Kidney transplant
Although rates of serious complications have fallen sharply in the last few decades, kidney transplants – like any other type of surgery – are not risk-free.
The risks of a kidney transplant include:
Most complications occur in the first few months after a transplant, but can develop after many years.
Some of the main short-term and long-term complications of a kidney transplant are outlined below.
Minor infections, such as urinary tract infections (UTIs), colds and flu, are common after kidney transplants.
Potentially more serious infections, such as pneumonia and cytomegalovirus (CMV), can occur and may require hospital treatment.
Blood clots can develop in the arteries that have been connected to the donated kidney. This is estimated to occur in around 1 in 100 kidney transplants.
In some cases, it may be possible to dissolve the blood clots using medication, but it's often necessary to remove the donated kidney if the blood supply is blocked.
Narrowing of the artery connected to the donated kidney, known as arterial stenosis, can sometimes occur after a kidney transplant. In some cases, it can develop months, or even years, after the transplant.
Arterial stenosis can cause a rise in blood pressure. The artery often needs to be stretched to widen it, and a small metal tube called a stent may be placed inside the affected artery to stop it narrowing again.
The ureter (the tube that carries urine from the kidney to the bladder) can become blocked after a kidney transplant. It can be blocked soon after the transplant – by blood clots, for example. It can also be blocked months or years later, usually due to scar tissue.
It may be possible to unblock the ureter by draining it with a small tube called a catheter. Sometimes surgery may be required to unblock the ureter.
Occasionally, urine may leak from where the ureter joins the bladder after surgery. This usually occurs during the first month after the procedure. The fluid may build up in the tummy or leak through the surgical incision.
If you develop a urine leak, you'll usually need to have further surgery to repair it.
Acute rejection means the immune system suddenly begins to attack the donated kidney because it recognises it as foreign tissue.
Despite the use of immunosuppressants, acute rejection is a common complication in the first year after a transplant, affecting up to one in three people.
In many cases, acute rejection does not cause noticeable symptoms, and is only detected by a blood test.
If it does occur, it can often be successfully treated with a short course of more powerful immunosuppressants.
Immunosuppressants prevent your body's immune system from attacking the new kidney, which would cause the transplanted kidney to be rejected.
A combination of two or three different immunosuppressants is usually taken long term.
These can cause a wide range of side effects, including:
The doctor in charge of your care will be trying to find the right dose that is high enough to "dampen" the immune system to stop rejection, but low enough that you experience very few or no side effects.
Finding the optimal dose to achieve both goals is often a difficult balancing act. It may take several months to find the most effective dose that causes the least amount of side effects.
Side effects should improve once the right dosage is identified. Even if your side effects become troublesome, never suddenly stop taking your medication because your kidney could be rejected. Speak to your GP or transplant team for advice.
Diabetes is a common complication of having a kidney transplant.
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. Some people develop it after a kidney transplant because, as they no longer feel unwell, they eat more and gain too much weight. Some types of immunosuppressants can also make you more likely to develop diabetes.
Symptoms of diabetes include:
Diabetes can often be controlled using a combination of lifestyle changes, such as alterations to your diet, and medication.
Read more about treating diabetes.
High blood pressure is also a common long-term complication of a kidney transplant.
Many people who need a kidney transplant already have an increased risk of developing high blood pressure, and taking immunosuppressants can make the condition worse.
High blood pressure doesn't usually cause any noticeable symptoms, but it can increase your risk of developing other serious conditions, such as heart disease, heart attacks and strokes.
Because of the risk of high blood pressure, you'll have your blood pressure checked at your follow-up appointments. You can also check your own blood pressure at home with a simple device available from most pharmacies. Read more about testing your blood pressure.
The long-term use of immunosuppressants also increases your risk of developing some types of cancer, particularly types known to be caused by viruses (as you will be more vulnerable to the effects of infection).
These include:
You can reduce your risk of skin cancer by avoiding exposure to the sun during the hottest part of the day and by applying sun cream to your lips and all exposed areas of your skin every day.
Your care team can give advice on your individual risks, whether you need regular check-ups, and any early signs to look out for.
A kidney transplant is the transfer of a healthy kidney from one person into the body of a person who has little or no kidney function. The main role of the kidneys is to filter waste products from the blood and convert them to urine.
Ideally, a kidney transplant should be performed when tests show that the extent of damage to your kidneys is so great that you'll need dialysis within the next six months. Most people with kidney failure need dialysis while they wait for a donated kidney to become available.
When a suitable donor kidney is found, the transplant centre will contact you. Staff at the centre will check you don't have any new medical problems and  then ask you to go to the centre. The kidney transplant procedure involves three main stages
Lifestyle advice is usually recommended to help you stay healthy after a kidney transplant. You should quit smoking, avoid eating foods that carry a high risk of food poisoning, start doing moderate-intensity exercise every week, etc
Although rates of serious complications have fallen sharply in the last few decades, kidney transplants like any other type of surgery are not risk-free. The risks of a kidney transplant include: risks related to the procedure itself, risks related to the use of immunosuppressant medications, etc.