What To Expect on Surgery Day LDKT

Living-donor kidney transplant replaces a diseased kidney with a healthy kidney from a living donor. During living-donor kidney transplant surgery, doctors remove the donor’s healthy kidney and place it in the recipient’s body.

Whether you’re receiving a new kidney or donating one of your healthy kidneys, you may wonder what surgery day will be like. Rita Swink, clinically certified living donor transplant coordinator at UPMC, offers insight into what donors and recipients can expect.

What You’ll Need on Living-Donor Kidney Transplant Surgery Day

Most donors and recipients arrive at the hospital about two hours before the surgery’s scheduled start time. But some kidney recipients will need to arrive earlier. “You may be admitted the day before if you need dialysis or special medication before surgery.”

Typically, you won’t need to complete any paperwork on the day of surgery. Donors and recipients usually take care of paperwork during their preoperative conference about two weeks earlier. That’s when the transplant team makes sure donors and recipients meet all living-donor kidney transplant requirements.

You may need to sign an updated consent form on surgery day, so bring your insurance card with you to the hospital. You may also want to bring:

  • A comfortable robe, socks, and slippers.
  • A special pillow if you have one.
  • Any personal hygiene items you like to use, like shampoo or conditioner.
  • A charger for your cell phone.

It’s best to leave money, jewelry, and other valuables at home.

What to Expect When You Arrive at the Hospital

After checking in, you’ll be admitted to the hospital. Your care team will take you to a preoperative holding area outside the operating room. A loved one can join you while you wait for the surgical team to prepare for surgery.

While you’re in the preoperative area, you can expect to:

  • Change into a hospital gown and relax in a hospital bed.
  • Have an intravenous (IV) line inserted.
  • Begin any pre-surgery fluids or medications you may need. You’ll receive these through the IV line.
  • Talk with your surgeon.
  • Talk with the specialist who administers anesthesia during surgery (anesthesiologist).

If you’re a kidney donor, you’ll receive extra fluids before surgery.

“Donors do a bowel prep the day before to clear the intestines, which can leave the donor dehydrated,” she says. A clean bowel makes it easier for surgeons to move the intestines and access the kidney during surgery.

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What Happens During Living-Donor Kidney Transplant Surgery?

Living-donor kidney transplant is major surgery. The kidney donor and the kidney recipient have surgery at the same time.

Just before the operation begins, the anesthesiologist gives you medication to put you to sleep (general anesthesia). You won’t feel any pain or be aware of what’s happening during surgery.

Your surgery team uses a sterile solution to wash the area where they’ll make any incisions. Then, surgery begins.

Living-Donor Kidney Transplant Surgery for Donors

If you’re a kidney donor, doctors position you on your side to best access the kidney you’re donating. For example, if you’re donating your left kidney, you lie on your right side.

Many living-donor kidney transplant surgeries are minimally invasive. Surgeons make small incisions in your abdomen and insert a thin instrument with a small camera (laparoscope). They remove the kidney — along with its artery, vein, and the vessel that carries urine (ureter).

Donor surgery usually lasts about two hours. After surgery, you move to a recovery area (post-anesthesia care unit). Your anesthesiologist checks on you often, and nurses track your heart rate, breathing and blood pressure.

Once you’re awake and stable, you move to a room on the transplant floor where nurses check your:

  • Blood count.
  • Kidney function.
  • Urine output.
  • Pain level.

You’ll receive medication to help you manage any pain you feel after surgery.

Living-Donor Kidney Transplant Surgery for Recipients

If you’re receiving a new kidney, your surgery usually takes about three hours.

Surgeons make an incision in your lower abdomen to place the donated kidney. They attach blood vessels in your abdomen to the new kidney and connect its ureter to your bladder. Typically, your own kidneys remain in place.

Once surgery is complete, you move to the post-anesthesia care unit for monitoring. When you’re awake, you move to the transplant floor. Trained transplant nurses check your:

  • Fluid intake.
  • Urine output.
  • Blood count.
  • Kidney function.
  • Pain level.

You receive medication (immunosuppressants) to keep your body from rejecting the new kidney. Nurses take blood samples to check your immunosuppression levels. Your doctor makes any needed adjustments to your anti-rejection drugs.

Recovering After Living-Donor Kidney Transplant Surgery

Recovery varies depending on whether you’re the donor or the recipient of the donated kidney.

Recovery for Living-Donor Kidney Transplant Donors

If you’ve donated a kidney, you can usually leave the hospital in about two days. Before you’re discharged, doctors make sure you can:

  • Urinate regularly.
  • Have a bowel movement.
  • Tolerate food and medication.

Donors usually see their transplant team for a follow-up visit one week after surgery. Your team schedules this visit before you leave the hospital.

Recovery for Living-Donor Kidney Transplant Recipients

Kidney transplant recipients usually spend about five days in the hospital’s transplant unit. Then you move to a post-transplant area where specialists check your immunosuppression levels and kidney function until you’re discharged. You can expect many follow-up appointments during the first few months after receiving a new kidney.

Whether you’re a living kidney donor or a kidney recipient, it’s important to follow your care team’s instructions. Talk with your doctor about when you can return to work and resume your regular activities.

American Kidney Fund, Preparing for Your Living Kidney Donation,


National Kidney Foundation, Getting Ready for a Transplant, https://www.kidney.org/atoz/content/trans_getready

UPMC Shadyside, What to Expect: Post-Anesthesia Care Unit, https://www.upmc.com/-/media/upmc/locations/hospitals/shadyside/services/surgical-services/post-anesthesia-care-unit/documents/pacu-brochure-upmc-shadyside.pdf

About Transplant Services

For more than four decades, UPMC Transplant Services has been a leader in organ transplantation. Our clinicians have performed more than 20,000 organ transplant procedures, making UPMC one of the foremost organ transplant centers in the world. We are home to some of the world’s foremost transplant experts and take on some of the most challenging cases. Through research, we have developed new therapies that provide our patients better outcomes — so organ recipients can enjoy better health with fewer restrictions. Above all, we are committed to providing compassionate, complete care that can change – and save – our patients’ lives. Visit our website to find a provider near you.