Specialties

  • Kidney Transplant FAQ & Liver Transplant FAQ

  • Yes! On average, transplant patients live about 10 years longer than similar patients who stay on dialysis.
    Dialysis is an excellent treatment for kidney disease, but even the best dialysis gives you only about 10-20% of your normal kidney function. At this level of kidney function you are at high risk for heart attacks, infections, and nerve damage. For example, a 20 year-old dialysis patient has the same chance of having a heart attack as an 80 year-old non-dialysis patient.
    Both the National Kidney Foundation and the American Society of Nephrology recommend that just about all patients with chronic kidney disease should receive a transplant rather than dialysis.
    If you are a type 1 diabetic (juvenile onset) and are younger than about 50, you will likely benefit from a pancreas transplant in addition to your kidney transplant.
    Just about anyone can get a transplant. The only things that would prevent you from getting a transplant are cancer within the last 2 years, the inability to take medicines and keep your appointments, or some types of chronic infection. Patients with heart disease can still get a transplant, although this should be discussed with the transplant team. If you are very overweight you will need to lose some weight prior to your surgery.
    There is no age cutoff for transplant. We will evaluate anyone, regardless of age. Of course the older you are, the more risky the surgery, so if you are older than 75 we will talk about whether transplant is the best option or not.
    Unfortunately, yes. In order to prevent rejection, you will need to take about 15-20 pills a day, and they all have side effects. We will work with you to minimize these side effects, but in some cases you will have to learn to live with them. We will review all possible side effects before your transplant. Also, there is a small risk of adverse events associated with the transplant surgery itself.
    Rejection is when your immune system attacks your new kidney. Even with the medicine you take, rejection may occur. Rejection rarely causes the kidney to fail completely, but does usually require treatment in the hospital.
    The most important thing you can do to prevent rejection is to always take your medicine on time and to get your labs drawn as instructed. You will have blood work everyday for a week or two after your transplant, and at least four times a year for life.
    Unlikely. The average time a kidney lasts in your body is 12 years, with a typical range from 5-20 years. If you lose your kidney, you can get another transplant.
    In the old days, it was important for your kidney to have a similar tissue type as your own. Now that is no longer the case, a kidney can be completely unlike the rest of you and it will still work. You do, however, have to have a compatible blood type.
    If your blood type is A, your donor's blood type must be A or O. If you're B, you need B or O. If you're O, you need O. If you're AB you can accept A, B, AB, or O. Positive and negative does not matter.
    Yes. If a living person can give you a kidney it will likely last longer and work better. If you don't have a living donor, you can get a deceased donor kidney. These kidneys work well but not as well as a living kidney.
    Just about anyone: a friend, spouse, relative, etc. We will evaluate a donor in our clinic and determine if they are healthy enough to donate to you and have a compatible blood type.
    Not only will you be off insulin and on a much less restricted diet, but you will not develop any further complications of diabetes. Also your kidney will likely last longer, as it will not get damaged by diabetes.
    The surgery is bigger and more complicated. Also, you will need higher doses of medications.
    Only a deceased donor can give you a pancreas. You can get a kidney and pancreas from the same deceased donor, or you can get a kidney from a living donor and later get a pancreas from a different, deceased donor.
    The new kidney goes into your pelvis, usually on the right side. It will be on the side of your abdomen, a little lower than your bellybutton. Your own kidneys are not removed, they stay where they are.
    The surgery takes about 3-4 hours.
    Well, it depends on what you mean by “big." The incision is about 8-12 inches long.
    Most patients are eating and out of bed within 12-24 hours of surgery. The average time before going home is 5 days.
    We will prescribe appropriate medicine to control your pain, both in the hospital and after you leave.
    We put that in the middle of your abdomen; the scar will run up and down next to your bellybutton.
    No, if you get a pancreas after a kidney or a pancreas and kidney together the surgery is longer and more involved. Expect to be in the hospital for 1-2 weeks.
    As with any surgery, there are risks. Anytime you go to sleep for surgery there is the risk of death. Also, if you have heart disease, you will be at increased risk for heart attack for up to 4 months after the surgery. All risks will be carefully explained to you well before the surgery.
