Kidney Transplant Program

A kidney transplant is a surgical procedure that provides you with a new kidney from a living or deceased donor. The new kidney takes over the work of kidneys that have been damaged by diseases such as diabetes, uncontrolled high blood pressure or polycystic kidney disease. These conditions can lead to kidney failure, also known as end-stage renal disease.

Dialysis

When you’re in kidney failure, your kidneys no longer work like they should. Dialysis is a treatment that filters waste products from your blood, which is one of your kidneys’ main functions. Through our Dialysis Access Center, we provide doctors with a way to “access” your blood so dialysis can take place. This involves surgery. However, dialysis is only a short-term treatment. It’s meant to tide you over until you can receive a kidney transplant.

You might need dialysis while waiting for a deceased donor kidney or searching for a living donor. Research shows that getting a transplant sooner rather than later is generally the best approach.

A new kidney will work much longer if you get it before dialysis. Those on dialysis for two years while waiting for a transplant are three times more likely to lose their transplanted kidney than those patients who wait less than six months.

Dialysis can be a lifesaving. But it does only about 10% of the work that a healthy kidney does. Because of its impact on your body, dialysis also can cause these and other health problems and complications:

• Anemia (a shortage of red blood cells, which deprives you of oxygen and saps your energy and strength)
• Bone disease
• Heart disease
• High blood pressure
• Infection

As a result of these problems, your life expectancy on dialysis is generally about five years. However, if you get a kidney transplant, you typically live 10 to 15 years longer than you do on dialysis. Younger adults gain the most time. But even people as old as 75 years of age gain an average of four more years after a transplant than if they had stayed on dialysis.

Kidney function is best for living kidney recipients. A living donor kidney functions, on average, 12 to 20 years. Deceased donor kidneys function from 8 to 12 years.

Compared to dialysis, kidney transplant usually results in a better quality of life. Most people who have been on dialysis and then had a transplant report having more energy, a less restricted diet, and fewer complications with a transplant than if they had stayed on dialysis. You’re also more likely to return to work after transplant than dialysis.

Preemptive Transplantation

Preemptive transplantation refers to kidney transplant before you require dialysis. Usually, this type of transplant comes from a living donor. Because you get your new kidney when your health is generally good, preemptive transplants tend to help you live longer and help your new kidney last longer. You also can avoid risks associated with procedures that provide dialysis access.

It's not always possible to have a preemptive transplant. For example, if you’re having severe symptoms or your blood work is very abnormal, dialysis might be in your best interest. Generally, however, you get the best results if you have your transplant before dialysis is needed.

At BIDMC’s Transplant Institute, we focus on making sure you get the right treatment at the right time. We help you evaluate your treatment options early on and make sure you understand the risks and benefits of transplant surgery and dialysis. We also carefully explain the advantages of having a live donor kidney compared to a deceased donor organ. Throughout your decision-making process, we offer advice and support to you and your loved ones.

If you’re interested in a kidney transplant, you need a thorough evaluation to ensure that a kidney transplant is your best treatment option. This assessment helps us determine if a transplant is safe for you, what we can do to help it be most successful and who would make a good match for you. Your health and well-being is our top priority.

Transplant Clinical Trials

Part of our work at the Transplant Institute includes looking for better ways to care for transplant patients like you. Through clinical trials, we study new treatments and ways to make transplants available to people who might not meet traditional eligibility criteria. We let you know if a trial might be right for you. Decisions about whether to participate are yours alone.

Education and support are vital to kidney transplant success. To prepare you for transplant we make sure that you fully understand what your surgery will involve and that you’re ready for the procedure physically and emotionally. After kidney transplant we help you learn to care for your new kidney and take good care of yourself.

With advances in surgical techniques, better immunosuppressive medications and a growing number of living kidney donors, transplanted kidneys are lasting longer and working better than ever before. Successful transplants improve survival rates and enrich quality of life.

Sometimes, kidney problems don’t occur by themselves. They can happen together with disorders of the pancreas, such as diabetes. You can receive expert kidney and pancreas care at BIDMC.

Our Transplant Institute, in collaboration with Joslin Diabetes Center, has a highly regarded joint kidney and pancreas transplant program. We may consider a pancreas transplant as a treatment option if you have Type 1 diabetes (when the body does not produce insulin). Some patients with Type 2 diabetes may qualify for a kidney and pancreas transplant, too.

If you have kidney failure or are close to needing dialysis, a simultaneous deceased-kidney/pancreas transplant — or a living or deceased donor kidney transplant followed by a deceased donor pancreas transplant — may be possible. With the benefit of a living donor, you might be able to have a kidney transplant without ever experiencing dialysis or dialysis access surgery.

Occasionally, if you have diabetes and early signs of kidney disease, you may be a candidate for a pancreas transplant alone. With a close collaboration with the world-renowned Joslin Diabetes Center, we’ve established one of the more active pancreas transplant programs in New England. As our patient, you benefit from the strengths of both institutions. And you receive excellent pre-transplant, inpatient and post-transplant care.