Kidney Transplant

Treating kidney disease through transplantation

Three Scripps Health kidney transplant experts having a discussion in a medical facility waiting area.

Dr. James Rice, Transplantation Nephrology, Scripps Clinic

Treating kidney disease through transplantation

Since 1994, Scripps Organ Transplantation Program has been helping patients with end-stage kidney disease through our kidney transplant program. Today, our kidney transplant program continues to have success rates that match or exceed the national average.

Expert care for kidney transplants

Our team of experts is here to help you though every step of the kidney transplantation process. Working as a multidisciplinary team, our kidney transplant surgeons and other specialists combine their skills and expertise to ensure you receive the best possible outcome, before, during and after your kidney transplant surgery.

In addition, Scripps offers a living donor program to help kidney transplant patients find a donor kidney faster. Scripps was the first in San Diego to perform a three-paired kidney exchange between six people, and recently participated in the first international kidney exchange.

Understanding your kidney transplant

Most people have two kidneys, which are located in their back just below the rib cage. Your kidneys have several important functions, including:

  • Removing waste and excess fluid from the blood
  • Controlling the body’s chemical balance
  • Assisting in the creation of new red blood cells
  • Regulating blood pressure

Some injuries and conditions — including kidney failure, polycystic kidney disease, infections, hypertension or glomerulonephritis — can damage the kidneys and limit their ability to function. If this happens, you may need to have your blood regularly cleaned through a process called dialysis, or you may be eligible for a kidney transplant.

During a kidney transplant surgery, a donor kidney is surgically placed in the lower abdomen near the major veins and arteries in the pelvis. The new kidney begins to clean the blood immediately. The damaged kidneys are often left in place unless they are badly infected or enlarged from polycystic kidney disease.

Frequently asked questions about kidney transplantation

If you need a kidney transplant, you may have many questions about kidney transplant surgery and what to expect. Here are answers to frequently asked questions about kidney transplantation. Always feel free to ask your physician or care team for more information and guidance.

Freedom from dialysis after a kidney transplant

At Scripps, our goal is to help people eliminate the need for dialysis with a successful kidney transplant — even for people who have a complex diagnosis, advanced age or other factors.

Our kidney transplant program helps patients spend less time on the transplant waiting list through numerous protocols not available at every transplant facility. These include:

ABO-incompatible kidney transplants 

Special protocols make it possible to transplant across blood types.

Steroid-free immunosuppression

We offer specific protocols for patients who cannot tolerate traditional steroid-based drugs for immunosuppression.

Cross-match positive kidney transplants 

Our program uses techniques which can, in many cases, remove the antibodies that would cause a transplanted organ to be rejected.

Kidney transplants for patients with HIV infection 

Our team can help patients with stable HIV infection manage the complex drug interactions between transplant and HIV medications.

Living kidney donation 

Despite ongoing efforts to encourage organ donation after death, there are still not enough kidney donors in the US to meet the need, and more patients join the wait list each year. Our living kidney donor program allows friends, family members and altruistic donors to help those in need of a kidney transplant. Learn more about becoming a living kidney donor.

Kidney donor exchanges 

Potential donors who are unable to donate to their own loved ones can choose to donate to each other’s loved ones in what is essentially a “swap,” or exchange.

Expanded criteria donor kidney transplants

The expanded criteria donor (ECD) is considered an “older kidney” and taking an older kidney enhances the opportunity to be transplanted sooner than waiting for a younger or standard criteria kidney (SCD). 

The specific criteria of an ECD kidney is any donor over the age of 60, or a donor over the age of 50 with two of the following:

  • A history of high blood pressure
  • A creatinine (blood test that shows kidney function) greater than or equal to 1.5
  • Death resulting from a stroke

Sometimes the function of a single kidney from an ECD organ would not be sufficient. In this situation, a pair of kidneys with limited function can be transplanted into a single patient. This type of transplant is called a dual-kidney transplant. Research shows that this option offers outcomes that are just as good as a single-kidney transplant with normal function and can effectively address the shortage of donor organs.

You can decide whether to accept an ECD kidney and you will be asked to consent to this in writing. Intuitively, an ECD kidney will not last as long as a younger SCD kidney. However, the one-year graft survival is estimated at over 80% for ECD vs greater than 90% for SCD and five year rate of function kidney is excellent. For older patients, this may be the best approach before age related complications preclude transplantation. 

Whether you receive SCD or ECD kidneys, there is a low rate of needing dialysis for days or weeks, and in rare cases, there is risk of the kidney not working. Kidney transplants have a superior survival when compared to remaining on dialysis. You should discuss with your nephrologist whether to consent to ECD kidney offers.

Living kidney donation

Despite ongoing efforts to encourage organ donation after death, there are still not enough kidney donors in the United States to meet the need, and more patients enter the wait list each year. Our living kidney donor program allows friends, family members and altruistic donors to help those in need of a kidney transplant. Learn more about becoming a living kidney donor.

Our approach to transplants

At Scripps, we treat the person, not the illness. Our patient-centered approach combines a multidisciplinary team with the most advanced treatments and technology available in San Diego and beyond.

Support groups for transplant patients and caregivers

Our program provides free, monthly support groups for organ transplant patients and their families. The groups are designed to share coping strategies, express frustrations and concerns, as well as share hope and support.

Patient support and resources

Scripps offers a wide range of supportive services to meet the specialized needs of transplant patients and their loved ones, including support groups and educational classes. Learn more about the support and resources you have access to at Scripps. Our inspirational transplant patient success stories are another great resource to learn more about the supportive, life-affirming aspects of Scripps transplant services and care.