Overview

Our renal service at Guy’s Hospital is internationally recognised as one of the largest units in the world and a leading centre for kidney transplantation. Combining excellence in clinical services with innovation and outstanding care.

We have a global reputation and operate one of the largest renal transplant programmes in the UK and Europe. Our living donor transplant programme is one of the largest and most successful in Europe with a one-year graft survival rate of 99%.

We were one of the first centres to have a laparoscopic donor programme and now the first to have a robot-assisted laparoscopic donor programme.

We specialise in complex transplant cases and perform around 300 transplants each year, including living donor adult and paediatric transplants and transplants for people with complex bladder and other urology problems.

What is a kidney transplant?

The kidneys play a vital role in the day-to-day function of your body. If their ability to work properly is compromised, a treatment called dialysis may be needed. However, dialysis can only take over kidney function for so long. Dialysis can also cause some unpleasant side effects and takes long periods of time, making it very inconvenient.

For many patients, the best option is to have a transplant. Since it is possible to live a full and active life with just one healthy kidney, a kidney can come from a living donor.

A kidney transplant is a surgery that is performed to replace a diseased kidney with a healthy kidney from a donor. Generally, transplants performed with a living donor are more successful and family members or friends are often good candidates for kidney donation.

Procedure details

Before your kidney transplant

Before you are admitted for surgery you will need to stop eating and drinking. At the hospital you will be assessed to review your current condition and check that the donor kidney is suitable for you. You’ll need to bring any medications you take with you, and a bag of essential items and clothes for your stay in hospital.

The sooner the donor kidney is transplanted, the more likely it is that the procedure will be successful.

How does a kidney transplant work?

Your kidney transplant will be performed under general anaesthetic, meaning you will be asleep for the duration of the procedure.

There are three main stages to your surgery:

• An incision will be made into the lower part of your abdomen. This will be used to place the donor kidney into your body since your natural kidney will be left in place unless it is causing issues like infection or pain
• Nearby blood vessels are attached to the blood vessels of the donated kidney. This will make sure the kidney has the blood supply needed to function properly
• The ureter of the donated kidney, which is the tube that carries urine from the kidney to the bladder, will be connected to your bladder

The incision on your abdomen will be closed using either stitches, staples or glue.

Initially, a stent, which is a small plastic tube, may be inserted into the ureter to support the flow of urine. However, this is normally removed in a small procedure called a cystoscopy around six to 12 weeks later.

The entire surgery usually takes around three hours to complete. Once it is finished, you will be taken to recovery where you will come around from the anaesthetic.

Recovery from a kidney transplant

It can take up to 48 hours for the full effects of a general anaesthetic to wear off, during which time you may feel very tired, nauseous, confused and disorientated.

Immediately after your surgery, you will be provided with pain relief to help keep you comfortable, as it’s normal to experience some discomfort around the surgical site. Your consultant will immediately start you on a medication designed to stop your immune system from rejecting your new kidney.

You should expect to stay in hospital for around a week, but this can vary between patients.

It could take up to two weeks for your new kidney to start working, and you may need to be kept on dialysis until this time. Regular appointments are necessary to check your kidney function and to ensure that your medicines are working, so you should expect to have two or three visits to our transplant centre each week during this time.

However, over time your appointments should become less frequent. A year on from surgery, you should only need to attend follow-up appointments every three to six months.

It takes time to recover from any type of surgery, and a kidney transplant is no exception. You should always follow the advice of your consultant, who will be able to advise you when you can resume activities like going to work, driving, exercising and taking part in your usual recreational activities.

Living with a kidney transplant

Getting a new kidney can give you a whole new lease of life. However, to get the best possible outcome from your kidney transplant, you’ll be advised to take steps to ensure that your lifestyle is as healthy as possible.

This will include things like:

• Stopping smoking – This is because smoking can reduce the list of your new kidney and increase your risk of developing some types of cancer.
• Eating a healthy, balanced diet – Although you may initially need to avoid certain foods while your body is getting used to your new kidney, a healthy, balanced diet will help ensure that you maintain a good weight and get enough nutrients for your organs to function optimally.
• Get regular exercise. You will need to wait until your consultant advises you that you are ready to begin physical activity again, but once you can, you should aim to do at least 150 minutes of moderate intensity exercise each week.
• Keep alcohol consumption to no more than 14 units per week. This is important because regularly drinking alcohol can raise your blood pressure — something which can be dangerous for people who have had a kidney transplant.

You will also need to take immunosuppressant medication for the rest of your life. This will prevent your immune system from reacting to and rejecting your new kidney.

This can mean that you are at increased risk of developing some types of illness and infection. You should avoid contact with people you know who have infections, make sure your vaccinations are up to date and practice excellent personal hygiene to reduce the likelihood of picking up an illness.

The better your lifestyle, the longer your transplanted kidney is likely to last.

Locations

Our team of  world-class transplant surgeons and nephrologists use a multidisciplinary approach to patient care. This means that our patients benefit from the shared knowledge and experience of our whole team.

Based at Guy’s Hospital, as part of our leading renal service we offer bespoke treatment plans created to meet your specific needs.