An alternative long term solution to regular dialysis treatments is to have a kidney transplant; when this is successful it usually means greater independence and a higher quality of life. Kidney transplantation is a procedure that places a healthy kidney in your body that will do the work of the two failed kidneys.

There are many factors to take into consideration such as the fact that a donor kidney can be difficult to obtain, a transplant involves major surgery with all the risks that this involves, and the following drug treatment will continue for the rest of your life. Making the decision to have a kidney transplant may therefore not always be an easy one.

Finding a donor for a kidney transplant

The biggest issue with kidney transplants is the lack of kidney donors. In the UK around 6,000 people a year would benefit from a kidney transplant, yet just 1,500 kidney transplants are achieved.

For eligible UK residents, the source of these kidneys in the UK is either from a live related donor (from relatives), from a live unrelated donor or from a person who has recently died (deceased donor).

Since people can function on only one kidney, you may receive a kidney from a member of your family. This is called a living related donation. It is important that your blood group and your tissue type match with that of the donor to prevent the body rejecting the organ. The donor must also have sufficient function in their kidneys to support a kidney donation and retain full function of the kidney that remains.

This not only avoids a long wait for a kidney transplant, but also increases the chances of a compatible match, as relatives are more likely to share your tissue type. All of the kidney transplants we do at The London Clinic are living donations.

There are 4,800,000 people in Britain carrying a kidney donor card. If you are legally resident in UK you may also place your name on the Organ Donor Register, a waiting list for kidney organs. A register of your tissue type and blood group and health details will be held to find a compatible match with a cadaveric kidney.

The time it takes to get a kidney varies. This is due to a lack of suitable kidney donors and the variation that exists in blood groups, tissue types and antibody levels in available donors. The waiting time can be years.

Kidney transplants at The London Clinic

Nephrologists at The London Clinic undertake living donor transplants only, which are provided by close family or friends who donate one of their healthy kidneys. All our transplants need to be approved by the Human Tissue Authority (HTA). 

We offer high standards of assessment, surgery and aftercare. We have an excellent team of surgeons and we can offer the most modern techniques such as laparoscopic removal of the donor kidney.

Matching donor kidneys

With a kidney transplant, the biggest risk is rejection, so it is important that the donor kidney is as close a match as possible to the recipient. For a successful kidney transplant, the donor organ should match the recipient according to:

  • Human leukocyte antigen or HLA tissue type.
  • Blood group: the same rules apply as in blood transfusion.
  • Antibody levels: known as cross-matching.

In cases where there is a living donor who is not compatible with the recipient, it is possible to arrange paired donations, or pooled donations, where 2 or more donor/recipient pairs are cross-matched so that each recipient ends up with a compatible kidney.

Kidney transplant success rates

The success rate of a kidney transplant depends on a number of factors in addition to compatibility. Living donations have a greater chance of success, as do donations from younger donors. Kidney transplants also tend to be more successful if they are done soon after dialysis starts.

The age, weight, fitness and general health of the recipient will also have a significant effect on the success of kidney transplants, with obvious factors such as smoking and alcohol intake playing a role.

On average, 94% of living donor kidney transplants are still working well after a year and that figure is slightly lower at 88% for non-living donor kidney transplants. Eighty per cent of recipients of a live donation will still be alive after five years and 70% of other recipients.

Immunosuppressant drugs

Much of the success of kidney transplants is down to recent improvements in immunosuppressant drugs. These drugs stop the body rejecting the transplant and attacking it as it would a foreign body or infection.

The immunosuppressant drugs used are tacrolimus, cyclosporine, mycophenolate mofetil and prednisolone. These drugs tone down the immune response to reduce the chances of rejection, but must be balanced so as not to leave the body too vulnerable to infections. Other drugs, such as acyclovir, ganciclovir, co-trimoxazole and isoniazid will often be given at the same time to mitigate the risks of the immunosuppressants following a kidney transplant.

Immunouppressants do have side effects, such as some psychological problems, but the benefits easily outweigh the risks. However, up to 25% of recipients will still experience acute rejection in the first year and their immunosuppressant medication will need to be adjusted to compensate.


Trade names quoted are given as examples only of the drug types described, alternatives may be available.