The Transplant Surgery

Most kidney transplants take a few hours. The new kidney is placed low in the abdomen and connected to nearby blood vessels and the bladder. In most cases your own kidneys stay in place.

Before the OR (check-in & prep)

• Confirm consent, allergies, and last dialysis/meds; surgical site is marked.
• IV started; antibiotics and other pre-op medicines are given.
• Immunosuppression is started per your center’s plan (some doses before, during, or right after surgery).

Anesthesia

• General anesthesia (fully asleep) with a breathing tube; monitoring lines are placed.
• You won’t feel or remember the procedure; nausea prevention is routine.

What the surgeon does

• Makes an incision in the lower abdomen (right or left, based on your anatomy and vessels).
• Connects the kidney vein and artery to blood vessels in your pelvis so blood flows through the new kidney.
• Connects the ureter (kidney tube) to your bladder. A small internal stent is often placed to help healing.
• Confirms bleeding is controlled and the kidney is well-positioned before closing.

Lines & devices you may wake up with

• Foley catheter: drains urine; usually removed a few days after surgery.
• Ureteral stent (internal): removed in clinic later (often 2–6 weeks).
• IV lines: for fluids and medicines; sometimes a wrist arterial line for close BP checks.
• JP drain (bulb): not always used; collects fluid near the incision, removed when output is low/light.
• Wound vacuum: occasionally used to help a difficult incision heal; dressing changes are scheduled.

How long it takes

• Living-donor kidneys: often ~2–3.5 hours.
• Deceased-donor kidneys: can be longer depending on timing and complexity.
• Prior surgeries, body habitus, vessel anatomy, and scar tissue can add time. Longer does not automatically mean something went wrong.

Right after surgery (PACU → surgical floor)

• You’ll wake in recovery; pain and nausea are treated right away.
• Urine may start immediately or take time—especially with deceased-donor kidneys. Lab checks begin day one.
• Fluids and blood pressure are adjusted to support the kidney. Early walking starts with help.

Pain plan & nausea

• Multimodal pain control (combining methods) is typical; some centers use a patient-controlled pump early on.
• Stool softeners with opioids; switch to acetaminophen when possible. Avoid NSAIDs unless your team says otherwise.
• Antinausea meds are available—ask early so you can keep medicines down.

When plans differ

• Delayed graft function: the kidney is slow to “wake up.” Short-term dialysis may be needed while recovery continues.
• Additional procedures: urine leaks/strictures or bleeding may require a procedure; your team will explain if this happens.

Family updates

• The team usually gives an update after the operation and again once you’re settled in recovery or your room.

Risks (brief)

• Bleeding, clots, wound issues; urine leak or narrowing; infections; and rejection risk later. Your team works to reduce these.

Read more: Post-Op Complications

What to bring / tell your team

• Photo ID, insurance card, medication list with exact times, and allergy list.
• CPAP machine if you use one; comfortable walking shoes; phone charger and a short checklist for questions.
• Tell the team about any blood thinners, recent infections, or last dialysis date/time.

This page is educational and can’t cover every case. Your surgical team will personalize the plan for you.