Kidney and pancreas transplants
Expertise and experience that result in better outcomes.
A kidney and/or pancreas transplant can help you get your extraordinary life back by enabling you to return to work and—most importantly—live longer.
When your kidneys are not functioning properly, you have symptoms that require a variety of medicines, a special diet, fluid restrictions and close supervision by your doctor. Chronic kidney disease (CKD), also called renal disease, may also require regular dialysis. A successful kidney transplant can eliminate the need for fluid and diet restrictions, plus the need for dialysis. A kidney transplant can also be done before starting dialysis. You will receive medical care from a team of experts specifically trained to address the special needs of transplant patients:
- We’re continually conducting research to minimize rejection and improve outcomes.
- We’ve made significant technological advancements that have greatly increased the chances of kidney transplant patients to live normal lives.
If your treatment is failing and/or you are at end-stage renal disease, your nephrologist may refer you to UCHealth to see if a kidney transplant is a viable option for you.
When your pancreas doesn’t make enough insulin, blood sugar levels rise to unhealthy levels, causing diabetes. A pancreas transplant is a potential cure for type 1 diabetes that can’t be controlled with standard treatment, but it may also treat type 2 diabetes.
Kidney transplant and pancreas transplant evaluation
First step: evaluation
To become a potential transplant candidate, your first step is to schedule a transplant evaluation with us. Your full-day evaluation appointment includes:
- One-on-one meetings with members of your care team, including the nephrologist, surgeon, nurse coordinator, social worker and financial coordinator.
- A full review of your health history and medical records, along with a physical examination.
- Blood testing that will include blood typing.
- CT scan of your arteries and veins.
- Other tests, such as a chest X-ray to check lung function, an EKG to assess heart function, and possibly a pharmacological stress test.
Before you come to your evaluation appointment, make sure your age-appropriate health screenings are up-to-date (e.g., a colonoscopy for men, or a mammogram and pap smear for women), and you bring copies of the results. We also recommend that you bring a family member or friend to this daylong appointment, as they can help with asking questions and taking notes.
A specific transplant nurse coordinator will be assigned to you, and will be available to you after the evaluation appointment and during your path to transplant.
Multidisciplinary approach to determining kidney and pancreas transplant candidacy
A multidisciplinary review
After you complete all testing and requirements for your evaluation, your case will be presented to the Kidney Pancreas Selection Committee. This committee is made up of our multidisciplinary team that includes transplant doctors, transplant surgeons, nurse coordinators, social workers, transplant pharmacists, financial coordinators, dietitians and others who are involved in kidney and pancreas transplantation. This committee will determine whether transplant surgery is safe for you, and to discuss a plan of care for you after transplant. Your transplant nurse coordinator will inform you of the committee’s decision and plan.
If you are accepted for a kidney and/or pancreas transplant, your name and other key medical information are entered into the United Network for Organ Sharing (UNOS) database and put on the waiting list for a donor kidney and/or pancreas. This national, computerized listing is maintained to ensure fair and equitable distribution of donated organs. Waiting time for a kidney could be several months to years. Living kidney donation is a way to get a transplant kidney faster.
Getting ready for a kidney or pancreas transplant
Staying ready means staying healthy
While you are on the waiting list, stay as healthy and as active as you can. This will make you better prepared for the transplant, and may also help your recovery:
- Take all medications as prescribed.
- Follow your diet and exercise guidelines.
- Don’t smoke.
- Keep all appointments with your health care team.
- Participate in healthy activities, including spending time with family and friends.
As it gets closer to transplant, pack a suitcase for your hospital stay, and make arrangements for transportation.
Kidney and pancreas transplant surgery
Kidney transplant surgery
During kidney transplant surgery, you’ll be under general anesthesia, and your surgical team monitors your heart rate, blood pressure and blood oxygen level. Your transplant surgeon makes an incision in the lower part of one side of your abdomen and places the donated kidney into your body. Your own kidneys are left in place unless they are causing high blood pressure, kidney stones, pain, infection or other complications. Your surgeon attaches the arteries and veins between the donated kidney and your abdomen, and connects the donated kidney’s ureter to your bladder.
There are two types of kidney transplantations:
Deceased donor transplant
A deceased donor transplant uses the kidney of a person who is brain dead or deceased by cardiac death. Once you are accepted as a transplant candidate, your name and information is entered into UNOS. When a kidney match is made, your transplant surgery will be scheduled immediately. The wait for a kidney match is based on many factors, including:
- How long your name has been on the list
- Blood type
- Tissue matching
If you began dialysis before you were listed for a transplant, your waiting time will be calculated from your dialysis date. This has been found to be the most objective and consistent way to measure when your need for a transplant began.
Living donor transplant
More than 40% of all kidney transplant recipients at UCHealth receive their organ from a living donor, eliminating the waiting period for a new kidney, reducing the risk of rejection, and improving overall outcomes. If you are approved for transplant, anyone interested in donating can call to be tested as a donor.
If you have a living donor who is not a match for you due to size or blood type, or you both would like to help more people get transplanted, we have a very active “paired donation” program. Paired donation matches living donor and recipient pairs with another donor and recipient pairs with whom they are good matches and can exchange kidneys. We participate in an internal and national program and conduct several successful transplants each year that have impacted donors and recipients from all over the United States.
Pancreas transplant surgery
There are different types of pancreas transplants, including:
- Pancreas transplant alone, or solitary pancreas transplant.
- Combined kidney-pancreas transplant. For people with diabetes who have or are at risk of kidney failure.
- Pancreas-after-kidney transplant. For those facing an extended wait for both a donor kidney and a donor pancreas to become available, a kidney transplant may be recommended first. Several recipients are able to receive a kidney from a living donor. You would then receive a pancreas transplant once a donor pancreas becomes available.
Complications and risks following kidney or pancreas transplant surgery
- Blood clot
- Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
- Organ failure
- Wound hernia
- Kidney disease returning after transplant
- Heart attack
These anti-rejection drugs suppress your immune system, which makes you more susceptible to infections, particularly in your kidney or pancreas. To help, you should:
- Regularly wash your hands and brush your teeth and gums
- Protect your skin from scratches and sores
- Avoid sick people and crowds
- Get all appropriate vaccinations
Even with the best possible match between you and the donor, your immune system will treat your new kidney and/or pancreas as a foreign body and will try to attack and reject it. This risk is highest immediately after transplant, but will reduce over time. We will put you on immunosuppressant medications to suppress your immune system, which may have side effects, and you will most likely take them for life.
Post-surgical care after a kidney or pancreas transplant
A kidney transplant is not a cure but it often successfully treats kidney disease and allows you to return to a healthy, active lifestyle. Your new donated kidney will filter your blood, and you will no longer need dialysis.
You will stay in the hospital from three days to a week so we can monitor you for complications. We will continue to monitor you closely for a few weeks for kidney function and to make sure your body is not rejecting the donated kidney. You’ll need to take immunosuppressant medication to prevent your body from rejecting your donor kidney. We will perform frequent blood tests, and we may adjust your medications.
As you recover, we will perform frequent checkups. Because immunosuppressants suppress your immune system and make your body more vulnerable to infection, we may also prescribe antibacterial, antiviral and antifungal medications. You must take all your medicines exactly as prescribed—your body may start rejecting your donated kidney if you don’t take your medications even once.