Transplant Recipient Surgery
Hear from Kenneth, a patient who received a kidney transplant while being cared for by Presbyterian Transplant Services, as he describes his gratefulness to his donor and describes how organ donation can give waiting patients a second chance at life.
Types of Transplant Surgery
Kidney Transplant Surgery
We offer two types of kidney transplants:
Deceased Donor Kidney Transplant In deceased donor kidney transplantation, the kidney is harvested from someone who has recently died. Deceased donors may give this gift of their kidney by using a donor card filled out prior to their death, or by the consent of their family after they have died.
Living Donor Kidney Transplant In living kidney transplantation, the donor has one of their two kidneys removed and this kidney is then transplanted into the recipient. This surgery is also called a nephrectomy (or kidney removal surgery). The living donor will continue to live a healthy life with their remaining kidney in place. If you are a patient awaiting a kidney donor, please visit Transplant Strong for more information on finding a kidney donor.
Simultaneous Pancreas and Kidney Transplant (SPK)
In this operation, both a kidney and pancreas will be transplanted into the recipient. This type of transplant is performed in cases where the recipient has kidney failure related to type 1 diabetes. This type of transplant uses organs from a donor who has recently died.
Pancreas After Kidney Transplant (PAK)
This is a 2-step transplant process. It may be used for those patients who are facing a long wait for a combined simultaneous pancreas and kidney transplant. A kidney transplant will be performed first, once a matching deceased-donor or living-donor kidney has become available. After recovery from this transplant, a second surgery will be performed for a pancreas transplant once an appropriate organ becomes available.
Pancreas Alone (PA)
For patients with diabetes and early stage or no kidney disease, a solitary (or pancreas alone) transplant may be recommended without a kidney transplant. For this surgery, a healthy pancreas from a deceased donor will be transplanted into the recipient.
Getting started/how does the transplant process work?
Your transplant team will coordinate the entire transplant process, and help walk you through it every step of the way. Here is a step-by-step description of the process:
Referral: Before anything else, you will have a 30-minute conversation with a member of the transplant team. We’ll go over your demographic information, insurance information and detailed medical information about the cause of your kidney failure and/or diabetes. At the end of the interview, we will schedule your orientation class, and we will mail you a packet of additional information about transplantation. Part of the packet is a background information form and a new patient intake information form. You can also download and print these forms below to fill out and mail back to us.Recipient Intake Form for New PatientsBackground Information Form for New Patients
It is very important that we receive these completed forms back from you before your orientation class. This will help us gather information we need from your healthcare providers and speed up the process.
Orientation: The orientation class will give you and your family, as well as potential donors a general overview of the kidney and kidney/pancreas transplant process. It will also provide you a chance to ask any questions you may have and give informed consent for transplant. This class is required before you can be scheduled for your initial evaluation. The class will last two and a half hours.
Initial Evaluation: Your initial evaluation with the transplant coordinator, social worker and nephrologist (kidney doctor) will take approximately four hours. You will have lab work and a chest X-ray done. The nephrologist and transplant coordinator will review your medical history to see what other types of medical tests you need to have and help your doctor see if you are healthy enough to have a transplant. During this evaluation, let your coordinator know if you have any friends or loved ones (living donors) who may be willing and healthy enough to share a kidney with you.Evaluation Test List
Surgical Evaluation: You will meet with the transplant surgeon, who will review the test results from your initial evaluation, as well as your medical history. The surgeon will also go over the risks and benefits to your health if you are able to have the surgery. This evaluation will take about 30 minutes.
Transplant Selection Committee: The transplant selection committee includes transplant nephrologists, transplant surgeons, transplant coordinators, social workers, pharmacists and a financial coordinator. This team will discuss your case and review the results of your initial and surgical evaluations, your blood work and other medical tests, as well as the information provided on your recipient intake and background information form. This committee will decide if a transplant is a safe treatment option for you and if you should be placed on the waiting list for an organ from a deceased donor. Once a decision is made, your transplant coordinator will call and let you know the decision. You will also receive an official letter with the committee’s decision.
Listing: Once you are placed on the deceased donor list, it may take several years before you are called for your transplant surgery. While you are waiting, it is important to make sure you stay healthy and keep up to date on any required medical testing. The following items will help you stay ready for your transplant:
Compliance: Make sure you follow your doctor’s instructions for your dialysis, diet, medications and testing. We want to make sure all of these things are up to date when you are called in with an organ offer.
