Kidney Transplant

The kidneys are paired organs located in the back of the abdominal cavity. Their main functions include maintaining fluid balance, regulating sodium, potassium, calcium, and phosphorus levels, and removing waste and toxins through urine. The kidneys also regulate blood pressure, produce hormones, and synthesize vitamin D. They play a vital role in red blood cell production via the hormone erythropoietin.

When both kidneys fail to function properly, the condition is known as kidney failure. It can be acute or chronic.

Acute kidney failure may be caused by major blood loss, dehydration (e.g., after trauma, burns, or poisoning), obstruction of the urinary tract, or preeclampsia. This condition is typically reversible.

Chronic kidney failure may be caused by infections, diabetes, high blood pressure, polycystic kidney disease, autoimmune diseases like lupus or FMF (familial Mediterranean fever). Other causes include kidney tumors, congenital defects, kidney stones, infections, certain medications, and atherosclerosis of the renal arteries.

Chronic kidney failure leads to irreversible damage and loss of kidney function. The rate of progression varies depending on the underlying cause, general health, and response to treatment.

Patients with end-stage kidney disease may undergo hemodialysis or kidney transplant abroad. However, kidney transplant in Israel is often the preferred solution, especially when a living donor kidney transplant is available. A successful transplant eliminates the need for dialysis and restores the patient’s quality of life.

In Israel, kidney transplant donors must be living and closely related. A healthy person can safely donate one kidney, which does not affect their overall kidney function but can save another person’s life.

At the best hospital for kidney transplant – the Ichilov (Sourasky) Medical Center in Tel Aviv – the procedure is performed under general anesthesia. A surgical incision is made in the lower abdomen, where the donated kidney is placed. The donor’s blood vessels are connected to the recipient’s vessels, and the ureter is connected to the bladder. Once blood flow is restored, the new kidney begins filtering and producing urine.

In most cases, the patient’s damaged kidneys are not removed unless they are infected, cancerous, or significantly atrophied.

The surgery is performed under general anesthesia and usually takes 3–4 hours.

Kidney transplant in Israel has been performed successfully for decades. Over 2,000 patients currently live in Israel with functioning transplanted kidneys. The Ichilov Medical Center performs around 40 transplants annually with excellent short- and long-term outcomes.

To date, the center has completed over 300 transplants, making it one of the top three transplant centers in the country. Most operations involve living donor kidney transplants. When the donor is a relative, the success rate exceeds 90%. Transplants from unrelated donors also show high success, although slightly lower.

A transplant is considered successful when there is no rejection and the patient returns to normal life.

As with any major operation, kidney transplant surgery carries risks, including bleeding, organ or nerve injury, and infection. One major risk is organ rejection, which can occur if the body recognizes the donor kidney as foreign. Early detection and prompt treatment are critical.

Rejection is more likely if the patient has a weakened immune system. Doctors at Ichilov closely monitor transplant recipients to manage any early signs of rejection effectively.

To be admitted for a kidney transplant without waiting, patients must provide recent blood and coagulation test results. They should bring prior ultrasound or CT scan results and consult their doctor about ongoing medications. For diabetic patients, insulin should be withheld the morning of the surgery but brought along. If taking anticoagulants (like aspirin), consult a physician.

Fasting is required for 8 hours before surgery.

After the procedure, the patient stays in the recovery unit for about two hours, then is moved to a hospital room. Most patients can sit up within hours and the transplanted kidney typically begins functioning within days. In some cases, dialysis is temporarily needed until the kidney starts working.

Most patients are discharged within 5 days of surgery.

For the first two weeks, patients must avoid physical strain. A follow-up visit is scheduled to remove stitches and staples.

Any signs of fever over 38°C or symptoms of rejection should be immediately reported.

Since the immune system is still weakened, patients must avoid large crowds, stay away from sick individuals, wash hands frequently, and lead a healthy lifestyle.