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What Is Kidney Transplantation?

Kidney transplantation is surgery that places a healthy donor kidney into a person with kidney failure. The donor organ can come from a living donor or a deceased donor. The transplanted kidney filters waste, controls fluid and electrolytes, and produces urine in place of the failed native kidneys. Kidney transplantation is a treatment for kidney failure rather than a cure because lifelong follow-up and anti-rejection medication are required.

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What Is Kidney Transplantation?

Kidney transplantation is surgery that places a healthy donor kidney into a person with kidney failure. The donor organ can come from a living donor or a deceased donor. The transplanted kidney filters waste, controls fluid and electrolytes, and produces urine in place of the failed native kidneys. Kidney transplantation is a treatment for kidney failure rather than a cure because lifelong follow-up and anti-rejection medication are required.

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Why Is Kidney Transplantation Performed?

Transplantation is considered for selected patients with irreversible kidney failure who are medically suitable for major surgery and long-term immunosuppression. A functioning transplant can provide better kidney function, fewer dietary and fluid restrictions, and greater independence from dialysis for many patients. Candidates undergo evaluation of cardiovascular health, infections, cancer risk, adherence, psychosocial readiness, and other conditions that can affect transplant safety or graft survival. Donor and recipient blood and immune compatibility are tested to reduce the risk of immediate rejection.

How Is Kidney Transplantation Performed?

The donor kidney is usually placed in the lower abdomen rather than in the normal anatomical position high in the back. The transplant renal artery and vein are connected to blood vessels in the pelvis so blood can flow through the new kidney. The donor ureter is connected to the bladder so urine can drain normally. The patient's native kidneys are usually left in place unless infection, severe enlargement, uncontrolled blood pressure, cancer, or another specific problem requires their removal.

What Is Recovery Like After Kidney Transplantation?

Patients stay in the hospital for monitoring while the transplant team checks urine output, kidney function, blood pressure, wound healing, medication levels, and signs of rejection or infection. Some donor kidneys begin working immediately, while others have delayed graft function and can require temporary dialysis. Immunosuppressive medicines are started to prevent immune attack on the transplanted kidney and must be taken consistently for as long as the graft is functioning. Long-term follow-up includes regular blood tests, medication adjustments, infection prevention, cancer screening, and management of cardiovascular and metabolic risks.

What Are the Risks and Complications?

Possible surgical complications include bleeding, infection, blood clots, lymphocele, vascular thrombosis, ureteral leak or narrowing, wound problems, and delayed graft function. Acute or chronic rejection can damage the donor kidney even with immunosuppressive treatment. Anti-rejection medicines increase susceptibility to infections and can contribute to diabetes, high blood pressure, bone disease, kidney toxicity, and certain cancers. A transplant can eventually fail and require dialysis or another kidney transplant.

Frequently Asked Questions About Kidney Transplantation

Are the old kidneys removed during kidney transplantation?

Usually not. The native kidneys are commonly left in place unless they cause infection, severe enlargement, uncontrolled blood pressure, cancer, or another specific problem.

Where is the transplanted kidney placed?

The donor kidney is usually placed in the lower abdomen, where its blood vessels can be connected to the iliac vessels and its ureter connected to the bladder.

Will anti-rejection medicine be needed after a kidney transplant?

Yes. Immunosuppressive medicines are required every day to reduce the risk that the immune system will attack the donor kidney.

Can a transplanted kidney fail?

Yes. Rejection, recurrent disease, infection, vascular problems, medication toxicity, or chronic graft injury can eventually cause loss of transplant function.

References

Kidney Transplant. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/kidney-transplant. Date Accessed September 11, 2026.

Kidney Transplantation. MedlinePlus. https://medlineplus.gov/kidneytransplantation.html. Date Accessed September 11, 2026.

Kidney transplant. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/kidney-transplant/about/pac-20384777. Date Accessed September 11, 2026.

Kidney Transplant Surgery. National Kidney Foundation. https://www.kidney.org/kidney-topics/kidney-transplant-surgery. Date Accessed September 11, 2026.

Kidney Transplant Anti-Rejection Medicines (Immunosuppressants). National Kidney Foundation. https://www.kidney.org/kidney-topics/kidney-transplant-anti-rejection-medicines-immunosuppressants. Date Accessed September 11, 2026.