Kidney transplant surgery and recovery

You can expect to be in surgery for 3-4 hours. You will be under general anesthesia, meaning you will be asleep for the surgery. Your surgeon will take a minimally invasive approach to the surgery. The surgeon makes a 4-inch incision in your lower abdomen, just above your groin, to insert your new kidney.

Your surgeon will “re-plumb” your new kidney to the rest of your body. This is done by surgically connecting blood vessels in your pelvis to the new kidney’s artery (which moves blood into the kidney) and vein (which removes filtered blood out of the organ). Your surgeon will also connect the ureter of your new kidney to your bladder. Your ureter is the tube that transports urine from your kidney to your bladder.

We leave them in place in your lower back. We do not remove them unless they are causing you severe medical problems like ongoing kidney infections or uncontrollable high blood pressure.

No, you will be under general anesthesia, which means you will be completely “asleep” during your 3–4-hour kidney transplant operation. 

After surgery, you will remain in the ICU (Intensive Care Unit) for several days. We need to observe you closely after your transplant to be sure your body accepts the new kidney. Organ rejection is a possible complication of any transplant surgery.

The transplanted organ may be “sleepy,” or slow to begin working correctly. If this happens, you may temporarily need to undergo dialysis. Most “sleepy” kidneys start functioning within about 4 weeks.

In rare cases, bleeding, clotting or obstruction of the kidney can cause it to fail. However, most of our recipients leave the hospital with a functioning new kidney. Our careful pre-transplant testing and planning minimize the chance of transplanted kidney failure.

We will provide you and your loved ones with information to help prepare for the whole recovery process. This includes instructions on medications you will need after your kidney transplant, dietary restrictions, activity guidelines and more.

Our supportive medical team will begin educating you about the immunosuppressant medications you will start taking. These medications reduce the likelihood that your body will reject your new kidney. You will take immunosuppressants for the rest of your life.

It is important to be patient with yourself after your procedure. You may experience some abdominal discomfort for several weeks after your surgery. This is completely normal. Also, it may take some time to adjust to your new immunosuppressant medications, which you will take for life to prevent kidney rejection.

• Expect ongoing follow-up: Your Sentara health team will closely monitor your health for the first year after your kidney transplant. For the first month or two, you may have several appointments per week at Sentara Norfolk General Hospital. If you live far from Norfolk, you may need to make arrangements to stay in town for a few weeks.
• Transition to more accessible appointments: Over time, your appointments will probably become less frequent. Some blood tests may be done at a Sentara location closer to your home.
• Rely on your Sentara transplant coordinator: We are here to help. Your transplant coordinator can help answer any questions you may have during your recovery period.

After you leave the hospital, you may walk and climb stairs.

• Driving and lifting restrictions: We do not recommend lifting anything heavier than a phone book or driving for the first three to four weeks. 
• Fatigue: You may need frequent daily naps for several weeks after transplant surgery. This is completely normal.
• Exercise: When you feel well enough, we strongly encourage you to start walking as much as you feel able.
• Returning to work: You may be able to go back to your job in 6-8 weeks. Your timeline will depend on the type of work you do. You may wish to work a reduced schedule at first.
• Continue checking in with your care team: For the first month or two, you may have several appointments per week at Sentara Norfolk General Hospital. That means you may need to make arrangements to stay in town for a few weeks if you live outside of Norfolk. Later, you will have fewer appointments. Some of them may be at a Sentara location closer to you.

Most patients live very normal lives after kidney transplant surgery. At the same time, you will need to closely monitor your health to ensure your new kidney has the best possible chance of surviving in your body.

• Dietary guidelines: Your doctor and transplant coordinator will inform you of any dietary restrictions you may have. They should not be as challenging as they may have been if you were on dialysis.
• Medication cautions: You will need to avoid certain over-the-counter and prescription medications that may make your immunosuppressant drugs (to prevent kidney rejection) less effective. Your doctor will provide you with a comprehensive list. 

In most cases, you will begin to feel better within about 6-8 weeks of your transplant surgery. However, your doctor will advise you to closely monitor for signs of a developing infection or complications with your new kidney. 

If you experience any of the following symptoms, please contact your nephrologist immediately. They may be signs of serious illness.

Signs of possible infection:

• A cough or cold that will not seem to go away
• Fever higher than 100 degrees
• Burning feeling when you urinate
• Pus draining from your surgical incision

Signs of possible kidney rejection:

• An increase in your blood pressure
• Significant decrease in how much you urinate
• Sudden ankle swelling
• A rapid rise in your weight
• Swelling and/or tenderness around the location of the new kidney