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What is kidney transplant surgery?
Your kidneys play an important role in filtering waste products and excess fluid from your blood. When your kidney function falls to a critical level, called kidney failure or end-stage kidney disease, a treatment called dialysis may be needed. Dialysis helps remove waste products and extra fluid from your blood when your kidneys are no longer able to do so effectively.
As dialysis can have some unpleasant side effects and impact your quality of life, our consultants may recommend a kidney transplant. This is where a healthy donor kidney is surgically implanted into your body to take over the function of your failing one. Transplants from a living donor have better outcomes, and family members or friends are often good candidates for kidney donation.
Evelina London Children’s and Guy’s hospitals are internationally recognised as leading centres for kidney transplantation in adults and children, combining excellence in clinical care with pioneering innovation.
Experts in kidney transplants
Our world-renowned services include:
- short notice appointments
- keyhole kidney transplant surgery
- fast access to treatment
Pioneering care in kidney transplantation
Our kidney transplant specialists at Evelina London Children’s and Guy’s hospitals have a global reputation in their field. Our notable achievements include:
- pioneering the use of robotic technology in donor nephrectomy (kidney removal)
- first in the world to use 3D printing to support the successful transplantation of adult donor kidneys into small children
Our living donor transplant programme is one of the largest and most successful in Europe with a one-year graft survival rate of 99%. We also have one of the largest blood group incompatible transplantation programmes in the UK, with a success rate of more than 95%.
We specialise in complex transplant cases and perform around 300 transplants each year, including living donor adult and paediatric transplants. We’re also recognised for providing kidney transplants to patients who would otherwise be considered unsuitable candidates, including those with complex bladder and other urology problems.
Our reputation is further enhanced by our commitment to ongoing kidney transplant research as part of the NIHR Biomedical Research Centre (BRC), a partnership between Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.
Who is suitable for a kidney transplant?
Kidney disease occurs when your kidneys are damaged and can’t filter your blood as well as they should. It is characterised into 5 stages, from stage I, where there is mild damage and they still function well, to stage V, where they have nearly or completely lost all function (called end-stage kidney disease).
The most common causes of kidney disease in adults is hypertension (high blood pressure) and diabetes. In children, kidney disease is most often caused by congenital abnormalities (problems that develop before birth) and hereditary conditions (where genetic disorders are passed down from parents).
There is no cure for kidney disease, but treatments can help relieve symptoms and stop the condition getting worse. If the condition worsens to end-stage kidney disease, you will need to start dialysis treatment to filter your blood of harmful waste products.
Dialysis can have some unpleasant side effects and takes long periods of time, which can disrupt school attendance and education for children, and work attendance for adults. For this reason, our consultants may recommend a kidney transplant.
Compared with dialysis, a kidney transplant is associated with a:
- better quality of life
- better long-term survival
- fewer dietary restrictions
A kidney transplant is normally offered to patients with end-stage kidney disease that are healthy enough to undergo major surgery and manage the necessary lifelong medication that prevents rejection of the donated organ (called immunosuppressants). Sometimes, a pre-emptive kidney transplant may be offered to patients before their kidney disease advances to the point that they need dialysis, if our consultants feel there will be better outcomes.
Most paediatric kidney transplant recipients are teenagers, but our specialists can perform surgery on children as young as a year old, and as small as 22 pounds in weight.
For some patients with end-stage kidney disease, a kidney transplant may be riskier than dialysis. This can include patients that are:
- of an advanced age
- have severe heart disease
- have active or recently treated cancer
If you would like to speak to one of our consultants about your or your child’s suitability for a kidney transplant, contact our team to arrange an appointment.
Types of kidney transplant
A healthy kidney for transplantation can come from a living donor or deceased donor. The kidney will need to be checked for compatibility in several ways to avoid your body rejecting it. This includes:
- blood type matching – we can only transplant a kidney from a donor with the same or compatible blood type. For example, blood type O donors can give a kidney to anyone, while blood type AB recipients can receive a kidney from anyone
- tissue type matching – human leukocyte antigen (HLA) proteins help your immune system recognise your own tissues. A donor needs to be a close HLA match to ensure that the transplanted kidney will last a long time and so that your body won’t reject the organ
- crossmatch testing – this is to check whether you have antibodies that will attack a donor kidney
A living donor means that your kidney comes from someone that is still alive with healthy kidneys – they can still live a normal life with one healthy kidney after donating the other to you. Although living kidney donors can be anyone, they are commonly immediate family members, spouses, partners, or friends. A living donor must be older than 18, healthy (they should have no major health issues) and will need to pass a medical and psychosocial evaluation before donating.
A deceased donor kidney is from someone who has just died from a cause that doesn’t affect the function of the healthy kidney. At Guy’s and St Thomas’ Specialist Care, we do not provide private kidney transplant surgery using deceased donor kidneys.
A kidney transplant from a living donor is associated with better outcomes than a deceased donor kidney. On average, a kidney transplant from a living donor lasts for 20-25 years, while it lasts 15-20 years from a deceased donor.
