In 1966, UF College of Medicine surgeons performed Florida’s first kidney transplant, marking the beginning of the UF Health Shands Transplant Center. Since then, our Kidney Transplant Program team has transplanted more than 4,700 patients with end-stage renal disease. Currently, 100,000 people are on the kidney transplant organ donor waiting list in the U.S. The rate of transplant at our center is significantly higher than the national average, which allows our patients to receive a transplant sooner and enjoy an enhanced quality of life.
WHAT DO KIDNEYS DO?
The kidneys are a pair of bean-shaped organs, each about the size of a fist, that lie in the abdomen close to the back. Most people have two, but it’s possible to live with one. They remove waste and extra fluid from the body, regulate blood pressure and assist with production of red blood cells. Kidney failure, also called end-stage renal disease, occurs when someone loses 90 percent of his or her kidney function and is often caused by diabetes or high blood pressure. When the kidneys no longer function adequately, renal replacement therapy is necessary through dialysis treatment or kidney transplantation. During transplantation, the recipient only requires one new kidney to sustain kidney function.
After a referral submission, the team reviews the patient’s medical history to determine the need for transplantation. If a transplant is required, the team schedules evaluation and testing.
During the initial transplant evaluation, the patient attends a pretransplant education class, completes medical tests and interviews with a team that includes a pre- and posttransplant coordinator, transplant surgeon, transplant nephrologist, financial counselor and social worker.
The team’s Medical Review Board reviews the patient case within two weeks of evaluation. The board includes everyone who participated in the evaluation and other integral team members. During review, the board decides whether the patient is accepted for transplant, requires additional testing or is denied due to risk factors.
Identifying a Donor
Kidneys are donated from a living or deceased donor. Candidates are encouraged to find a living donor to enable shorter wait times and better outcomes. A living donor can be a relative or a person not related by blood. For deceased donor kidneys, specific criteria determine the best patient/donor match.
Transplant Waiting List
Once accepted, the patient is placed on the United Network for Organ Sharing waiting list. If the patient isn’t scheduled for a living donor transplant, he or she is offered a deceased donated kidney. This can lengthen the wait time for up to six years, depending on availability and severity of the patient’s medical condition. The transplant coordinator and social worker ensure the patient stays as healthy as possible and has support during this time.
For a living donor transplant, a surgery time is coordinated between the patient and donor. For a deceased donor transplant, time is limited: When a kidney becomes available, the patient is taken to the OR for presurgical preparation and transplantation, which typically lasts four to five hours.
The average stay following a kidney transplant is five to seven days, during which the care team focuses on recovery and on medication adjustments. The patient and his or her support person learn how to care for the new kidney by managing medications and making positive lifestyle adjustments. A posttransplant coordinator and transplant nephrologist are assigned to help the patient throughout postsurgical care.
Before discharge, the patient receives instructions on posttransplant clinic appointments and follow-up care. After discharge, the patient meets with his or her surgeon and nephrologist to complete lab work, track progress and identify potential issues. Frequent clinic visits occur within the first few months and regular care follows. Most kidney transplant recipients have an average kidney function of 12.5 years for a living transplant and 8-12 years for a deceased donor kidney.