    If you have a living donor, we will remove his or her kidney laparoscopically. This allows for very small (about 4 inch) incisions and a faster recovery time.
    Most donors have little pain and generally go home within 48 hours of the surgery.
    We carefully evaluate all potential donors and will not allow them to donate if there is a risk of kidney failure after the surgery. Nationwide, donors do not have any higher risk for kidney failure than the general population.
    If you have a catheter we will remove it either at the time of or shortly after transplant. If you have a fistula or graft we will leave it alone unless it's bothering you.
    The list is a collection of names of patients waiting for a kidney transplant. When a kidney becomes available, a computer looks at everyone in the area waiting for a kidney and uses a complex formula to determine who should get the kidney. Waiting time is the most important factor, but there are others. Thus it is possible you will get your kidney before someone who has been waiting longer than you, and vice versa.
    This is very difficult to predict, as there are so many factors that are taken into account when assigning a kidney to a recipient. The average waiting time in our area is about 2 years, nationwide it is about 3 years. In some parts of the country it is about 4 years.
    The list is run by the United Network of Organ Sharing, a federal agency. There are very strict requirements for allocating organs. The only way you can get one sooner is if you find a living donor.
    While you are waiting for your organ, it is very important to try to stay healthy. If you are as healthy as possible the chances of success are much higher. Also, if you are too ill, you may not be able to get your kidney at all when you are called. It is also very important to keep your transplant team up-to-date on your health status. We don't like surprises! For this reason we will see you every year while you are waiting for your organ. If you have any changes in your medications or health status in between visits you should call your coordinator.
    You will receive a call when you have an organ offer. It is important that we can get in touch with you at any time. Some patients find it a good idea to get a beeper. Once we call you, you should be able to get to the hospital within about 6 hours. If we can't find you in a few hours, we will decline the offer and give the kidney to the next person.
    We will begin to teach you about your medicines the day you have your surgery. A nurse coordinator from the transplant department will work with you while you are in the hospital to make sure you know how to take your medicine. We will give you a book designed just for you that lists all your medicine and when to take them. We will NOT let you leave the hospital until you are 100% clear on how to take your medicine. After you leave you can call with any questions, and we will go over everything again when we see you in clinic.
    For the first month after transplant we will see you twice per week. This is important so we can make sure everything is going well. After that, you will mostly see your own nephrologist, about once per week for a month, then every other week, then once per month for the first year. After a year you can just come in every 6 months.
    If you forget to take a medication, please do not panic. You should call your nurse right away and he or she will tell you what to do. Never double-up on your medicine if you miss a dose!
    You will get your blood tests everyday for a week or two, then twice a week for a few months, then once per week until 6 months after your transplant, then every other week. After a year you can get them just once per month. In some cases, after several years, you can go down to 4 times per year.
    Generally you will get them here at Porter. However, if it is more convenient, we can arrange to have them done just about anywhere.
    Most patients do not return to the hospital other than for clinic visits once they are discharged. However, about 1 out of 3 patients will have to be admitted for complications such as infection, rejection, or surgical complications within the first year after transplant. After the first year it is very rare to have to be admitted.
    We will discuss a transportation plan with you prior to being placed on the list. If you live a long way from Denver you may want to fly here. Many major airlines offer discounts for medical emergencies. There are also other options that we can discuss at your visit.
    Yes! Most patients return to work full time about two months after transplant if they wish to. There are no restrictions on working after transplant.
    We will carefully evaluate your emotional and psychological health prior to your transplant. If necessary we can refer you to a transplant psychiatrist before and/or after your transplant.
    Yes! Several of our transplant patients have volunteered to be mentors. If you request it, we will assign you a mentor who can talk to you as much as you like before and after your transplant. We also provide transplant support groups for all pre- and post-transplant patients.  Learn more by calling 303-765-6956.
