Transplant Center at Porter

Porter Adventist Hospital

Transplant Center at Porter

Porter Adventist Hospital

Kidney/Pancreas Transplant

Kidney Transplant

Porter's kidney transplant program was started in 1986 by transplant surgeons dedicated to the care of patients in the Denver area. Since then we have grown significantly, caring for patients throughout Colorado and the Rocky Mountain region.

Common conditions we treat:

  • Lupus
  • IgA nephropathy
  • Diabetes
  • Congenital urological deficiencies
  • FSGS
  • Hypertension
  • Polycystic Kidney disease
     

Combined Kidney/Pancreas Transplants

Some patients battling type 1 diabetes may discover that their pancreas has stopped functioning properly even with medication, often due to serious complications caused by type 1 diabetes. Our highly trained medical team works with each patient individually to identify what treatment plan is best for them. 

A pancreas transplant is commonly done in conjunction with a kidney transplant. This is because diabetes is one of the main causes of kidney failure, so often times both organs are functioning improperly.

  • What You Can Expect

    Kidney Transplant Procedure

    The process begins when your nephrologist refers you to the Transplant Center at Porter Adventist Hospital. With a simple phone call we are able to begin your journey to transplant. We work to get everything in place for you to have an evaluation for a potential kidney transplant, whether that is here in our office in Denver, in your hometown, or at one of our satellite sites.

    Our kidney transplant process begins with an evaluation for a transplant which involves a day-long visit with the entire transplant team. During this visit you will meet a transplant nephrologist, a transplant surgeon, a social worker, the financial coordinator, a dietitian and your transplant nurse coordinator. Each member of the multi-disciplinary team works to ensure that every aspect of your care is addressed and that your transplanted kidney will last as long as possible.

    There are two options for a kidney transplant procedure; you may be placed on a kidney transplant wait list for a deceased donor kidney to become available, or have a living donor donate one of their kidneys to you. The team will go over these options with you in detail and provide all the information to find the best choice for you.

    The typical kidney transplant surgery lasts 2-4 hours, and the average length of stay in the hospital is 3-5 days. Following your discharge from the hospital, you will be followed closely by the transplant team as an outpatient a few times per week for the first few weeks immediately after your kidney transplant.

    Your transplant experience will continue – we will visit with you every year and celebrate each transplant anniversary with you and your new gift of life.

  • Living Donor Program

    Since 1986, the Transplant Center at Porter Adventist Hospital, has worked with living kidney donors to perform transplants. Today more than half of our kidney transplants involve living donors.

    There are several benefits of living kidney donation as compared to receiving a kidney from a deceased donor. In Colorado, the average length of the kidney transplant waiting list is three to five years. Having a living donor can decrease a patient's wait time for a kidney transplant, allowing them to avoid or stop dialysis earlier. Additionally, living donor kidneys are healthier and can last longer than deceased donor kidneys.

    Living donors save the life or improve the quality of life of their recipient and act out of great compassion and generosity. Often, the recipient is a family member or beloved friend. Sometimes, the donor is a Good Samaritan who has learned of a need and steps forward to fill it. Living donors must be 18 years or older.

    All living donors undergo an extensive evaluation to test their kidney function and their overall health. The evaluation takes place in our Denver clinic, where potential donors meet with a nephrologist, surgeon, dietitian, living donor advocate, social worker and nurse coordinator.

    Living donors should want to donate of their free will and not be pressured by family members or friends to donate. The decision to donate an organ is a personal matter – it should be motivated by altruistic reasons only, without influence from others. Donors can change their minds at any time during the process.

Kidney/Pancreas Transplant FAQ's

  • How does kidney disease affect my body?

    Dialysis is an excellent treatment for kidney disease, but even the best dialysis gives you only about 10-20% of your normal kidney function. At this level of kidney function you are at high risk for heart attacks, infections, and nerve damage. For example, a 20 year-old dialysis patient has the same chance of having a heart attack as an 80 year-old non-dialysis patient.

  • Is a kidney transplant the best option for me?

    Both the National Kidney Foundation and the American Society of Nephrology recommend that just about all patients with chronic kidney disease should receive a transplant rather than dialysis.

  • Should I also get a pancreas transplant?

    If you are a type 1 diabetic (juvenile onset) and are younger than about 50, you will likely benefit from a pancreas transplant in addition to your kidney transplant.

  • Can I get a transplant?

    Just about anyone can get a transplant. The only things that would prevent you from getting a transplant are cancer within the last 2 years, the inability to take medicines and keep your appointments, or some types of chronic infection. Patients with heart disease can still get a transplant, although this should be discussed with the transplant team. If you are very overweight you will need to lose some weight prior to your surgery.

  • Am I too old for a transplant?

    There is no age cutoff for transplant. We will evaluate anyone, regardless of age. Of course the older you are, the more risky the surgery, so if you are older than 75 we will talk about whether transplant is the best option or not.

  • Are there any risks with a transplant?

