About the operation

A kidney transplant is a surgery which places a healthy donor kidney into someone who has kidney failure. Only one donated kidney is needed to replace the work previously done by your two kidneys. Donor kidneys can come from a living donor or a deceased donor (a person who has passed away).

The surgery may take 3 to 4 hours. The surgeon places the new kidney through an incision in your lower stomach. The surgeon will attach the blood vessels of the new kidney to suitable blood vessels in your body. The tube that carries urine (called a ureter) is then attached to your bladder. Your new kidney often begins to work right away.

Your own kidneys are left in place unless they are causing a medical problem.

During the operation, the surgeon will make a 10 to 15 inch incision (cut) in either your left or right lower abdomen.

Once the operation is complete, we will use staples to close up the surgical incision. The staples go along the line of the incision. We take out the staples in 10 to 14 days.

You can expect to stay in the hospital for about 7 days.

Where the transplanted kidney may be placed.
About the Operation - Kidney  

Read our guide below to learn more about your kidney transplant surgery, or click on the topic that matters most to you. If you have questions or need more information, talk to your transplant surgeon or your transplant coordinator.

When You are Called In

Once your kidney transplant evaluation is complete, you are placed on the kidney transplant waiting list. When a kidney becomes available, you will receive a call from a Transplant Coordinator. The call for a transplant may come at any time of the day or night.

The transplant coordinator on-call will ask you a few questions:

  • How are you feeling?
  • Do you have any symptoms of a cold or fever?
  • Have you had any recent procedures, blood transfusions, or infections?
  • Are you taking any antibiotics?
  • Are you on any blood thinners?
  • When was your last dialysis session?

If there are no concerns about your current health, the transplant coordinator will ask you to come to the hospital as soon as possible. We expect you to arrive at the hospital within 2 hours after you are called in for a kidney transplant. The transplant coordinator will tell you where to go once you arrive at the hospital. Do not eat or drink from this time on.

  • Time is critical when your kidney becomes available. The transplant coordinator will call all your contact numbers repeatedly for 1 hour. Messages will be left where answering machines are available. If they cannot reach you, another organ recipient must be chosen.
  • If you are unable to reach the person who pages or calls you, contact the Transplant Inpatient Unit at 416 340 5163; ask to speak to the charge nurse.
  • If you refuse to come in when called for transplant, you will immediately be placed on hold and we must contact your transplant coordinator to discuss your situation.

What should I bring when I am called in?
  • Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
  • Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
  • Your spouse/partner, a trusted friend or family member.
  • Your medications.
What if I am called in as a back-up?

In some cases, you may be called in as a back-up. This happens when there is a chance that the primary person will not receive the kidney. Whenever possible, we will try to have you stay at home during this waiting period. If tests show that the primary person on the list is not a good match, then you, as the back-up, will be given the kidney.

Is there a chance my transplant will be cancelled?

Yes. Your surgery can be cancelled for many reasons:

  • Donor kidneys are found unsuitable
  • An unsuitable match between you and your donor
  • Your health status may have changed and you may not be able to have surgery at this time

You and your family may feel shock, disappointment, and sadness when this happens. All of these feelings are normal. You should call your transplant coordinator to talk about any concerns you have about a cancellation.

You are still on the transplant waiting list and now know what to expect the next time you are called in.

Coming to the Hospital
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Living Donor Recipients must stop eating and drinking by midnight on the night before your operation. Your stomach needs to be empty.

When do I come to the hospital?

If you are receiving a living donor kidney transplant, you will be admitted the day before your surgery, to have a final assessment and ensure you are fit for surgery.

For deceased donor kidney transplants, you will have the same assessments done right before the surgery to make sure it is safe to go ahead with the transplant.

Hospital Arrival
What happens when I arrive at the hospital?

You will be admitted to the Transplant Inpatient Unit and examined by the kidney transplant team. You will have a blood test (cross match) against the donor to ensure that you are a good match. The test usually takes about 5 to 6 hours. If needed, we will arrange dialysis before your surgery.