    Yes! The idea of a transplant is to lead a more, not less, active life. There are no restrictions on activity once you are healed after transplant. If you play contact sports we will ask you to wear an abdominal protector to prevent injury to the kidney.
    Most transplant patients find their sex life improves significantly after transplant. If you take Viagra or a similar medicine you can still take it after transplant. None of the anti-rejection medications are known to cause impotence. The only limit on sexual function after transplant is your own imagination. Sexually transmitted diseases can be devastating to a transplant patient, so you will still need to practice safe sex.
    If you are a man, you may become a father after transplant, although the risks of birth defects are slightly higher. Pregnancy is risky after transplant but in the majority of cases mom, baby, and kidney all do very well. Therefore it is reasonable to try to become pregnant after transplant, as long as you understand it is more risky than before your transplant. As unplanned pregnancies can be a big problem, we will ask you to use contraception until you decide you want to try to have a baby and if you think you may be pregnant you will need to tell us right away.
    No. Tobacco in any form is very bad for your kidney and your general health. If you smoke we will help you to quit before your transplant.
    Uhh, no. Not only are these substances bad for your kidney, but they may interact in unpredictable ways with your medications. Furthermore, being in jail makes it hard to keep your clinic appointments!
    We use body mass index (BMI) to determine if you are too heavy for a transplant. If your BMI is greater than 35 you will not be able to get a transplant until you lose weight. If your BMI is less than 40, you can be on the list gaining waiting time while you are losing weight. You will have to have a BMI less than 42 to be evaluated. To determine your BMI click here: BMI calculator from the CDC
    A BMI less than 30 is necessary to be a kidney donor.
    If you need to lose weight, our transplant dietitian will customize a meal plan based on your individual needs and goals.
    One of the nicest things about transplant is that the diet is much less restrictive than the dialysis diet. Typically, potassium and phosphorus no longer need to be limited. It will be important to eat a sensible, healthy diet and continue to limit sodium. If you are diabetic, you will need to continue your diabetic diet unless you get a pancreas transplant.
    After your transplant you will no longer be on a fluid restriction. In fact, we will encourage you to drink about 2 quarts of water per day.
    One to two drinks a day is permissible. A drink is one 12 oz beer, 4 ozs of wine, or 1.5 ozs of spirits. Alcohol must be consumed in moderation and even if you don't drink on a regular basis, it is not alright to have more than two drinks on any occasion. For example, it is not ok to wait until Saturday and then have 14 drinks.
    Please do not take any over-the-counter medicines or supplements without talking to the transplant team. Many of these substances can interact with your medications and cause a rejection. Just because you don't need a prescription doesn't mean it's safe.
    The average patient gains from 5-10 lbs after transplant. Some of this is due to the steroids you have to take, but most of it is because you’ll feel better and eat more. A healthy lifestyle including exercise and a sensible diet is the best way to prevent this.
    The transplant financial coordinator is a trained professional who counsels patients and families. Questions pertaining to insurance benefits, authorizations, and insurance case management follow-up will be answered for you. The financial coordinator will also follow the insurance company claim process and payment in a timely manner.
    The vast majority of the costs will be covered by your insurance. Your biggest out-of-pocket expenses are usually for medications, which can run up to several hundred dollars per month. We can answer this in more detail when you come in for your visit.
    It is very, very rare that a patient can't receive a transplant for financial reasons. There are a variety of community resources available to help with the costs of transplant. We can discuss this in further detail at the time of your transplant.
    A Medicare covered kidney transplant will be paid at 80%. You will be responsible for 20%. Anyone in need of a kidney transplant will automatically qualify for Medicare. A Medicare covered kidney transplant will pay for most of your medical cost for a period of 36 months. If you have Medicare only we will discuss with you the various Medicare supplemental plans available to help pay for the medications, co-insurance and deductibles.
    In almost all cases, your insurance will cover any tests, clinic visits, and surgery for your donor. It is not necessary for a donor to have insurance.
    A subspecialist in liver disease.  The hepatologists in our program are board-certified in both gastroenterology and hepatology.  They also perform procedures in the GI lab related to liver disease.

