Participant Information

You should be ready to leave the hospital and head home within a few days after surgery. You will receive a schedule of follow-up clinic visits for lab tests and check-ups. At these visits, your doctors will track your progress and detect potential complications as early as possible.

You should bring your medication list and surgery handbook to all follow-up visits. You will be given specific instructions for routine lab work or special tests that you might need.

Taking Care of your New Kidney

The most important aspects of post-transplant care are to listen to your doctors and take your immuno-suppression medications, which you’ll need to take for the rest of your life. This medication greatly decreases the chance of rejection episodes, in which your immune system attacks the new kidney.

Modern medical advances, including immunosuppressant drugs that prevent rejection of the new kidney, make kidney transplant complications less and less common. Patient and organ survival rates are high, and life expectancy rates are good. Intermountain’s Transplant Center team is knowledgeable and experienced. Our expertise paired with your diligent efforts to care for your new kidney, increase your likelihood of returning to a normal life.

Signs of Infection and Rejection

The primary concerns for your new kidney involve infection and rejection. Your local physician can handle many problems, such as colds or flu, adjustment of your medications, and minor infections. Learn to watch for signs of infection and rejection that necessitate notifying a local physician or transplant team immediately:

• Fever that continues for more than 2 days
• Shortness of breath
• Cough that produces a yellowish or greenish substance
• Dry cough that continues for more than 1 week
• Prolonged nausea, vomiting, or diarrhea
• Inability to take prescribed medication Rash or other skin changes
• Vaginal discharge or itching
• Burning discomfort with urination
• Exposure to mumps, measles, chicken pox, or shingles
• Unusual weakness or light-headedness
• Emergency-room treatment or hospitalization
• Pain, redness, tenderness or swelling at the incision siteFluid retention/weight gain (2 lbs. in 24 hours)
• Decrease in urine output
• Pain or burning during urination
• Blood in the urine
• Strong odor to the urine
• Feeling urgent need to urinate or need to urinate frequently

Team Utah - Idaho

Once you're well enough, we invite you to join Team Utah Idaho in the Transplant Games of America. The team is made up of transplant recipients and living donors of all organs from throughout Utah and Idaho. Team members have ranged in age from 3 to 70. Grateful athletes with new hearts, kidneys, livers, lungs and pancreases participate in strenuous athletic events to celebrate a new life and prove that organ donation brings a full return to good health.

Before you undergo a transplant, we perform an evaluation to see if you’re an appropriate candidate. Your first clinic visit will begin in the morning with a short orientation and proceed throughout the remainder of the day. In this first visit you will be seen by many of the professionals on our transplant team

• A Transplant Nephrologist: A doctor who specializes in kidney disease and treatment, including dialysis and kidney transplantation. This doctor will determine if you are medically suitable for a transplant or need further tests. The transplant nephrologist will also discuss necessary medications and possible complications after a transplant. 
• A Transplant Surgeon: Will discuss the transplant surgery, associated risks, and the possible complications during and after your transplant.
• A Social Worker: Will meet with you to help you cope with the stress of transplantation and, if needed, follow a rigorous treatment plan after the transplant. The social worker will also help you identify a support network. 
• A Financial Coordinator: Will discuss the costs of a kidney transplant and the medications you will need after the transplant. The financial coordinator will help you understand your insurance coverage and any costs not covered by your insurance. 
• A Transplant Pharmacist: Will provide information about transplant medications, including instructions and side effects.
• A Dietitian: May meet with you as requested by you or your doctor to assess your needs and suggest food choices to best support you before surgery, during your hospital stay, and recovery.

After your first clinic visit, our transplant team will have a clear picture of how to proceed with your transplant work-up.

A majority of our patients will need additional testing to determine their suitability for a transplant surgery. Some of those tests can be done during your initial visit; others can be done at your local hospital.

These pre-transplant tests will help us determine your overall health status and identify potential problems before they occur. These tests also help us decide whether or not transplantation is the best option for you.

