Surgery

You can call (800) 749-7424 ext 5-0254 to make a referral to the kidney transplant program at the Shands Transplant Center at the University of Florida.

In order to prepare for the kidney transplant surgery, it is in your best interest to complete all tests and dental work as soon as possible. Once the transplant team has a full picture of your current health status, they will proceed with plans for your transplant. The waiting period for a well-matched cadaveric kidney may take several months or years, depending on your blood type, your transplant antigens and your antibody level.

Kidney removal

Sometimes kidneys are removed if there is uncontrollable high blood pressure, infection, excessive protein loss and congenital problems. These conditions can create problems after a transplant. The transplant doctor can tell you whether or not your kidneys will have to be removed.

Hospitalization

The kidney recipients usually stay about 4 to 6 days, or longer if necessary. During this time, your medications will be regulated, and you will be closely watched for signs of rejection and infection. You will also be given information on how to care for your new kidney.

After the surgery, you can expect the following equipment and medication:

A Foley catheter is used to drain urine from your bladder. It will be in place for several days.

Two intravenous (IV) lines are placed to provide you with fluid and your medications during and after the surgery. You will have one or more IVs for 2-3 days until you are eating and able to take your medicines by mouth.

A Jackson-Pratt (JP) drain is sometimes used to drain blood and lymph fluid from around the transplanted kidney. If you have a JP drain, it will remain in your side near your incision until the drainage each day is minimal.

A stent may be placed in your ureter during the transplant surgery. If you have a stent, it will need to be removed several weeks after the transplant. You will be scheduled for stent removal by the Urology service as an outpatient.

Laboratory tests will be done on your blood. Your blood will be drawn every morning to help the medical staff know how well your transplanted kidney is working. The blood results will help guide the staff in adjusting your medication. Laboratory values also help to predict if a rejection might be starting.

The following tests are checked daily while you are in the hospital and periodically after discharge. Your laboratory results may fall outside the normal ranges listed below in the first weeks after your transplant. It will take time for your new kidney to function at full capacity.

Blood Urea Nitrogen Creatinine (BUN Cr)
Normal range: BUN = 10 - 20 MG/DL, Cr = 0.4 - 1.1 MG/DL
Both BUN and creatinine are waste products that are removed from the blood by the kidneys. When the kidneys are not working, the BUN and creatinine stay in the body and the blood levels become increased.

White Blood Cell Count (WBC)
Normal range: 4,500 - 11,000 THOU/CU MM
The WBC count is the total number of white blood cells in the blood. The white blood cells help to fight infection. Imuran, one of the drugs that helps to prevent rejection, may lower the WBC.

Hematocrit (HCT)
Normal range: 36 - 46%
The hematocrit is a measure of the red blood cells in the blood stream. Red blood cells are needed to carry oxygen to all parts of your body.

Cyclosporine Level (CsA)
Normal range: Initial range = 250 - 350. Range after first month = 150 - 250 NG/ML
This test measures the level of cyclosporine in the blood. The cyclosporine level will determine the cyclosporine dose best for you.

Phosphorous (PO4)
Normal range: 2.5 - 4.6 MG/DL
Newly transplanted kidneys may spill too much phosphorus into the urine causing a low phosphorous level.

Magnesium (Mg)
Normal range: 1.8 - 2.8 MG/DL
Cyclosporine often causes a low magnesium level.

Other blood tests will be drawn at certain times to check such things as your liver and exposure to certain viruses. Urine cultures will be checked every so often for infection. Sometimes you will be asked to bring a 24-hour urine collection to clinic to help in the understanding of how well your transplanted kidney is working.

Intake and Output (I & O): While in the hospital, you will be expected to keep your own I & O records. This means measuring and recording how much you drink and urinate every day. This record, along with your daily weight, helps the medical staff to understand how well the transplanted kidney is working. The nurses will teach you how to measure and record your I & O while you are in the hospital. Drainage from your Foley catheter and JP drain will need to be included in your daily output. If you empty your Foley or JP drain, be sure to write the amounts on your I & O sheet. It will not be necessary for you to measure your I & O once you go home, unless you are specifically asked to do so.

Diet - You will be allowed nothing by mouth until your intestines "wake up" from anesthesia. We will want to hear your stomach making noises and know that you are beginning to pass gas before we let you drink and eat. Alert the medical staff if you begin to feel bloated or develop nausea and vomiting.

Activity - The nurses will help you to get up in a chair the day after your surgery. On the days to follow, you will be expected to be more physically active in preparation for your return home. We encourage you to walk laps around the Transplant Unit. When you are up to it, you may take the elevator downstairs and walk around the medical center. Be sure to check with your nurse before leaving the floor.

Education about your new lifestyle and kidney is important. Consider every day to be a learning experience. You will be given a medication sheet to help you learn the names of your medicines, dosages, and schedule for taking your medicines. You will be given a copy of your laboratory results each day that you are in the hospital or in the Transplant Clinic. The nurses will explain what the various laboratory values mean.

After the transplant

To make sure that you are comfortable with all the new information you have learned, you will be taking several tests on the new medications and the instructions you have received on how to take care or your transplanted kidney.

We encourage those of you who are transplanted with cadaveric kidneys to take the time to write thank you letters to the donor family and donor support team. We will take care of sending your letters to the appropriate groups.

Statistics
Success rate and various other statistics regarding the Shands Transplant Center at UF are available from the Scientific Registry of Transplant Recipients at ustransplant.org.

Information
If you have any questions about the kidney transplantation program at the Shands Transplant Center at the University of Florida, call (352) 265-0254.

Transplant Navigation

Heart and Lung Transplant

Kidney Transplant Navigation

Discharge after transplantation

Make an Appointment

To make an appointment or find out more information about transplant services offered at Shands at the University of Florida, please call 352.265.8000 or toll-free 1.800.749.7424

You may also email our Consultation Center (consult@shands.ufl.edu) or use our secure online form.