    Both the National Kidney Foundation and the American Society of Nephrology favor transplantation over dialysis for most people with chronic kidney disease. A living donor kidney lasts, on average, 13 to 15 years, and a deceased donor kidney from 8 to 12 years.Patients who get a kidney transplant before dialysis live an average of 10 to 15 years longer than if they stayed on dialysis.It is best to receive the transplant as soon as possible after you are actively listed on the transplant list. Research indicates that the shorter time you are on dialysis the better the outcome will be for your transplanted kidney.Although kidney transplantation offers many benefits, it does have some limitations and risks. It is not always the right treatment option for everyone. These limitations include:

    • The uncertainty of success (the transplanted kidney may fail)
    • The risk of surgery
    • The need for close follow-up appointments at the doctor's office
    • Possible hospitalizations
    • Possible organ rejection

    Dialysis is an excellent treatment for kidney disease, but even the best dialysis gives you only about 10 percent to 20 percent of your normal kidney function. At this level of kidney function, you are at high risk for heart attacks, infections, and nerve damage. For example, a 20-year-old dialysis patient has the same chance of having a heart attack as an 80-year-old non-dialysis patient. Also because of its impact on the body, dialysis can cause other serious health concerns including:

    • Anemia
    • Bone disease
    • High blood pressure
    • Heart disease
    • Infection
    • Nerve damage
    Yes! In fact, people who have preemptive transplants are generally healthier after transplant than those who wait for a kidney while on dialysis.
    If you have Type I Diabetes (juvenile onset) and are younger than age 50, you may benefit from a pancreas transplant in addition to your kidney transplant. Not only will you be off insulin and on a much less restricted diet, but you will likely not develop any further complications of diabetes. Also, your kidney will likely last longer, as it will not get damaged by diabetes. A pancreas surgery is more complicated than a kidney transplant. Only a deceased donor can give you a pancreas. You can get a kidney and pancreas from the same deceased donor, or you can get a kidney from a living donor and later get a pancreas from a different, deceased donor.
    The best way to determine if you are a transplant candidate is to ask your nephrologist. Sometimes conditions prevent you from getting a transplant, including: cancer within the last two years, the inability to take medicines and keep your appointments, or some types of chronic infection. Patients with heart disease can still get a transplant, although this should be discussed with the transplant team. Transplant recipients need to be at a Body Mass Index of less than 30. Calculate your BMI. At Porter Transplant there is no age cutoff for transplant. We will be happy to evaluate you regardless of age.
    The average time a transplanted kidney lasts in your body is 12 years, with a typical range from 5-20 years. Living donor kidneys last several years longer, on average, than kidneys from cadavers. If your kidney fails, you will need to be re-evaluated for another transplant.

    "We will perform several tests, including blood typing to make sure your donor is a match.

    If your blood type is

    Your donor's blood type must be:

    O

    O

    A

    O or A

    B

    O or B

    AB

    O, A, B, or AB

    Positive and negative does not matter."