Keep in Touch: Let your transplant coordinator know right away if your health changes in any way. If your phone number or address changes or if you are traveling out of state, let us know as soon as possible.
Functional Status: Stay active! Please keep doing your best to maintain your physical fitness before your transplant. It is important to be in good shape before your transplant so that you will recover well.
Sunscreen: Start wearing sunscreen every day, even in the winter. New Mexico is bright and sunny year-round, and this may cause skin cancer. When you start the medications you need after your transplant, you may be more likely to develop skin cancer, so it is important to start protecting yourself from the sun now.
Each year that you wait for your transplant surgery, you may need to have the following tests and/or appointments to maintain your status.
Nephrology Appointments: You will need to come to the clinic to see the transplant team from time to time. The transplant selection committee will decide how often you need to be seen, but it may be once every six months or up to once every two years. These appointments will be scheduled by your transplant coordinator. It is important to also keep your transplant coordinator updated about any new medical issues while you are on the transplant list.
Surgical Appointments: You may need to see the transplant surgeon. This will also be decided by the transplant selection committee based on your specific case. Your transplant coordinator will help you schedule this appointment as needed. It is also important to notify your transplant coordinator if you have any other surgeries while you are on the transplant list.
Cardiology Appointments: Your transplant coordinator will help you schedule a visit to your cardiologist for an updated assessment. Your cardiologist and the transplant selection committee will decide how often you need to be seen, but it may be once every six months or up to once every two years.
Chest X-ray: Your transplant coordinator will help you plan and schedule this once a year.
Lab Work: The transplant team will decide what lab work you should have each year.
Mammogram: All women over 40 years old must have a mammogram every year.
Colonoscopy: All patients over 50 years old must have a colonoscopy as recommended by their gastroenterologist. A repeat colonoscopy is based on the gastroenterologist’s recommendations after your first colonoscopy.
Presbyterian Transplant Services offers three types of transplants: Kidney transplant surgery, simultaneous pancreas and kidney transplant surgery, and pancreas transplant surgery either after kidney transplant or on its own.
What to Expect During Kidney Transplant Surgery: During surgery, you will be given general anesthesia and placed on a ventilator to help control your breathing. Your surgeon will make a long incision in your lower abdomen on one side. The donor kidney will be placed in your lower abdomen, on either the left or right side. The renal artery and vein are will be attached to your iliac vessels to provide blood flow to the kidney. The donor ureter (the tube that drains urine from the kidney) will be connected to the bladder. Your incision will then be closed with stitches or surgical staples. Your surgeon will place a drain in your incision site to help reduce swelling and a Foley catheter will be placed to help drain the urine in the bladder. The kidney transplant surgery takes about three to four hours, but this can be different for every patient.
What to Expect During Pancreas Transplant Surgery:
Simultaneous Pancreas and Kidney Transplant (SPK): During surgery, you will be given general anesthesia and placed on a ventilator to help control your breathing. Your surgeon will make an incision in your middle and lower abdomen. Usually, the kidney and pancreas will come from the same donor and be transplanted together. The donor kidney will be placed on the lower side of your abdomen, where it will be surgically connected to blood vessels and the bladder. The new pancreas is then placed on the lower side of the abdomen, where it is also surgically connected to nearby blood vessels. Once all connections have been made, the incision is closed. The kidney/pancreas transplant surgery takes approximately five to seven hours to complete, but this can be different for every patient.
Pancreas After Kidney Transplant or Pancreas Alone (PAK or PA): During surgery, you will be given general anesthesia and placed on a ventilator to help control your breathing. Your surgeon will make an incision in your lower abdomen. Your diseased pancreas will not be removed during this operation. The donor pancreas will be placed in the lower portion of your abdomen and attached to the appropriate blood vessels and intestine or bladder. The pancreas transplant surgery takes approximately four to five hours to complete, but this can be different for every patient.
Right before surgery and during your stay in the hospital, the transplant team will meet with you and your caregiver every day to provide education on post-transplant care.