What will happen before my operation?
  • Nurses and doctors will examine and prepare you for the operation.
  • Some patients will need dialysis before their transplant.
  • Blood tests, an ECG, and a chest x-ray will be done.
  • An intravenous line (IV) will be inserted into your arm.
  • Doctors will see you to discuss the operation and answer any questions you may have.

After Your Operation

On this page, you can read all about what to expect during your hospital stay. Or, just click on one of the links below, to get the answer you want right now.

What will happen right after my operation?
  • After the surgery, you will be cared for in the Acute Care Unit (ACU) and will usually stay there for 1 – 2 days. Your transplant team will watch you closely for signs and symptoms of any complications and will make changes to your care as needed.
  • You will have a catheter in your bladder to drain your urine and you will receive IV fluids until you are able to take in enough food and fluids. Blood samples will be taken frequently to check the status of the new kidney, as well as other body functions. Your diet will be gradually changed from liquids to more solid foods as tolerated.
How will I feel after my operation?
  • Once you have recovered from the anesthetic, you will likely feel some pain at the site of your incision.
  • Our pain management team will work with you during and after surgery to make sure your pain is well managed.
  • Many kidney transplant recipients say they begin to feel better quickly because of the new kidney.

How can I take care of myself after my operation?

After the operation, you will immediately begin treatment with medication designed to prevent your immune system from rejecting your new kidney. These types of medication are known as immunosuppressants. You will now take these medications for life.

Moving your body is an important part of your recovery.

  • Start some deep breathing and coughing exercises. We'll show you an exercise called incentive spirometry
  • You will shower while you are in the hospital.
  • Wiggle your toes and move your feet. This helps the blood in your legs to circulate.
  • Sitting up in a chair, performing self-care, and walking in the hallway are excellent ways to improve your strength and stamina.
  • You will be encouraged to sit up and walk as soon as you are able.

Nurses, pharmacists, dietitians, physiotherapists, and other members of the transplant team will teach you how to take care of yourself once you are discharged from the hospital.

Will I learn about my medication?

On the Transplant Inpatient Unit, you will learn about your new life with a kidney transplant, including how and when to take your new transplant medicines and any side effects you may have. You will meet with one of our transplant pharmacists. The pharmacist will answer any questions you may have about your new medicines. You can also visit our patient toolbox to learn more about your transplant medicines and life after transplant.

How long will I stay in the hospital?
  • You can expect to be in the hospital for up to 7 days.
  • Before you leave the hospital, your transplant team will give you a schedule that will tell you how and when to take all of your transplant medicines and when you will need to come to the hospital for regular blood tests and clinic visits.
  • Your schedule will be based on your progress and your doctor's recommendations. Over time, your clinic visits and blood tests will become less frequent.
Back at home
How can I take care of myself when I go home?
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  • Eating a healthy diet by following Canada’s Food Guide will help give you a balance of protein, fats, and carbohydrates and help you to maintain a healthy body weight.
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    You cannot eat grapefruit or drink grapefruit juices after transplant. It interferes with the absorption of your immunosuppressive medications

