Fort Worth, Texas,
10:23 AM

7 Questions Answered about a Kidney Transplant Surgery

Following Selena Gomez revelation, we talk to a pediatric surgeon

Selena Gomez posted a photo on her Instagram to let her fans know the reason why she has been “laying low” during the summer. She received a kidney transplant from her best friend, actress Francia Raisa.

“So I found out I needed to get a kidney transplant due to my Lupus and was recovering,” Gomez wrote. “It was what I needed to do for my overall health. I honestly look forward to sharing with you, soon my journey through these past several months as I have always wanted to do with you.”

With the news of Gomez’s transplant, we thought it would be a good time to talk about a kidney transplant surgery. Cook Children’s has been performing transplants for years. The most recent was just two weeks ago on a toddler. Robert Gillespie, M.D, is a nephrologist and medical director of the program.

To get a better idea of what is involved with a kidney transplant, we talked with Blake Palmer, M.D., a member of Cook Children’s Urology Program and a surgeon who performs the kidney transplant operations.

1. What is a kidney transplant?

Dr. Palmer:  kidney transplant is when someone whose kidneys are not working for whatever disease process (i.e. -Lupus for Selena) can be on dialysis for renal replacement therapy and do the job her kidneys are not doing to maintain her life and health or they can have a kidney transplant. A kidney transplant means we remove a functioning kidney from a donor (can be living or recently deceased) and surgically place the kidney in the patient. This requires connecting the artery and vein of the kidney to the patient’s blood system and connecting the ureter from the new kidney to the patient’s bladder so that the new urine the kidney makes goes into the bladder so they can pee again.

2. How is the decision made that someone needs a new kidney and what goes into the decision making process?

Dr. Palmer: First, you have to have poorly functioning kidneys to the point you need to be on dialysis because they have failed. Second, you have to be otherwise healthy enough to benefit from the transplant and be healthy enough to undergo the surgery and recovery process.

3. Who can receive a kidney transplant at Cook Children’s?

Dr. Palmer: You have to be at least 10 kilograms (about 22 pounds) and healthy enough with renal failure. We go all the way up to age 18. Kids who weigh at least 10 kilograms are usually 2 years at the earliest.

4. How long is the surgery and what is involved in the recovery period?

Dr. Palmer: Surgery is 4 to 6 hours long and as described above requires connecting the transplanted kidney blood vessels to person’s blood vessels and connecting ureter to bladder.

Recovery is 5-7 days in the hospital on average.

5. Selena Gomez needed an operation because of lupus. What are the main causes for children needing a kidney?

Dr. Palmer: Lupus is a rare type of renal failure cause and even more rare in the pediatric population. It is more common in adults. In kids, about 50 percent are due to urologic causes that they were born with like vesicoureteral reflux, posterior urethral valves or bladder anomalies. The other 50 percent are kidney problems and those can be congenital dysplastic kidneys to disease that come on later in adolescents that cause kidneys to fail. It’s usually very different types of problems for grownups, where the main reasons adults need a kidney transplant are hypertension or diabetes.

6. Selena had her best friend donate a kidney. How do we decide who the donor will be?

Dr. Palmer: It’ s very rare to have a non-family member donate. For most patients the donor will be a cadaveric, recently deceased donor. How the donor is decided goes through the UNOS matching system. LifeGift is our local organ sharing and procurement non-profit who coordinates this process for our region. 

7. What do you hope people learn from this news?

Dr. Palmer: Awareness that people in all walks of life and all ages are in need of donated kidneys. That it is a safe and common practice. That non-family members can donate kidneys as well. I have done two previous non-family member donations at a previous transplant program. Our goal is that 40-50 percent of our donations will be living related because our patients will do slightly better with a living donated kidney than a cadaveric. Although, they can do very well from both.

To learn more about organ sharing, visit the United Network for Organ Sharing.

Related Story: 8 Facts About Lupus

About Cook Children's Urology/Genitourinary Program

Cook Children's has opened the doors to a state-of-the-art pediatric urology center dedicated to treating kids with many different genitourinary conditions. Click to learn about this groundbreaking program. 

About Nephrology

Whether your child needs inpatient care, outpatient care, dialysis or even kidney transplantation, our nephrologists provide continuous care for children with kidney-related problems. Click to read more.

* Photo from Selena Gomez's Instagram.

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