Kidney Transplant

About Our Kidney Transplant Program

With the tremendous improvements in transplant management, most patients with kidney failure can be considered for transplantation. We perform at least 300 kidney transplants per year and have one of the nation's largest kidney transplant programs. We are also at the forefront of laparoscopic living donor nephrectomy, which has made kidney transplantation much easier.

Watch our video about the kidney transplant process at UMMC.

Entering the Transplant Program

Most transplant candidates are referred to the program by their primary physician, specialist, or dialysis unit. Many also enter at their own initiative. The process begins with a call to the Transplant Office (410-328-5408).

Evaluation

All transplant candidates begin the program with a comprehensive series of tests conducted by our multidisciplinary team of specialists. Some of these tests are required for any operative procedure (history and physical, chest x-ray, EKG, etc.) while others (such as specific blood tests) are required for transplantation surgery.

After a candidate is accepted for transplantation, he or she is placed on the University of Maryland wait list and the national list of the United Network for Organ Sharing (UNOS). The allocation of organs is based upon a point system which takes into account medical urgency, time on the waiting list and blood type compatibility. Because of the ongoing shortage of donor organs in this country, candidates may be on waiting lists for a year or longer.

In the case of kidney patients, the identification of possible living donors is an important part of the pre-transplant screening process.

A Network of Support

During the initial stages of evaluation, the patient undergoes many tests and sees many specialists. This is also the time when the patient is first introduced to the support network, a distinguishing component of our program. Social workers and nurse coordinators play an extremely important role in providing this support.

Social workers are a resource, an advocate and a link between patients and all the services designed to assist them. They help patients and their families address the many complex social, personal and financial issues that arise for transplant patients. Their services range from helping with personal and psychological issues that result from living with a chronic medical condition, to the practical issues of paying for medications, arranging transportation and lodging, joining support groups and receiving vocational rehabilitation.

Nurse coordinators are involved in the pre-transplant screening and stay involved throughout the years of follow-up care. In this way, patients benefit from having the same people available to them 24 hours a day throughout their participation in the program. Our patients tell us that the nurse coordinators, because of the range of their involvement and the depth of their concern, are essential participants in the support network.

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The Transplant

When a compatible organ becomes available, the transplant patient is immediately contacted by a nurseMedical illustration of a kidney coordinator and admitted to the hospital. At this time, a history is taken of any medical events that may have occurred since the initial transplant evaluation. Appropriate testing ensures the patient's readiness for surgery. At this time, the patient may begin taking immunosuppressive medication.

Depending on the organ, the surgery lasts approximately three to eight hours. When the surgery is completed, the patient is taken to the recovery room, and then over the subsequent days to a step-down unit.

Careful, comprehensive post-surgical monitoring constantly evaluates whether the body is accepting the new organ.

The length of stay in the hospital is determined by a number of factors, including overall health of the patient before surgery and, of course, the surgical procedure. Hospital stays generally extend from one to three weeks.

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Going Home

The Outpatient Clinic

Follow-up care initially involves returning to the Transitional Care Clinic and the Outpatient Clinic weekly for the first month after leaving the hospital. A series of tests, including blood tests, are conducted to closely monitor the patient's progress. This is a period when medications are precisely adjusted to reach a point of effective stability to avoid rejection of the transplanted organ. After this initial period, patients are seen periodically as determined by their physician.

The Patient's Responsibility

While transplantation can greatly improve the recipients' quality of life, it also requires frequent clinic visits and lab draws, especially immediately after surgery to prevent complications. They must become active participants in preserving their health. In addition, of course, they must take their medications on a regular basis to avoid rejection of their transplant.

Immunosuppressive Medication

Transplantation has become so successful in recent years in large part through the development of new, more effective drugs which prevent rejection by the body of donated organs. These drugs inhibit the body's immune system from identifying the new organ as foreign. These medications will be carefully reviewed prior to discharge. It is necessary for all patients to take immunosuppressive medication for the rest of their lives following transplant. A successful transplant can be undermined very quickly by the failure of patients to take their medications appropriately and responsibly.

A Program That Changes Lives

The University of Maryland Medical Center's Transplant Program has saved and greatly improved the lives of hundreds of people in recent years. By replacing organs that have ceased to function effectively, the program has given new life -- new energy and new possibilities -- to people whose lives had been restricted by debilitating conditions.

We have worked to build a team of committed and gifted physicians, nurses, social workers, researchers and counselors whose special expertise guarantees that our patients receive the best treatment available.

We are confident that as new advances are made -- as we ourselves help to make them -- we will help growing numbers of people in the future.

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This page was last updated: December 9, 2013

         
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