• Complete medical and surgical history: Determines additional tests that may need to be done. 
• Physical exam: Gives the doctor an overall picture of your condition(s). 
• Chest x-ray: Determines the health of your lungs and lower respiratory tract.
• Electrocardiogram (EKG or ECG): Determines how well your heart is working and may reveal previously unsuspected heart damage. 
• Ultrasound with Doppler examination: Determines the quality of the iliac vessels.
• Blood tests: Your blood count, blood and tissue type, blood chemistries, and immune system function will all be checked. Blood tests for certain infectious diseases will also be performed. 
• Pulmonary function test: You will breathe into a tube attached to a measuring device, which will reveal how well your lungs are working and determine your blood's capacity to carry oxygen. 
• Upper gastrointestinal (GI) series: This will show whether or not your esophagus and stomach are disease free. 
• Lower GI series: Ensures that you are free of intestinal abnormalities. 
• Renal function studies: Urine may be collected from you for 24 hours in order to determine if the kidneys are working correctly. Blood tests such as serum creatinine are also performed to measure kidney function. 
• Mammogram: X-ray of a woman's breast that can detect signs of breast cancer. 
• Pap smear: Cells collected from a woman's cervix are microscopically analyzed for signs of cancer. 
• Echocardiogram: Reveals any abnormalities in the heart.
• Dental Evaluations: You need to have a dental check-up before you will be listed for transplant. Your dentist must tell us that your teeth and gums are healthy. You will also need to be checked by your dentist every year while you are waiting for your transplant. 
• Other tests: Any special tests or doctor visits that might be needed for the transplant workup.

Histocompatibility Laboratory Tests

• Tissue Typing: This test is done on white blood cells. The white blood cells have special "markers" that tell your "tissue type." You inherit tissue type from your mother and father. This test is used to match a kidney and/or pancreas to you. 
• Panel Reactive Antibody (PRA): This test shows how active your immune system is. It is easier for you to get a kidney if your immune system is calm or measures 0%. Blood will be drawn at your dialysis center and sent to our laboratory. Your immune system may be active from blood transfusions, pregnancy, a previous transplant, or a current infection. 
• Crossmatch Testing: This test is done when a donor kidney is available. Your blood is mixed with the donor's blood. If there is no reaction (negative crossmatch), then you are "compatible" with the donor. If there is a reaction (positive crossmatch), then thekidney will not work for you because it is "incompatible." 
• Other Tests: The transplant doctors will ask for any special tests they think you need. For example, people with diabetes need more tests for their heart. Your transplant coordinator or dialysis doctor can help you make arrangements for these tests.

Clinical Laboratory Tests

• Blood Typing: There are four different blood types: A, B, AB, and O. Every person has one of these blood types. The donor's blood type does not have to be the same but it must be "compatible" with your blood type for you to receive their kidney and/or pancreas. 
• Viral Testing: It is important for us to know if you have been exposed to hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), or acquired immune deficiency syndrome (AIDS). We will test you for these at your clinic appointment.

The Telephone as a Lifeline

As soon as a donor kidney becomes available, the coordinator will call you to get ready. Since this call could come at any time during the day or night, the transplant team should be able to reach you whether you are at home, at school, at work, or on vacation.

Please provide our transplant team with the phone numbers of family members and close friends as well, and do everything you can to make sure that you can be contacted immediately.

When the Phone Call Comes

When that phone call comes, everything will seem like a blur. The coordinator will advise you when to be present at the transplant center. You must move quickly and get to the transplant center without delay. When a kidney becomes available, there is a time limit!

At the Hospital

After admission, you will have a thorough physical examination, including more blood work, a chest x-ray, an EKG, dialysis, and possibly other tests. Unfortunately, surgery must be postponed in some cases. You will be sent home if:

• You have an infection or have developed any other medical problem that would interfere with surgery or recovery
• The donor kidney shows signs of deterioration or poor function
  If surgery is postponed, the transplant team can help you through the disappointment. This is only a temporary setback, and the search for a new kidney will go on.

