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Transplant Services

Kidney Transplant Surgery

Since 1968, the surgeons and transplant specialists at the Medical University of South Carolina have been helping kidney transplant patients across South Carolina – and beyond – live happy and productive lives. Our patient-centered approach is designed to work with you before, during, and after kidney transplantation.

 

Why Choose MUSC?

Short wait times:  MUSC has one of the shortest wait times in the country, improving the odds of finding you a new kidney.

High Survival Rates: Our program is recognized for having a very high survival rate, despite twice the number of high-risk patients

Nationally Recognized Team: MUSC has some of the best physicians and surgeons, the latest technology and state-of-the-art facilities. Our Adult and Pediatric Nephrology programs have been ranked by the U.S. News and World Report.

Strong Living Donor Program: We specialize in living donor kidney transplants, which can speed up the availability of healthy kidneys for those who need them most. We are also a partner in an exchange program that matches donors who do not have the same blood group, this means two people get a kidney transplant without having a matching living donor. Learn more about our Living Donor Program.

Location: We are located in Charleston, South Carolina, one of the most beautiful cities in the world.

 

Is a Kidney Transplant Surgery Right for You?

Transplantation is a complicated process and can put an enormous strain on your body. You must be healthy enough to handle the stress of the surgery and the post-transplant recovery. Ask your doctor if transplantation is right for you.

Generally, a kidney transplant is indicated for patients who are suffering from irreversible kidney failure. These patients are in Stage IV or V of chronic kidney disease (CKD). Being selected as a good kidney transplant candidate is based on a thorough review of your:

  • Current health condition
  • Past medical history
  • Psychosocial history and evaluation
  • Lab results
  • Medical testing

Patients who are NOT good candidates for kidney transplant surgery include those who have:

  • Cancer other than certain malignancies, including most skin cancers
  • Active infections
  • Active immunological disease, such as Lupus, Goodpasture, Wegener's or other vasculitis, or Scleroderma
  • Advanced cardiac disease
  • Advanced primary pulmonary or thoracic disease
  • Sickle cell disease
  • Morbid obesity with a BMI of >40
  • Malnutrition
  • Unstable psychiatric disorders
  • Evidence of poor compliance
  • Active alcohol or substance abuse
 

UNOS Waiting List and Selection Process

Who decides if and when I get a kidney?

After the transplant evaluation and further testing, your complete case will be presented to the Transplant Selection Committee where a team of experienced transplant specialists make sure that transplantation is a safe option for you. Eligible patients are placed on the United Network for Organ Sharing (UNOS) transplant waiting list. After you are placed on the waitlist, MUSC Health physicians do not decide who will be the next patient to receive a kidney from the list. UNOS has a pre-determined process for allocating kidneys from deceased donors to eligible transplant candidates. Learn more about the UNOS process.

The quickest way to get a kidney is from a living donor, someone you know who is healthy and is willing to donate a kidney. They do not have to be a match to your blood group as we have ways to match you with another group of patients and donors. This is even more important if you are not yet on dialysis as you will have to wait longer to get a kidney from a deceased donor. Learn more about our Living Donor Program.

 

What Does the Whole Transplant Process Involve?

The kidney transplant process:

  1. Discuss your options with your primary care physician and nephrologist.
  2. Ask you nephrologist or your dialysis social worker to refer you to MUSC - Kidney Transplant Referral Form.
  3. After an assessment of your whole case you will be informed about the next step.
  4. If you need to have a full assessment, we will schedule you for an evaluation appointment at our transplant clinic in Charleston.
  5. Complete all the tests your nurse coordinator has asked for as quickly as possible.
  6. After the tests are completed the transplant team will evaluate your whole case again at a selection committee.
  7. Your nurse coordinator will call you with the final decision of the committee. They might decide that it is not safe for you to be transplanted.
  8. If you are deemed a candidate for transplant, you will be registered with UNOS and be placed on the waiting list.
  9. While you are on the waiting list, you must be ready to come to MUSC at any time that we have an organ offer for you.  You need to stay in good health and let us know immediately if your health, insurance, phone number, address or caregiver changes.  These could all make a difference to the organ offer and might mean that you get skipped for the offer if we cannot get in touch with you or your circumstances have changed without us knowing.
  10. Another very important part of being on the waitlist is remembering to get your blood drawn every 30 days.  Your dialysis unit will help you or if you are not on dialysis, we will send you a kit every 6 months to get this completed.