    Unfortunately, yes. In order to prevent rejection, you will need to take about 15-20 pills a day, and they all have side effects. We will work with you to minimize these side effects, but in some cases you will have to learn to live with them. We will review all possible side effects before your transplant. Also, there is a small risk of adverse events associated with the transplant surgery itself.

  • What is rejection?

    Rejection is when your immune system attacks your new kidney. Even with the medicine you take, rejection may occur. Rejection rarely causes the kidney to fail completely, but does usually require treatment in the hospital.

  • How can I prevent rejection?

    The most important thing you can do to prevent rejection is to always take your medicine on time and to get your labs drawn as instructed. You will have blood work everyday for a week or two after your transplant, and at least four times a year for life.

  • Will my kidney last forever?

    Unlikely. The average time a kidney lasts in your body is 12 years, with a typical range from 5-20 years. If you lose your kidney, you can get another transplant.

  • What is a compatible blood type?

    If your blood type is A, your donor's blood type must be A or O. If you're B, you need B or O. If you're O, you need O. If you're AB you can accept A, B, AB, or O. Positive and negative does not matter.

  • Does it matter what type of kidney I get?

    Yes. If a living person can give you a kidney it will likely last longer and work better. If you don't have a living donor, you can get a deceased donor kidney. These kidneys work well but not as well as a living kidney.

  • Who can give me a kidney?

    Just about anyone: a friend, spouse, relative, etc. We will evaluate a donor in our clinic and determine if they are healthy enough to donate to you and have a compatible blood type.

  • What are the benefits of a pancreas transplant?

    Not only will you be off insulin and on a much less restricted diet, but you will not develop any further complications of diabetes. Also your kidney will likely last longer, as it will not get damaged by diabetes.

  • Who can give me a pancreas?

    Only a deceased donor can give you a pancreas. You can get a kidney and pancreas from the same deceased donor, or you can get a kidney from a living donor and later get a pancreas from a different, deceased donor.

  • Where do you put my new kidney?

    The new kidney goes into your pelvis, usually on the right side. It will be on the side of your abdomen, a little lower than your bellybutton. Your own kidneys are not removed, they stay where they are.

  • Will it hurt?

    We will prescribe appropriate medicine to control your pain, both in the hospital and after you leave.

  • What are the risks of the surgery?

    As with any surgery, there are risks. Anytime you go to sleep for surgery there is the risk of death. Also, if you have heart disease, you will be at increased risk for heart attack for up to 4 months after the surgery. All risks will be carefully explained to you well before the surgery.

  • Are there risks to being a donor?

    We carefully evaluate all potential donors and will not allow them to donate if there is a risk of kidney failure after the surgery. Nationwide, donors do not have any higher risk for kidney failure than the general population.

  • What is “"the list"?

    The list is a collection of names of patients waiting for a kidney transplant. When a kidney becomes available, a computer looks at everyone in the area waiting for a kidney and uses a complex formula to determine who should get the kidney. Waiting time is the most important factor, but there are others. Thus it is possible you will get your kidney before someone who has been waiting longer than you, and vice versa.

  • How long will I have to wait?

    This is very difficult to predict, as there are so many factors that are taken into account when assigning a kidney to a recipient. The average waiting time in our area is about 2 years, nationwide it is about 3 years. In some parts of the country it is about 4 years.

  • Is there anything I can do to get a kidney sooner?

    The list is run by the United Network of Organ Sharing, a federal agency. There are very strict requirements for allocating organs. The only way you can get one sooner is if you find a living donor.

  • What should I do while I am on the list?

    While you are waiting for your organ, it is very important to try to stay healthy. If you are as healthy as possible the chances of success are much higher. Also, if you are too ill, you may not be able to get your kidney at all when you are called. It is also very important to keep your transplant team up-to-date on your health status. We don't like surprises! For this reason we will see you every year while you are waiting for your organ. If you have any changes in your medications or health status in between visits you should call your coordinator.

  • How do I know when it's time to get my kidney and/or pancreas?

    You will receive a call when you have an organ offer. It is important that we can get in touch with you at any time. Some patients find it a good idea to get a beeper. Once we call you, you should be able to get to the hospital within about 6 hours. If we can't find you in a few hours, we will decline the offer and give the kidney to the next person.

  • How will I keep all my medications straight?

    We will begin to teach you about your medicines the day you have your surgery. A nurse coordinator from the transplant department will work with you while you are in the hospital to make sure you know how to take your medicine. We will give you a book designed just for you that lists all your medicine and when to take them. We will NOT let you leave the hospital until you are 100% clear on how to take your medicine. After you leave you can call with any questions, and we will go over everything again when we see you in clinic.

  • How often will I have to come to clinic?

    For the first month after transplant we will see you twice per week. This is important so we can make sure everything is going well. After that, you will mostly see your own nephrologist, about once per week for a month, then every other week, then once per month for the first year. After a year you can just come in every 6 months.

  • What happens if I forget to take my medicine?

    If you forget to take a medication, please do not panic. You should call your nurse right away and he or she will tell you what to do. Never double-up on your medicine if you miss a dose!

  • How often will I have to get labs?

