Kidney transplantation is the preferred treatment option for most people with end-stage kidney disease because it offers potential benefits such as greater freedom and a longer, healthier life in comparison to dialysis.
The St. Paul's Kidney Transplant Program offers pre-transplant referral and assessment services, transplant surgery, post-transplant care as well as a variety of living donor programs. The program works in partnership with the BC Transplant Society. BC Transplant leads and coordinates all activities relating to organ donation and transplantation throughout BC.
For more detailed information about all aspects of kidney transplantation at St. Paul’s Hospital, please download our Kidney Transplant Recipient Booklet.
On this page:
- Considering a kidney transplant
- Pre-transplant referral and assessment
- Living kidney donor transplant
- Deceased kidney donation
- Transplant surgery
- Post transplant care
Considering a kidney transplant
For patients who are already on dialysis or who are approaching end-stage kidney disease, transplantation may offer a second chance at life and hope for the future. However, transplantation also requires a lifetime commitment to taking care of a new kidney. Not everyone is a suitable candidate for transplantation.
The potential benefits of transplantation include:
- Freedom from dialysis
- Better overall health
- Improved energy
- Freedom to travel
- Added survival years
There are also challenges and responsibilities:
- Recipients require regular post-transplant care and monitoring for life
- Recipients must take anti-rejection medication for life
- Recipients must manage the potential side effects of anti-rejection medication, such as increased risk for infections and certain cancers
If you are thinking about the possibility of transplantation, speak to your kidney specialist.
Pre-transplant referral and assessment
If your kidney specialist thinks you may be a suitable candidate for assessment, you will be referred to the Kidney Transplant Program at St. Paul’s Hospital (patients in BC may also be referred to the transplant program at Vancouver General Hospital).
Once your referral is received, the Kidney Transplant Program will send you an information package. You may also receive requisitions to have additional blood work or testing done.
After your tests have been reviewed, you will be booked to be seen by the Transplant Team. Potential transplant recipients are assessed individually by the Transplant Team to determine if the benefits of a kidney transplant outweigh the risks. Individuals must be healthy enough to survive the surgery and have a good chance of benefiting from a transplant.
A full assessment involves numerous steps and may take several months to complete. This information is used by the Transplant Team to make the decision about the suitability of transplantation in your case.
If the Team determines that you are eligible for kidney transplantation, you will follow one of two paths:
- You can plan for a living kidney donor transplant, OR
- You will be added to the Provincial Transplant Waiting List for deceased kidney donation
Living kidney donor transplant
A transplant from a friend or relative is called living donation. With the increasing demand for kidney transplants and the decreasing number of deceased donors, living donation is the only option for receiving a kidney transplant in a timely way.
The Renal Program at St. Paul’s Hospital operates a Living Kidney Donor Program to support and assess the suitability of individuals who are thinking about becoming a living kidney donor. There are three ways to be a living kidney donor:
- Donating a compatible kidney directly to a friend or relative
- If the donor kidney is not compatible with the recipient, using the Living Donor Paired Exchange (LDPE) Program to be matched with another donor/recipient pair in a similar situation
- Donating a kidney without personally knowing someone needing a transplant through the Living Anonymous Donor (LAD) program.
The decision whether to donate a kidney is a very personal one and there is no right or wrong choice. The prospective donor should know that she or he may decline to donate at any time. Learn more about donating a kidney through the Living Kidney Donor Program.
Deceased kidney donor donation
If you do not have a living donor, you will be placed on the Provincial Transplant Waiting List in the order of your dialysis start date. The average waiting period for a deceased donor kidney transplant is estimated at five to 10 years.
Currently, kidneys are allocated, within your same blood group, to those people who have been on dialysis the longest. In addition, priority will be given to:
- Patients who are unable to dialyze
- Patients under the age of 18; and
- Patients who have a high antibody level and are at high risk for rejection (if a suitable kidney is identified).
If you are receiving a living kidney donor transplant, your surgery date will be scheduled and you will have time in advance to prepare for your hospital stay and recovery.
For patients waiting for a deceased kidney donation, a surgery date cannot be planned in advance. As you near the top of the waiting list, you should prepare yourself to be contacted at any time if a suitable kidney becomes available.
Before and after your transplant surgery, you will be cared for in the Nephrology/Urology Inpatient Unit at St. Paul’s Hospital. This is a specialized hospital unit for transplant patients and other patients with kidney disease. Before your surgery, you will undergo blood work and other tests. You will also meet with members of the transplant team including a surgeon, physician and anesthetist. The transplant ward nurses and physicians will explain the transplant procedure to you in detail at the time of your admission.
Kidney transplant surgery takes about three hours. After your surgery, you will stay on the Nephrology/Urology Inpatient Unit until discharge. Everyone recovers at different rates, but most people are discharged within five to seven days.
Post transplant care
Following your discharge from hospital, your health will be closely monitored by the Transplant Team, especially in the early months after your transplant. If you live outside of Metro Vancouver, you will need accommodation in Vancouver for about the first two or three months.
The Post-Transplant Clinic will become an important part of your ongoing care. For the first six weeks, you will attend the clinic twice a week. If there are no complications, your clinic visits will gradually become less frequent. After the first year, most individuals continue to visit the clinic every two to four months, in addition to having monthly blood work. Transplant recipients who live outside of Metro Vancouver may be referred to one of six regional clinics across British Columbia for ongoing monitoring closer to home.
Your Transplant Team will help you live successfully with your transplant by providing lifelong education, support and medical care.
Here are some resources about transplant that you may find helpful
- Post-transplant patient handout (PDF) – Renal Program at St. Paul’s Hospital
- Approved over the counter (OTC) products for transplant recipients (PDF) – Renal Program at St. Paul’s Hospital
- An overview of Immunizations and Recommendations for Patients on Immunosuppressants (PDF) – Renal Program at St. Paul’s Hospital
- Patient education materials for post transplant from the International Transplant Nurses Society
- Recognized sunscreens from the Canadian Dermatological Association
- About skin cancer after transplant from the AT-RISC Alliance
- Skin Cancer Risks in Transplant Recipients: Know the Facts (PDF), from the International Transplant Nurses Society