If you would like to discuss options for a living donor kidney transplant procedure, get in touch with our team to arrange an appointment with our specialists.
What happens during a kidney transplant?
Our team is here to guide you through every step of a kidney transplant procedure, making the process as smooth and comfortable as possible. As we perform a healthy living donor kidney removal and a kidney transplant to a recipient on the same day, we have provided some information below to help both of you feel more confident and prepared.
Since it is possible to live with one healthy kidney, living donations are a common way to ensure that you or your child receive a donor kidney. Family members tend to be good candidates for a living kidney donor, however we will conduct tests on all potential donors to confirm compatibility.
As most kidney transplants last around 20 years, children are very likely to need more than one during their lifetime. Generally, the better matched they are with the donor in the first transplant, the easier it will be to match a second transplant donor.
While a good match is preferable, our expert team do specialise in complex cases. We have the UK’s largest antibody incompatible transplant programme and the only such programme for children.
As a kidney transplant procedure is performed under general anaesthetic, you and your donor will need to refrain from eating and drinking for a number of hours beforehand. Our transplant team will tell you when this is.
For a kidney donor:
- We will use a minimally invasive keyhole surgery procedure to remove one of your healthy kidneys.
- A camera and surgical instruments will be inserted through several small incisions in the abdomen, before our surgeon carefully frees your kidney from the surrounding tissues, seals and cuts the blood vessels, as well as the ureter (urine tube going down to the bladder).
- Your donor kidney is then removed through a larger incision, before all incisions are closed with stitches, staples or glue.
The whole procedure takes 2 to 3 hours to complete. Once it is finished, you will be taken to recovery where our team will support you as you wake up from the anaesthetic.
For a donor kidney recipient:
- An incision will be made in the lower right side of your abdomen. This will be used to place the donor kidney into your body since your natural kidneys will be left in place (unless they are causing issues like infection or pain).
- Nearby blood vessels will be attached to the blood vessels of the donated kidney – this will make sure the kidney has the blood supply needed to function properly.
- The ureter of the donated kidney, which is the tube that carries urine from the kidney to the bladder, will be connected to your bladder. Initially, a stent, which is a small plastic tube, may be inserted into the ureter to support the flow of urine. However, this is normally removed in a small procedure called a cystoscopy around 6 to 12 weeks later.
- The incision on your abdomen will be closed using either stitches, staples or glue.
The entire surgery usually takes around 3 hours to complete. Once it is finished, you will be taken to recovery where you will come around from the anaesthetic.
For a kidney donor:
Immediately after surgery, you will receive pain relief, as it’s normal to experience some discomfort around the surgical site. You can expect to stay in hospital for up to 1 week, but this can vary between patients. After discharge, we will arrange follow-up appointments as needed to monitor your recovery.
Our consultants will advise you on when you can return to work, as well as when you can resume activities such as driving and exercising. We will also advise you on any adjustments needed to your lifestyle to ensure you remain healthy with one kidney.
For a donor kidney recipient:
Immediately after surgery, we will provide you with pain relief to manage any discomfort experienced around the surgical site. Our consultants will also immediately start you on immunosuppressant medications designed to stop your immune system from rejecting your new kidney. You will need to take these medications for the rest of your life. You can usually expect to stay in hospital for 1 week, but this can vary depending on your personal circumstances.
It could take up to 2 weeks for your new kidney to start working, and you may need to be kept on dialysis until this time. Regular follow-up appointments are necessary to check your kidney function and to ensure that your medicines are working. You should expect to have 2 or 3 visits to our transplant centre each week during this time.
Our consultants will advise you when you can resume normal activities such as driving or exercising, as well as going back to school or work. We will also provide guidance on maintaining a healthy lifestyle with a donor kidney, such as what diet to follow as well as any restrictions.
What are the benefits of a kidney transplant?
The main benefits of a kidney transplant are an improved quality of life and freedom from dialysis. A successful kidney transplant gives you increased strength, stamina and energy. It also means you can return to a more typical lifestyle, with unrestricted food and fluid intake.
What are the risks of a kidney transplant?
The main risk of a kidney transplant is experiencing transplant rejection, where your body recognises the new organ as foreign. However, with advances in immunosuppressant medications that prevent rejection, kidney transplants are very successful, with few complications after transplantation.
Immunosuppressant medications carry their own risks, including an increased risk of infections and certain cancers. Our consultants will explain these risks to you and will only recommend a kidney transplant if the benefits outweigh the risks.
For a kidney donor, the main risk after surgery is surgical site infection and bleeding, but this will be no more common than other surgical procedures.
Reviewed regularly to reflect clinical best practice
Last reviewed: 23 April 2026
Locations
Our kidney services are offered at the following locations:
Discover our kidney transplant specialists
Our internationally renowned kidney specialists are experts in kidney transplants for adults and children. They are pioneers, continually working to improve the success rates of kidney transplants and ensuring better outcomes.