You're Almost There!

This is the big event you've been preparing for: You're ready...your Transplant Team is standing by...and before you know it, you will be on the road to recovery!

If your kidney donor is living, your hospital admission will be scheduled 1 to 4 days before your surgery. You will have plenty of time to prepare for the procedure.

But, if you are receiving a kidney from a deceased donor, you will not have the same luxury-so making plans ahead of time will really pay off!

Be sure to bring the following to the hospital with you:

• A list of all the medications you are taking

• A list of all your drug allergies, if you have any

• Your health insurance information

IMPORTANT: As soon as you learn a kidney is available, stop all eating and drinking immediately.  Your stomach MUST be empty when you are taken into the operating room.

Once You Get to the Hospital...

After admission, you will have a thorough physical examination, including more blood work, another chest x-ray, and another EKG.  You will have dialysis if you need it.  And a final crossmatch will ensure that you and your new kidney are compatible.

Unfortunately, surgery must be postponed in some cases.  You will be sent home again if:

• You have an infection or have developed any other medical problem that would interfere with surgery or recovery.

• Your final crossmatch shows that there is a good chance your new kidney will be rejected by your body

If surgery is postponed, your Transplant Team can help you through the disappointment.  Remember-this is only a temporary setback.  The search for a new kidney will go on, and none of the work you have done so far will be lost.

When Your Team Gives You the Go-Ahead...

An intravenous (IV) tube will be put in place to keep you from getting dehydrated and to increase your flow of urine. The site for your incision will be shaved clean to prevent infection. And you will receive I or more enemas to clean out your intestines and prevent constipation after surgery. You will also be given a sedative to help you relax and feel sleepy before you go to the operating room.

Just think! You will wake up with a brand new kidney and a brand new lease on life.

IMPORTANT: Because transplantation is a major surgical procedure, you may need a transfusion. Today, all blood is screened very carefully; the likelihood of contracting a disease is very small. However, if you are concerned about the source of the blood you will receive, talk to your Transplant Team during the waiting period. DON'T wait until you get to the hospital. Most hospitals offer the option of "autotransfusion"-you donate your own blood before your surgery. Your blood is stored and then used during your transplantation.

The Procedure

You will be under general anesthesia throughout your surgery.

Once you are asleep, your Transplant Surgeon will make an incision, 8" to 10" long and shaped like a hockey stick, just above your groin. The surgical team will then attach the artery and vein of your new kidney to one of your arteries and veins, and they will attach the new kidney's ureter (the tube that carries urine to the bladder) to your bladder. If you still have 1 or both of your own kidneys, they will not be removed.  The procedure should take about 4 hours to complete.

In the Recovery Area...

You will wake up in the recovery room or in the intensive care unit (ICU) after your anesthesia wears off. If you find yourself in the ICU, don't be alarmed. In some hospitals, this is standard procedure.

The is what you can expect:

• You will feel pain and discomfort, but the medication you receive will help to relieve it

• You may or may not feel nauseated from the anesthesia. If you do, it will wear off gradually. Tell your Transplant Nurse, and he or she can help you through this

• You will be asked to cough periodically to keep your lungs clear. If it hurts to cough, ask someone to support your abdomen and back with his or her hands or a pillow

• You may have a tube in your throat to help you breathe, but it will be removed when you can breathe on your own. Your throat may feel sore or scratchy for a few days afterward.

• You may have an IV line in your arm, so you can get fluids and medication for the first few days after surgery

• A catheter inserted near your collar bone or in your neck will help your Transplant Team keep an eye on your fluid levels. These lines will come out anywhere from 3 to 14 days after your surgery

• You will also have a catheter in your bladder to help you pass urine. It may feel uncomfortable, and you may feel that you have to urinate constantly. But you will only have to tolerate it for a few days.

• If you don't produce urine right away after surgery, you may need dialysis for a short time.  Do not regard this as a setback or complication; the transplanted kidney can be temporarily "in shock" for a few days but then becomes fully functional

The length of your hospital stay will depend on your progress. Barring complications, you could be released in a short time.

Remember that procedures vary slightly from hospital to hospital. If you feel uneasy about anything that is happening to you, talk to someone on your Transplant Team.  They care-and they're committed to making you feel as comfortable as possible until you go home again.