been made that you are a good candidate for transplantation, your name is added to the UNOS national donor waiting list. There are two options for obtaining a kidney: from deceased donors or from a live donor. The average wait for a deceased donor kidney is 4 to 6 years. A living donor is the ideal choice as it expedites the waiting period. A living donor can be related or non-related and must undergo compatibility tests to ensure there is a match.


What is the length of a hospital stay after a kidney transplant?

The average hospital stay for a kidney transplant is seven days, but it varies for each patient.


Will I have to go back to the hospital after transplant?

Organ rejection is a concern after transplant. Transplant patients have a schedule of necessary follow-up visits with the transplant team which will include clinic and hospital visits.


How safe is the donor operation?

Our experience with living donors is greater than any other Texas program. Most donor operations are now done with laparoscopic techniques which speed recovery of the donor. Typically, donors return to normal activities within a few weeks.


Will I be on medications for a long time after the transplant?

Transplant patients generally start out with six to eight medications in addition to their anti-rejection medications. By six months, they generally take two to three per day. Eventually, patients are required to take only their anti-rejection medication for the rest of their life.


Will insurance pay for the transplant surgery and medications?

If a kidney transplant is medically necessary, the patient’s health insurance covers the majority of the costs.


What organization oversees transplant centers?

The United Network for Organ Sharing (UNOS) is contracted by the federal government to administer the deceased donor organ waiting list, as well as collect data regarding patient outcomes for transplant centers.


Click above for answers to your questions including:

  • What are the advantages of a kidney transplant compared to dialysis?
  • How do I qualify for a kidney transplant?
  • What are the advantages of live donor transplantation?
  • How do I approach someone about being a kidney transplant donor?
  • How does the kidney waitlist work?
  • What do you recommend for patients who are waiting for a transplant off the list?
  • Is it safe to donate a kidney to someone?