Kidney Transplant Step-By-Step

What exactly happens when you receive a kidney transplant? While the actual process is very complex and takes a team of medical professionals – and of course a kidney - this section will assume all of those things are in place. Here we’ll take an abbreviated walk through the kidney transplant process.

1. Getting the Green Light

After receiving the call from the transplant team indicating they have a kidney for you, a patient needs to get to the hospital as quickly (and safely) as possible. A suggested list of things to bring to the hospital to ensure everything goes as quickly and smoothly as possible includes a list of current medications, a list of drug allergies, health insurance information and clothing for several days.

It’s also important for a patient to stop eating and drinking as soon as they get notice a kidney is available. A patient’s stomach needs to be empty when the operation begins.

2. Arrival at the Hospital

Once admitted, the patient will receive a physical exam, blood work, a chest x-ray, EKG and perhaps even other tests.

While disappointing, there are some cases where surgery will be postponed and the patient will be sent home. These include:

  • The patient has developed an infection or a medical problem that could cause problems with the surgery or recovery.
  • The kidney being donated looks to be in bad shape or there is reason to believe it would have poor function.

3. Patient Preparation before Surgery

To ensure the patient is ready for the operation, several things will be done. Hair on the chest and abdomen will be shaved, a laxative or enema may be administered to clean out the intestines and prevent constipation after surgery, and an intravenous line will be inserted to supply medicine and prevent dehydration. A sedative will also be administered to help the patient relax before surgery.

There is a possibility a patient will need a transfusion of blood during the surgery. Today’s donated blood is screened very carefully so the chance of contracting a disease from the transfusion is small. If you have concerns about transfusions, make sure you talk to the transplant team during the time you are waiting for a kidney. 

4. The Kidney Transplant

The patient will be put “under” using a general anesthesia and will remain asleep for the duration of the surgery. Once asleep, the transplant surgeon will make an incision on the lower abdomen just above the groin.

The donor kidney will be placed in the lower abdomen. The kidney's blood vessels will then be connected to the recipient's iliac artery and vein. The surgeons will then connect the ureter to the bladder. A small drain may be inserted into the abdomen to drain any excess fluid that may have accumulated during the operation.

5. After the Surgery

After the surgery, the patient will be taken to the intensive care unit or acute care unit where they will be monitored by medical personnel until the anesthesia wears off and they wake up. While recovering here are some things a patient can expect:

  • Some pain and discomfort. Medication will be provided to help relieve this.
  • To help keep the lungs clear, a patient will be asked to cough.  
  • Fluids and medications will be delivered through IV lines in the arm or neck for the first few days after surgery.
  • A catheter to drain urine from the bladder will be inserted.  While it may feel uncomfortable and create the feeling for the need for constant urination, it’s only temporary.
  • If a drain was inserted near the incision during surgery to help with fluid removal, it will remain there for five to 10 days.
  • In some situations, while waiting for the donated kidney to fully recover from the procurement/transplant process, dialysis may still be used to help remove excess fluid and toxins.
  • Patients will be monitored for laboratory results, medications, eating and exercise.  As soon as the patient is able, they will be prepared for going home.

What happens to my "old" kidneys?
If your kidney(s) are removed during the transplant, you can donate them to a research organization to help develop treatments and a cure.  If donating your kidney is something you are interested in, please talk to your transplant coordinator about this option.

Helpful Resource
HOPEline is a toll-free call-in line offering patient-to-patient encouragement and support from operators who have lived successfully with chronic kidney disease. This program is offered by the Renal Support Network, a nonprofit organization providing non-medical services to those affected by chronic kidney disease (CKD).  Learn more.



Number of kidney transplants performed in the United States. Learn More