Beyond Dialysis:
Other Options
to Consider

As end stage renal disease (ESRD) approaches, opting for treatment—or nontreatment—is a deeply personal choice. If you are choosing treatment, a kidney transplant may be a good choice and may offer you a chance for a longer, healthier life. Or, because of personal beliefs or quality-of-life issues, you may prefer to let nature take its course and choose not to treat your ESRD. In both cases, there are important things to consider.

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Kidney Transplant: For Some, a Chance for 
a Longer, Healthier Life

A successful kidney transplant is closest to natural kidney function and is considered one of the most effective treatments for ESRD. New advances in technology, donor matching and surgery have greatly increased transplant success rates and many people who have had kidney transplants are living longer and healthier lives. However, as with any major surgery, there are pros and cons to consider.

Mother hugging after kidney transplant

What to consider before a kidney transplant procedure

If you elect to have a kidney transplant, you should know that your best chance for a successful surgery depends on:
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Your overall health 

If your doctor feels you may be a good candidate, he or she will most likely recommend a kidney transplant. To make sure you are healthy enough for surgery, you will need to have a complete medical exam and a series of tests to screen for any medical conditions that may affect your ability to have a good outcome.
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A good kidney donor match

For a kidney transplant to be successful, the new kidney must be from a donor who has the same tissue type and a compatible blood type. People with O blood type are the “universal donor” and are compatible with any blood type, while people with AB blood type are the “universal recipient” and can receive a kidney from a donor with any blood type. An ideal match is from a living donor, usually a relative, with the same tissue and blood type, whose genetic characteristics are most like your own.

If getting a kidney from a living donor is not possible, you can still have a good match, but you will need to be placed on a waiting list to receive a kidney from a nonliving donor. In either case, your Fresenius Kidney Care treatment team can help guide you on finding a good match and connect you to appropriate resources.
Learn more about finding a donor match

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Timing

With kidney transplants, the earlier the better. If possible, it is best to have your kidney transplant surgery before you actually need dialysis. However, like most people electing to have a kidney transplant, you may need to wait for a good donor match. 

Since the average wait time is approximately 3 to 5 years, people waiting for a kidney donor will need to maintain their kidney function through dialysis treatments until a kidney is available. During your waiting period, you have a number of effective dialysis choices including at-home hemodialysis, at-home peritoneal dialysis or in-center treatment options.

What happens in a kidney transplant procedure

A kidney transplant is a major surgery during which a person with kidney failure receives a new kidney—either from a living donor or a deceased one. 

You only need one working kidney to be healthy; so only one kidney is transplanted during surgery. Your two original kidneys will usually remain in place and the new "good” kidney will be placed in another area of your abdomen. If the surgery is successful, your new kidney will take over the tasks of filtering your blood and making urine just like your own kidneys did before you had kidney disease.

What to expect after surgery

Immediately after surgery:
  • You can expect soreness in your abdomen.
  • You will need to remain in the hospital for up to a week. Your doctor and medical team will closely monitor your status.
  • You will need to take immunosuppressants—drugs that will help prevent your body from rejecting your new kidney.
  • You will also need to take other drugs to help reduce your risk for infection and other potential complications.

After you’re discharged, you will need to:
  • Have regular checkups for a few weeks after surgery. If you live away from the transplant center, you will need to make arrangements to stay nearby.
  • Be monitored for the rest of your life to check on your new kidney.
  • Take immunosuppressants for the rest of your life. 

Key benefits of a kidney transplant 

If you have a successful kidney transplant, you may live a longer life than you would have while on dialysis. You may also enjoy fewer complications and have a better quality of life—and experience more energy, better overall health and have fewer restrictions on your diet.

Potential risks and side effects

As with any surgery, there may be risks and complications. Key risks for kidney transplant surgery include:

  • Temporary lack of kidney function—Your new kidney may not start working immediately and you may need dialysis until it resumes normal kidney function.
  • Organ rejection—Your body may reject the donor organ and you may need medication to help your body accept the new kidney.
  • Kidney failure—Your new kidney may fail after a number of years and you may need to have a second transplant or go back on dialysis.
  • Cancer—Immunosuppressants may leave you more vulnerable to disease.
  • Diabetes—Medications taken after a transplant can cause diabetes
  • Heart attack or stroke


Potential side effects of a kidney transplant may include:

  • Narrowing of the artery leading to the kidney—also called renal artery stenosis
  • Blood clots 
  • Infection
  • Bleeding 
  • Weight gain
  • High blood pressure

The search for a living kidney donor: asking the big question

If you become a candidate for a kidney transplant, your first reaction may be to ask a relative or friend to donate their kidney to you. Or you may find it difficult to ask such a big question.

Before you make “the big ask,” learn all you can about kidney transplants and find out just what it means for a living donor to give a kidney. 

When people volunteer to be a living donor, they will need a series of tests to find out if they are a good match for a kidney transplant—and if they are both physically and psychologically ready for surgery. They will also need to take time out of their schedule for the surgery and recovery period and may even need to make special financial arrangements. 

Finally, providing they meet all the requirements, living donors will undergo kidney transplant surgery. While donating an organ is no small thing, the majority of risks following a nephrectomy (surgery to remove a kidney) are minor and many living donors are able to have less invasive, laparoscopic surgery.

When you are ready to ask the big question:
Couple reviewing kidney transplant
  • Share your story. You may want to privately discuss your situation with close friends and relatives or give a big shout-out via social media to spread the word. If you do go “social,” play it safe and be selective about your audience.
  • Try not to take it too personally. Some people who want to donate their kidney may not be a good match. Others may say “no” for a variety of reasons, but it doesn’t mean they don’t care about you.
  • Be informed. When people ask you what it means to donate a kidney, know the facts and help them learn more. 
  • Stay positive. Speak with a social worker or another counselor to help ease your fears. 
  • Have a backup plan. Place your name on donor waiting lists in case you can’t find a living kidney donor on your own. With today’s advanced donor matching technology, it is possible to find a good match with a living or nonliving donor.

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