    The transplant wait list is managed by the United Network of Organ Sharing, a federal agency. There are very strict requirements for allocating organs. The only way you can get one sooner is if you find a living donor.
    While you are waiting for your organ, it is important to try to stay healthy. If you are as healthy as possible the chances of success are much higher. If you get sick or have an infection you may not be able to get your kidney when you are called. It is also very important to keep your transplant team up-to-date on your health status. For this reason, we will see you every year while you are waiting for your organ. If you have any changes in your medications or health status in between visits you should call your coordinator.You will receive a call when you have an organ offer. We will need to be able to get in touch with you at any time. Once we call, you should be able to get to the hospital within about six hours. If we can't find you in a few hours, we will decline the offer and give the kidney to the next person.
    Rejection is when your immune system attacks your new kidney. Even with the medicine you take, rejection may occur. Rejection rarely causes the kidney to fail completely, but does usually require treatment in the hospital. The most important thing you can do to prevent rejection is to always take your medicine on time and to get your labs drawn as instructed. You will have blood work every day for a week or two after your transplant, and at least four times a year for life.
    We will begin to teach you about your medicines the day you have your surgery. A nurse coordinator from the transplant department will work with you while you are in the hospital to make sure you know how to take your medicine. We will give you a book designed just for you that lists all your medicine and when to take them. We will NOT let you leave the hospital until you are 100 percent clear on how to take your medicine. After you leave, you can call with any questions, and we will go over everything again when we see you in clinic. If you forget to take a medication, please do not panic. You should call your nurse right away and he or she will tell you what to do. Never double-up on your medicine if you miss a dose!
    For the first month after transplant we will see you two to three times per week. This is important so we can make sure everything is going well. After that, the frequency of your office visits decreases to about once per week for a month, then every other week, then once per month for the first year. After a year, you can just come in every six months with close follow-up with your primary nephrologist.
    One of the nicest things about transplant is that the diet is much less restrictive than the dialysis diet. Typically, potassium, and phosphorus no longer need to be limited. It will be important to eat a sensible, healthy diet and continue to limit sodium. If you have diabetes, you will need to continue your diabetic diet unless you get a pancreas transplant.
    The majority of the costs will be covered by your insurance. Your biggest out-of-pocket expenses are usually for medications, which can run up to several hundred dollars per month. We can answer this in more detail when you come in for your visit. For example, a Medicare-covered kidney transplant will be paid at 80 percent. You would be responsible for 20 percent.
    At the Transplant Center at Porter Adventist Hospital, more than half of our kidney transplants are from living donors. You do not need to be a blood relative to be a donor; we have friends, family and sometimes strangers donate to others in need. All of our living donors go through an extensive evaluation to make sure that they are healthy enough to donate. Learn more about living donation
    Our one year and three year patient survival is 95.4% and 87.4% respectively, which is comparable to the national average, and slightly higher than the expected survival based on our patient population. Our one year and three year graft survival is 89.9% and 85.4%, respectively. So 9 out of 10 transplants work for at least one year, and 17 out of 20 for three years.
    Our average is 60 per year.
    No. As a non-academic program, all our physicians are board-certified in their specialties.
    We are well aware of our patients' reluctance to take steroids after transplant. However, with the low doses we currently use, steroid-related side effects are minimal. If you have had problems with steroids in the past, or are particularly scared of taking them, we can do your transplant without using steroids, although it is likely your kidney won't last as long.
    It is illegal to buy or sell a kidney in the United States. This refers not just to money but to goods, services, etc. However, it is OK to pay for a donor’s expenses associated with donating, including travel, hotel, and lost wages.
    Talk to your nephrologist and ask her or him to refer you to our program for transplant.
    Have them call us at 303-778-5797 or 1-888-872-8891 toll-free and say they want to be a donor.
    Now! It is never too late to start the process. You can be on the list before you start dialysis, and can therefore get a transplant rather than starting dialysis, especially if you have a living donor.
    Our financial coordinator will assess your situation with you.  Every insurance company is different and has unique requirements and benefits for transplant.  If you are underinsured we will provide guidance on other options to obtain adequate coverage.  Some of those options may include Cover Colorado which can provide coverage for those with a preexisting condition, or who do not qualify for Medicare or Medicaid.
    If a member of the multidisciplinary team cannot address your questions while you are here, feel free to call Alan Qualls, Director of Transplant Services, at 303-765-6917.
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