    You will get your blood tests everyday for a week or two, then twice a week for a few months, then once per week until 6 months after your transplant, then every other week. After a year you can get them just once per month. In some cases, after several years, you can go down to 4 times per year.

  • Will I have to come back into the hospital after my surgery?

    Most patients do not return to the hospital other than for clinic visits once they are discharged. However, about 1 out of 3 patients will have to be admitted for complications such as infection, rejection, or surgical complications within the first year after transplant. After the first year it is very rare to have to be admitted.

  • How do I get to Denver for my transplant?

    We will discuss a transportation plan with you prior to being placed on the list. If you live a long way from Denver you may want to fly here. Many major airlines offer discounts for medical emergencies. There are also other options that we can discuss at your visit.

  • Can I talk to someone who has had a transplant?

    Yes! Several of our transplant patients have volunteered to be mentors. If you request it, we will assign you a mentor who can talk to you as much as you like before and after your transplant. We also provide transplant support groups for all pre- and post-transplant patients.  Learn more by calling 303-765-6956.

  • Can I jog/play piano/go skydiving/swim/etc. after transplant?

    Yes! The idea of a transplant is to lead a more, not less, active life. There are no restrictions on activity once you are healed after transplant. If you play contact sports we will ask you to wear an abdominal protector to prevent injury to the kidney.

  • What about, ahem, you know, sex?

    Most transplant patients find their sex life improves significantly after transplant. If you take Viagra or a similar medicine you can still take it after transplant. None of the anti-rejection medications are known to cause impotence. The only limit on sexual function after transplant is your own imagination. Sexually transmitted diseases can be devastating to a transplant patient, so you will still need to practice safe sex.

  • Can I have a baby after transplant?

    If you are a man, you may become a father after transplant, although the risks of birth defects are slightly higher. Pregnancy is risky after transplant but in the majority of cases mom, baby, and kidney all do very well. Therefore it is reasonable to try to become pregnant after transplant, as long as you understand it is more risky than before your transplant. As unplanned pregnancies can be a big problem, we will ask you to use contraception until you decide you want to try to have a baby and if you think you may be pregnant you will need to tell us right away.

  • Can I smoke after my transplant?

    No. Tobacco in any form is very bad for your kidney and your general health. If you smoke we will help you to quit before your transplant.

  • Can I use illegal drugs after my transplant?

    No. Not only are these substances bad for your kidney, but they may interact in unpredictable ways with your medications. Furthermore, being in jail makes it hard to keep your clinic appointments!

  • Will I need to lose weight before my transplant?

    We use body mass index (BMI) to determine if you are too heavy for a transplant. If your BMI is greater than 35 you will not be able to get a transplant until you lose weight. If your BMI is less than 40, you can be on the list gaining waiting time while you are losing weight. You will have to have a BMI less than 42 to be evaluated. To determine your BMI click here: BMI calculator from the CDC

  • How can I lose weight?

    If you need to lose weight, our transplant dietitian will customize a meal plan based on your individual needs and goals.

  • What can I eat after my transplant?

    One of the nicest things about transplant is that the diet is much less restrictive than the dialysis diet. Typically, potassium and phosphorus no longer need to be limited. It will be important to eat a sensible, healthy diet and continue to limit sodium. If you are diabetic, you will need to continue your diabetic diet unless you get a pancreas transplant.

  • What about alcohol?

    One to two drinks a day is permissible. A drink is one 12 oz beer, 4 ozs of wine, or 1.5 ozs of spirits. Alcohol must be consumed in moderation and even if you don't drink on a regular basis, it is not alright to have more than two drinks on any occasion. For example, it is not ok to wait until Saturday and then have 14 drinks.

  • Can I take herbal supplements after my transplant?

    Please do not take any over-the-counter medicines or supplements without talking to the transplant team. Many of these substances can interact with your medications and cause a rejection. Just because you don't need a prescription doesn't mean it's safe.

  • Will I gain weight after my transplant?

    The average patient gains from 5-10 lbs after transplant. Some of this is due to the steroids you have to take, but most of it is because you’ll feel better and eat more. A healthy lifestyle including exercise and a sensible diet is the best way to prevent this.

     

  • What is the responsibility of the financial coordinator?

    The transplant financial coordinator is a trained professional who counsels patients and families. Questions pertaining to insurance benefits, authorizations, and insurance case management follow-up will be answered for you. The financial coordinator will also follow the insurance company claim process and payment in a timely manner.

  • What if I can't afford my co-pays?

    It is very, very rare that a patient can't receive a transplant for financial reasons. There are a variety of community resources available to help with the costs of transplant. We can discuss this in further detail at the time of your transplant.

  • What will Medicare pay for?

    A Medicare covered kidney transplant will be paid at 80%. You will be responsible for 20%. Anyone in need of a kidney transplant will automatically qualify for Medicare. A Medicare covered kidney transplant will pay for most of your medical cost for a period of 36 months. If you have Medicare only we will discuss with you the various Medicare supplemental plans available to help pay for the medications, co-insurance and deductibles.