Information about all your medications will be provided. Information on transplant medications, side effects and how to take these medications will also be provided. Instructions on how to monitor your blood pressure, heart rate, weight and temperature will be given. To make sure that the transplanted organ is functioning well, it is also important to measure and record fluid intake as well as urine output for at least six weeks after the transplant surgery. All transplant recipients are provided with their transplant medications, and a discharge binder that will include all appointment schedules, lab schedule, medication list and a health record to keep track of all necessary information. Our goal is to help you feel comfortable and confident about taking care of yourself before you go home.
After you go home from the hospital, you will need to have frequent blood draws and appointments with the transplant doctors and the transplant team. We will monitor your health closely after the transplant and during your follow-up appointments. Please bring your post-transplant notebook and medicines to each appointment. It is very important to keep your scheduled lab and follow-up appointments.
Most transplant recipients recover fully, return to work, and get back to a normal, active life within one to two months after receiving their transplant. To lower your chances of infection, you must avoid people with colds or flu for at least three months.
We encourage your primary care provider (PCP) to continue to monitor your health after your transplant. However, we recommend that for the first year after your transplant, you receive most of your healthcare with our transplant team members since we must be notified of any changes to your medications or in your lab results. You should also continue to see any specialists who have been involved in your healthcare, such as your cardiologist, gynecologist, or, in case of younger patients, pediatrician. If you are seen by other healthcare providers, let us know who these providers are and why you see them.
Tips for a Healthy Transplant Recovery
Take all your medicines exactly as prescribed
Keep all of your scheduled appointments with the transplant team
Call the transplant team if you have any questions or concerns
Have your blood drawn as instructed by the transplant team
Follow your recommended dietary plan
Follow your recommended fluid intake
Follow your recommended exercise plan
Avoid being around anyone who has an infection
A fever higher than 100°F (38°C)
Flu-like symptoms such as chills, aches, headaches, dizziness, nausea or vomiting
New pain or tenderness around the transplant site
Fluid retention (swelling)
Sudden weight gain of greater than 4 pounds within a 24-hour period
Significant decrease in urine output
FAQs and Patient Resources
Do I qualify for a kidney transplant?
A kidney transplant is a treatment option for patients who have been diagnosed with kidney failure. It may offer an improved quality of life without having to depend on dialysis.
Patients who have stage 4 or stage 5 (end-stage) renal disease, will be placed on dialysis. Patients who qualify and receive a kidney transplant may be able to avoid dialysis and experience an improved quality of life. Talk to your dialysis social worker or your primary nephrologist (kidney doctor) to see if you qualify for a referral to Presbyterian Transplant Service.
Do I qualify for a pancreas transplant?
A pancreas transplant is a treatment option for patients with kidney failure AND type 1 diabetes. When successful, a pancreas transplant means that you will no longer require insulin injections for your diabetes, since your new pancreas produces insulin. Pancreas transplants are most often performed when a patient has kidney failure and is also receiving a kidney transplant, as the surgeries are usually done at the same time. Talk to your dialysis social worker or your primary nephrologist (kidney doctor) to see if you qualify for a referral to Presbyterian Transplant Services.
Do I need a referral from my healthcare provider for a transplant?
You can be referred by your primary care provider or your nephrologist (kidney doctor), but your dialysis unit can also refer you. If you have a known diagnosis of end-stage kidney disease, you can also refer yourself.
How long does it take to get a transplant?
The time length will vary from patient to patient, as many factors can make your wait time longer or shorter. It will likely take several years before you receive your transplant.
Why should I have my transplant surgery performed at Presbyterian?
The Presbyterian Transplant Services team includes pre- and post-transplant coordinators to answer all your questions before and after your surgery. Our team also has financial coordinators to help you understand insurance and payment options, as well as social work support if needed. We are here to walk you through every step of the process, before and after surgery, to make sure your new organ stays healthy as long as possible. Presbyterian Transplant Services is the only Optum Center of Excellence in kidney transplant surgery in New Mexico. Our program successfully achieves quality standards that show our dedication to providing safe, high-quality care with more successful surgical outcomes, fewer post-surgical complications and lower re-admission rates.
Where can I go online to find out more information about kidney and kidney/pancreas transplants?
Clinics & Facilities
Our transplant team consists of a multidisciplinary panel of surgeons, physicians, nurses, social workers, transplant coordinators, and donor advocates.