Transplant Surgery

Prior to entering the operating room, your anesthesiologist will review your medical history with you. Once he or she has completed this review, they will give you some medicine to help you relax. You will then be taken in to the operating room Once you’re asleep, special IVs will be placed to help monitor your status during the surgery. This process takes between 30 and 60 minutes.

After everything has been properly prepared, your surgeon will begin your surgery. The surgery usually lasts between 2 and 3 hours. The surgery is usually performed through an incision close to your hip bone, measuring between 6 and 12 inches in length, depending on your size and the size of the kidney.

26 million Americans, or one in every nine people, are afflicted with Chronic Kidney Disease (CKD). CKD can affect a person at any age but people suffering from diabetes and/or high blood pressure are especially at risk for developing this disease. CKD can progress to the point where the kidneys completely fail, known as End Stage Kidney Disease (ESKD). When this happens a person has two treatment options: dialysis or kidney transplant.

The National Kidney Foundation estimates that about 350,000 people in the United States have end-stage renal disease and about 67,000 people die of kidney failure every year. Since the first kidney transplant in 1967, the success of this procedure has grown to the point that transplant is accepted as the preferred treatment for ESKD over dialysis.

The most common types of kidney disease referred for kidney transplantation are listed below with links to more information:

• Polycystic Kidney Disease (PKD): A genetic kidney disorder that causes cysts to form on the kidneys, which eventually leads to ESKD. 
• Diabetic Nephropathy: Lowered kidney function due to complications from diabetes mellitus. 
• Glomerulonephritis (GN): Damage to glomeruli (filtering capillaries found within the kidneys). 
• Hypertension (HTN) or high blood pressure: Over time, elevated blood pressure can damage the blood vessels in kidneys, causing them to stop filtering the blood.

Educational Resources

• My Transplant Coach: An educational website to help patients understand the options available to those in need of a kidney transplant.

Financial Resources

• National Transplant Assistance Fund: Provides emergency one-time grants for patients that have had a transplant.
• Social Security: Financial assistance for patients who will be disabled for at least a year and have enough “work credits.” SSI and SSDI.
• Cameron Siemers Foundation for Hope: Provides $5000 grant if you are between the ages of 18-28 and have been diagnosed with a life threatening illness, to be used in the fulfillment of a dream, goal, or project that you take on to make a difference.

Medication Assistance

• Rx Outreach: Provides deeply discounted mail order medications; 90 and 180 day supplies for many medications.
• Rx Assist: Quick and easy-to-use database of all medication patient assistance programs. If you have trouble paying for a medication, then you can do a quick search to find out if there might be an assistance program to help.

Kidneys from deceased donors are allocated according to the policy of the United Network for Organ Sharing (UNOS). Factors that contribute to the allocation process include: ABO blood type, antibody levels, and waiting list time. 

If you are accepted as a transplant candidate, your name will be placed on the UNOS waiting list at Intermountain Medical Center. The kidney transplant waiting list is a list of transplant candidates maintained by UNOS. You will begin to build up waiting list time on the day you are listed — you will receive a letter telling you that date. Your nephrologist will monitor your health throughout the time you are on the waiting list. 

The average waiting time for a kidney transplant at Intermountain Medical Center averages just over two years, depending on several different factors:

• ABO blood type: The kidney needs to come from a donor with a compatible blood type. 
• Your antibody level: This measures the strength of antibodies within your system. A high level of antibodies makes it more difficult to find a compatible donor for you.
• The availability of an organ.

When a donor organ becomes available, the transplant coordinator will call you. You will always have the right to decline an organ. If the organ is determined by the surgeon to be unusable, or if there is an incompatible cross match, you will be discharged home without the transplant. 

Certain conditions in the donor may affect the success of your kidney transplant. These include the donor’s history, the condition of the organ when it is received, and the potential risk that you may contract infectious diseases or cancer if the doctor cannot detect them in the donated kidney.