A kidney transplant provides the best long-term outcome for patients with end-stage kidney disease. The kidney may come from a cadaveric donor or from a living donor. All patients with end-stage kidney disease should be considered for a transplant. Age is not a major determinant of the outcome but the presence of comorbid disease adversely affects survival. Patients do not generally have their native kidneys removed and the transplanted kidney is placed extraperitoneal in the iliac fossa. A kidney transplant generally takes three to four hours. The blood vessels of the donor's kidney are attached to your blood vessels and the ureter (the tube which connects the kidney to the bladder) is joined to your bladder. A small plastic tube called a stent is placed inside the ureter to make sure you are able to pass urine. The average length of stay is 7-10 days. Between four and six weeks after your transplant, the stent is removed under local anesthetic as a day case procedure, with no need to stay overnight in the hospital. Patients require frequent follow-up after discharge (two or three times each week initially). Lifelong immunosuppression is required to prevent rejection. Long-term follow-up is also imperative, including annual screening for cancers, drug toxicity, and cardiovascular disease. A formal and informative discussion will be done prior to transplantation with your transplant surgeon regarding the benefits of transplantation, and the risks and complications (early and late) following kidney transplantation.
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