A kidney transplant replaces a failed kidney with a healthy one from either a living donor (often a relative or friend) or a deceased donor, restoring the body's ability to filter blood without needing dialysis. It's considered the best long-term treatment for end-stage kidney disease in patients healthy enough for major surgery.
Over 808,000 Americans live with end-stage kidney disease; about a third have a transplant and the rest are on dialysis (NIDDK). Roughly 90,000+ people are on the kidney transplant waiting list at any given time.
Causes & risk factors
- Diabetes — the single leading cause of kidney failure, about 46% of new cases
- High blood pressure — about 29% of cases
- Chronic glomerulonephritis and inherited kidney diseases (e.g. polycystic kidney disease)
- Long-term or recurrent urinary/kidney infections
- Obesity and cardiovascular disease
- Family history of kidney disease
Symptoms to watch for
- Little or no urine output, severe swelling, breathlessness, or confusion can signal life-threatening fluid/toxin buildup — needs emergency dialysis
- Persistent fatigue and weakness
- Swelling in the legs, ankles, or around the eyes
- Nausea, loss of appetite, and a metallic taste
- Itchy skin and muscle cramps
How it's diagnosed
- Blood tests (creatinine, eGFR) to measure kidney function
- Urine tests for protein or blood
- Ultrasound imaging of the kidneys
- Tissue/cross-match and blood type testing between donor and recipient
- Full cardiac and general health work-up before surgery approval
Treatment options
- Living-donor transplant: a kidney from a relative, spouse, friend, or altruistic donor; typically lasts longer, around 12–15 years on average.
- Deceased-donor transplant: a kidney from a recently deceased donor; average graft lasts about 10–12 years.
- Dialysis: haemodialysis or peritoneal dialysis, an alternative or bridge for those awaiting transplant.
- Lifelong immunosuppressant medication: required after any transplant to prevent rejection.
- Paired kidney exchange: swapping incompatible donor-recipient pairs to find a match.
Outlook & prevention
1-year survival is about 98% for living-donor recipients and roughly 93% for deceased-donor recipients (NIDDK). Many transplanted kidneys function well for 15–20+ years. Controlling diabetes and blood pressure remains the most effective way to prevent kidney failure in the first place.
- Diagnosed diabetes or hypertension with declining kidney function on routine blood tests
- Swelling, reduced urination, or unexplained fatigue
- A family history of kidney disease — worth asking about screening