What is a kidney transplant?

A kidney transplant is a surgery where a healthy kidney from another person is placed into someone whose kidneys are no longer working properly.

Who can donate a kidney?

You can donate one kidney when you are alive (called a living donor). You can also donate both kidneys after you have passed (called a deceased donor).

If you are a living donor, you can choose to donate your kidney to a relative, friend or someone you do not know. To become a living donor, you need to provide informed consent. This means you understand:

• the risks of donating your kidney
• the surgery involved
• how it will impact the person receiving your kidney

If you choose to become a deceased donor, you must register as an organ donor on the Australian Organ Donor Register.

It is important to tell your family about your decision, as they will need to agree to donate your organs after you pass away. You cannot choose who will receive your kidneys.

Read more about organ transplants.

What are the benefits of a kidney transplant?

A kidney transplant can improve your quality of life and even save your life if you have severe kidney failure.

If you have severe ('end-stage') kidney failure, your body cannot remove extra fluid and waste products. This can make you very sick and be life threatening. Your treatment options are dialysis or a kidney transplant. A kidney transplant may offer you a longer life and a better quality of life than dialysis.

If you have severe kidney failure, your healthcare team will check if you are medically suitable for a kidney transplant. This depends on your health.

In Australia, you are only eligible for a kidney transplant if you have already started dialysis. There may be some rare exceptions.

If you are suitable for a kidney transplant and do not have a living donor, your name will be put on a waiting list. This is because there are not enough donor kidneys for everyone who needs a transplant.

When a donor kidney becomes available, it is offered to the person who is the best match. This is based on blood tests and other matching factors.

What does a kidney transplant involve?

During the kidney transplant, your surgeon will make a cut in the lower abdomen (tummy) and place your new kidney in your pelvis. The new kidney will be connected to your bladder through its ureter (the tube that carries urine from the kidney to the bladder). It will also be connected to your blood supply.

Your damaged kidneys are usually left in place unless they are causing health problems. The surgery takes about 3 to 4 hours.

How can I prepare myself for a kidney transplant?

To be ready for a kidney transplant and to help your recovery, stay as healthy and fit as possible. While you are on the waiting list, you should:

• follow your health team's advice on food and fluids restrictions
• stick to your dialysis schedule
• get enough physical activity
• try to lose some weight if you are living with overweight or obesity
• avoid or quit smoking

As you wait for your transplant, prepare yourself for life-long treatment and monitoring to look after your new kidney.

How soon will I recover?

After your surgery, you will need to stay in hospital for about 4 to 5 days to recover. If there are any complications or you get an infection, you may need to stay longer.

You will have a tube (known as a catheter) in your bladder to drain your urine for a few days. If your new kidney does not work right away, you may need dialysis for a short time until it does.

Your medical team will check if your kidney is working properly. They will look for any early signs of rejection by your body. You will have frequent blood tests and scans to check how your new kidney is working.

Maintaining a healthy lifestyle

It's important to follow your healthcare team's advice on living a healthy lifestyle after your transplant. They may advise you to:

• get enough physical activity
• eat a healthy diet with plenty of fruit, vegetables and whole grains
• limit alcohol and avoid foods that are high in salt — these can raise your blood pressure, which can damage your new kidney
• stop smoking
• maintain a healthy weight

What complications can happen?

After your kidney transplant, complications may happen, including:

• infection
• rejection of your kidney
• cancer
• heart disease
• return of kidney disease
• complications from steroid medicines taken after the transplant

Usually, kidney transplants are successful surgeries.

Kidney transplant rejection

Kidney transplant rejection happens when your immune system sees your new kidney as foreign and attacks it. Rejection is one of the biggest risks after a transplant. To prevent this, you will need to take anti-rejection medicines for the rest of your life.

Rejection does not always cause symptoms. As your body rejects the kidney, it gets damaged and may slowly stop working. Rejection can happen immediately after transplant, within weeks after or even months later. It's important to know the signs. Contact your transplant team if you:

• feel unwell or have a fever
• have pain where your new kidney is
• are gaining weight
• are producing less urine than usual
• have a higher blood pressure than usual

While you are taking anti-rejection medicines, your immune system is weakened, making infections more dangerous. It's important to avoid infections and seek medical advice if you feel unwell.

Are there alternatives to a kidney transplant?

If you cannot have a kidney transplant for medical reasons, you can receive dialysis treatments. Dialysis treatments do not work as well as a transplant. You will also continue to be monitored by your healthcare team.

What will happen if I decide not to have a kidney transplant or it is delayed?

If you choose not to have a kidney transplant or if it's delayed, your doctors may start dialysis or suggest palliative care. Palliative care aims to improve your quality of life if you are living with an illness like kidney failure.

If you want to become a donor, you will need to undergo tests to check if your kidney is suitable for donation.

Resources and support

• To read more about organ or tissue donation after death or to register as a donor, visit DonateLife.
• For more information and support about kidney transplants visit Transplant Australia or Kidney Health Australia.
• The Transplant Network supports and empowers the transplant community.
• Donors and recipients living in remote and rural areas may be eligible to access Kidney Transplant Houses.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• DonateLife has a community resource library with information in many community languages.
• Kidney Health Australia has translated resources about kidney diseases into multiple languages.

Aboriginal and/or Torres Strait Islander peoples

• Kidney Health Australia has a First Nations Australians resources library for Aboriginal and/or Torres Strait Islander people.