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  • You might get tired easily. Listen to your body and don't do more than you can handle.
  • Our transplant psychiatry team is here if you need help with the following:
    1. Anxiety and depression
    2. Smoking cessation
    3. Stress management
    4. Support and coping
  • The Transplant Psychiatry Program offers a Mindfulness-Based Stress Reduction (MBSR) program, please call: 416 340 4452 or fill out the Mindfulness-Based Stress Reduction (MBSR) program application form.
  • If you are looking for counseling, referrals, support groups or a mentor program .Please talk to a transplant social worker, transplant coordinator or your family doctor.
  • Don't lift heavy things for 3 months after your operation. Anything over 5 kilograms or 10 pounds is too heavy.
  • You can use small weights of 1 to 2 pounds to increase arm strength but be careful not to strain your shoulder joints.
  • Lifting larger amounts may result in stress to your incision and can affect your healing, and may cause a hernia in the incision.
  • Walking is the best exercise. Try to increase the distance and speed you walk.
  • In winter, many people walk in malls to avoid icy surfaces and cold conditions or they use a treadmill if they have access to one.
  • Don't take anti-inflammatory medication such as Advil® or Ibuprofen for 2 weeks after the operation, unless your surgeon has told you to continue taking them.
  • Please consult your transplant team for direction in managing any cold symptoms.
  • You cannot have any type of live vaccine as it could be harmful to you. This includes measles, mumps, rubella, shingles vaccine and yellow fever vaccine.
  • Do not drive for 2 or 3 weeks after operation.
  • Do not take long car trips. If you are travelling a long distance, stop every 2 hours to urinate.
  • Discuss readiness for driving at your clinic appointment.
  • You must not drive while taking narcotic pain medication. You need to be sufficiently strong, and flexible enough to move your leg and foot on the pedals, and be able to check your blind spot.
  • If your driving license was suspended pre-transplant, it may take several weeks or months to re-activate your license once you are fit enough to drive.
  • Always wear your seatbelt when you are driving or riding in a vehicle. If the belt causes discomfort where it crosses your incision, place a towel under the belt.
  • We will not provide letters to excuse you from wearing your seatbelt.
  • You can use public transportation any time after your transplant.
  • It is best that you do not travel by plane for one year after your transplant. Please talk to your transplant team about your travel plans to make sure it is safe for you to travel.

What is the easy call system?

Easy Call lets our transplant recipients and their transplant coordinators communicate with each other. Before being discharged from the inpatient transplant unit, you will receive the Easy Call phone number and your unique personal identification number (PIN). We will make sure you know how to use the system, and set up a password, before you leave.

Who do I call if I experience complications?

If you are experiencing health issues or concerns please use Easy Call to leave a message for your transplant coordinator. Use Easy Call if you have any of these symptoms:

  • Your temperature goes higher than 38ºC (100ºF), and/or you feel chills.
  • There is significant redness or increased pain at your incision.
  • Your urine flow has decreased, or if you cannot pass urine at all.

If your health issue is urgent or requires immediate attention please go to your local emergency department.

Who do I call with general post-operative questions?

Easy Call is your first place to call for post-operative questions.

Please DO NOT call your surgeon's clinic with post-operative questions.

Follow-up appointments

Before you leave the hospital we will arrange your follow-up clinic appointments. A detailed plan will be given to you, based on your progress and your doctor's recommendations.

​Blood tests

2-3 times a week, to start.

Kidney Transplant Clinic
Toronto General Hospital
Peter Munk Building - 12th floor
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What to Expect
You will need to have regular blood tests. The results will be viewed by the transplant team who will follow-up as necessary.

What to bring

Weekly clinic visits

You will also be seen every week in the Kidney Transplant Clinic. Over time, your clinic visits and blood tests will become less frequent. Follow-up appointments usually take 1 -2 hours.

When you arrive at the Kidney Transplant Clinic your blood work will be done, you will be weighed, and taken to a clinic room then you will be seen by your transplant doctor and coordinator.

To change an appointment, call your transplant coordinator by using the Easy Call system.

My contacts
Who do I call if I experience complications?

If you are experiencing health issues or concerns please use Easy Call to leave a message for your transplant coordinator. Use Easy Call if you have any of these symptoms:

  • Your temperature goes higher than 38ºC (100ºF), and/or you feel chills.
  • There is significant redness or increased pain at your incision.
  • Your urine flow has decreased, or if you cannot pass urine at all.

If your health issue is urgent or requires immediate attention please go to your local emergency department.

Who do I call with general post-operative questions?

Use Easy Call to speak with your transplant coordinator about post-operative questions.

Who Do I Call With In An Emergency?

If you have an emergency, please go to the closest emergency room or call 911.

Can I Email My Coordinator?

Talk to your transplant coordinator about email options, a consent form is required.

Please DO NOT call your surgeon's clinic with post-operative questions.

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