The Operation and Recovery
Once the assessments are complete, a date will be scheduled for surgery.
This is a joint decision by the transplant team, the doctor looking after the person needing the transplant (the recipient), and of course the donor themselves.
Typically, both donor and recipient operations each take 3-4 hours with 2-3 hours in recovery afterward for observation.
A kidney can be removed in either of two ways, the laparoscopic or ‘keyhole’ surgery which uses a ‘minimal access’ technique, or by using traditional open surgery. The ‘keyhole’ (laparoscopic) technique is widely used in all transplant centres.
Occasionally if the surgeon is not happy with the progress, or there is any concern regarding damage to the bowel or blood vessels, then a bigger incision will be made.
This is called ‘conversion to an open’ operation and happens to approximately one or two people in every 100 who donate. The purpose is always to maintain the safety of the donor. If you have an open operation you will take longer to recover than after keyhole surgery.
Although ‘key-hole’ surgery, clearly there has to be a cut sufficiently long to allow the kidney to come out! This larger incision can be in a similar position to a C-section wound, or may be just below the ribs. Different surgeons sometimes have different techniques, so your own surgeon will discuss in detail where the incisions will be for your particular operation.
Donors will experience some pain after the surgery, paracetamol is provided regularly, initially into the vein via a ‘drip’.
Morphine is given as required, sometimes through an intravenous pump which gives a dose of morphine on the push of a button (‘patient controlled analgesia’ or PCA).
Morphine may alternatively be given in tablet or liquid form by mouth. Once the tubes are removed donors are encouraged to get out of bed and sit on a chair.
Immediately after the operation
The donor will wake up in the recovery room in their own time, where they will be for a couple of hours before going to the ward. Once settled, family members are allowed to visit.
Several temporary tubes or lines are inserted during the operation. These include a plastic drain tube attached to a wound drainage bag, which collects fluid from the wound and also a urinary catheter, however in some cases these are removed immediately after surgery.