To be sure that you are healthy enough to have a successful transplantation, the following is what you should expect to do before your assessment by the MUSC Health Transplant Center and your listing with the United Network for Organ Sharing (UNOS) list. Unlike many transplantation programs, you will not have to move to Charleston while you are waiting and you may complete many of the necessary steps near your home.

Patient and family education

We want patients and caregivers to know as much as they can about kidney transplantation, so they can make the right choices.  You and your family will have an opportunity to attend an education class, where you will learn the necessary steps to take in planning for a transplant. After this class you will be able to complete the first steps of the transplant evaluation on the same day. You can preview the video below that is part of our education class to give you an overview of our kidney transplant program.

Patient education video

 

At your evaluation, in addition to the education class, you will have:

  • A medical evaluation with a transplant nephrologist
  • A surgical evaluation with a transplant surgeon
  • A social work evaluation by a transplant social worker
  • A nutritional evaluation by a transplant dietician
  • An EKG, chest x-ray, and pre transplant screening labs
  • A full medication evaluation (after you leave) by a transplant pharmacist

After the class, a transplant nurse coordinator will meet with you to let you know what other tests you will need before the selection committee can make their decision. Some of these tests are routine health screening tests that you might have already completed or you can arrange to complete before you even get to your transplant evaluation:

  • Mammogram and PAP smear for females
  • PSA blood test for men over age 50
  • Colonoscopy for patients over age 50 or whenever you were told to follow up after your last colonoscopy
  • PPD skin test- for tuberculosis (you might have had this recently at dialysis and they can give you a copy)

If you complete or already have any of these tests completed please bring the results with you to the evaluation.

The results of these tests ensure that you do not have an issue, such as a hidden infection, cancer or other complicating factor that would expose you to unacceptable risk – or even lead to denial of transplantation.

 

What to Expect at MUSC Health 

The MUSC Health patient-centered approach is designed to work with you before, during, and after kidney transplant surgery.  A comprehensive team of transplant certified specialists will help guide you through the process and provide the kind of care you expect from one of the nations' leading teaching hospitals.

Surgery

The procedure takes about two to four hours. The surgeon will make an incision, usually on one side of your abdomen, and insert the new kidney. The kidney will be attached to an artery and a vein to provide access to your blood supply. The urinary tract will be surgically connected to  your bladder. The incision will be closed using staples. You will be in recovery for another few hours, and then transferred to the Organ Transplant Unit.

Hospital stay - Organ Transplant Unit

You can expect to stay in the hospital for three days. The transplant staff will monitor you closely and ensure that your new kidney is functioning well. You will start eating solid food as soon as you're ready – although your diet will not be as restrictive as while you are on dialysis. You will stand and walk short distances very soon after surgery.

Discharge

When discharged from the hospital, you will move to a nearby hotel or other local housing arrangement. You don’t need the intensive care of a hospital, but we do want you close for several days, so we are certain that you are recovering well enough to go home, and for us to monitor your new kidney.

The MUSC Health Transplant Team will work with you and your family to prepare for care at home. We will provide a book on how to manage your post-transplant care and make an appointment with our post-transplant clinic to monitor your progress.  Your team is available 24 hours a day, 365 days a year to answer any questions you may have.

Care after your transplant surgery

The two biggest concerns post-surgery are infection and organ rejection. You will need to take new medications to prevent both of these from happening. These are absolutely necessary, but sometimes they have side effects. You may also be taking medicines for blood pressure control, vitamins, diuretics (water pills), antacids, etc. Some of these medicines may only need to be taken for a short time, while others may be continued for other medical conditions you have. If another doctor prescribes medication for you, it is wise to let the transplant team know to make sure that they do not interfere with your immunosuppressive medicines.

Remember, transplantation is a treatment, not a cure. So you have to take good care of yourself. Your post-transplant team will work with you to be sure that you are doing everything that you can to have a successful recovery. The MUSC Health Transplant Program has an excellent success record. You should enjoy a high quality of life, free from dialysis and many of the dietary restrictions you had.

MUSC Health has post-transplantation clinics for kidney patients in these areas.

  • Charleston
  • Greenville
  • Telemedicine will be available soon in Columbia
  • Florence and Columbia outreach clinics coming soon
 

To contact the MUSC Health Kidney Transplant Program, please call 843-792-5097.