Kidney transplant

In 2006, the RMH successfully performed Australia's first kidney transplant across incompatible blood groups.

The RMH transplant team has also continued to drive innovation in transplantation in Victoria and Australia, using kidneys often discarded by other units with excellent results. 

The RMH offer the second largest kidney transplant service in Australia, transplanting patients from Victoria and Tasmania.

All patients are considered for kidney transplantation and while we cannot guarantee that everyone will be suitable, if we can transplant you we will tell you. The RMH kidney transplantation program is known for taking on many difficult transplants, often those that other services cannot perform. 

Contact the Kidney Transplant Coordinators for more information.

We also perform many kidney transplants from living donors. If you wish to donate to a friend or relative, please talk to us about this.

You do not necessarily have to be the same blood group or tissue type or related in any way for us to consider this. You do need to be in good health and be prepared to perform some tests for us to verify that you have normal kidney function and your health is otherwise good.

The risks of living donation

There are some risks involved in donating a kidney. There are small risks of complications around the time of the surgery, such as bleeding, infection, blood clots, heart attack, stroke, pneumonia or other problems.

There have been reports of deaths in donors after transplantation in Australia but this risk is very small and in the United States this is approximately 1 in every 3,000 donors.

In the long term, donors appear to have an increased chance of developing high blood pressure. They also seem to have higher chance of developing some protein in the urine although usually this is at a low level.

There has been difficulty studying whether the risk of kidney failure (needing dialysis or a transplant) is higher in donors in the long term compared to if they had not donated.

There are several studies looking at this and recent studies have tried to compare donors with similar healthy people who have not donated called a ‘control group’. Unfortunately finding an appropriate ‘control group’ is difficult, making some of these studies hard to interpret.

Overall, recent studies suggest that the risk of kidney failure is increased by donating but the risk is still very low and lower than the rate in the general population.

For example, in one study, the rate of kidney failure at 15 years after donation was 2.3 people out of every 1,000 in those who were not Black Americans or Hispanic. These risks can be changed by factors such as the age of the donor at the time of operation, sex, race and other factors.

Kidney failure in donors can occur due to the donor having a condition that was not detected by current methods in the tests performed before surgery, or by a new kidney disease developing in the years after surgery and rarely, due to either trauma affecting their remaining kidney or another problem such as a tumour developing in the remaining kidney.

Other things that could increase the risk to donors are gaining a significant amount of weight or not having follow-up clinic appointments to detect problems such as high blood pressure. We recommend donors have a check-up at least yearly for blood pressure, kidney function and urine analysis.

There have also been some studies of the life expectancy in donors. Although some studies have shown different results, overall donors do not seem to have any reduction in their life expectancy compared to others who do not donate.

Donating a kidney is a wonderful gift. If this is your wish you should be aware that it may have some implications for your health longer term. These problems may be treatable if detected early and we recommend a yearly kidney screen after donating.

Live donors from other regions

We can transplant live donor and recipient pairs from anywhere around Australia or overseas. 

Contact the Kidney Transplant Coordinators for more information.

The RMH has pioneered ABO blood group incompatible (ABOi) kidney transplantation in Australia and we have performed more of these kidney transplants than any other unit in Australia.

We have developed new protocols for ABOi transplants making the procedure safer and available to more patients. Our cohort of patients who have undergone this procedure is one of the largest in the world and our outcomes are among the best of all published experiences.

We continue to develop new approaches to this procedure and present and publish this work internationally.

Our ABOi transplant program has underpinned the success of the Australian and New Zealand Paired Kidney Exchange (ANZKX) Program.

We have also now performed some of the first ABOi transplants from deceased donors opening a new avenue for transplanting kidneys and other organs across a previously absolute barrier.

The RMH kidney transplantation team also has one of the largest experiences in Australia of transplanting ‘highly sensitised’ patients with antibodies directed against HLA molecules of their donor. This technically demanding and difficult area is now a focus in all solid organ transplantation although the bulk of experience and data remains in kidney transplantation.

We have continued to incorporate new approaches and technologies into the transplantation of these patients including combinations of kidney paired donation, ABOi transplantation to avoid HLA antibodies, ‘desensitisation’ to remove antibodies and the pioneering use of new therapies to block the pathogenic effect of HLA antibodies.

Despite transplanting more complex patients, often with a greater range of medical comorbidities, our kidney transplant outcomes are excellent and our patient survival is better than most other units and significantly better than the aggregate of other centres in Australia and New Zealand. This is in part related to our use of progressive refinements in our immunosuppressive management and a different approach to the treatment of rejection, which remain areas of research.

The RMH Kidney Transplant Coordinators focus on the organisation of the live kidney donor and their recipient and management of the deceased donor program for people who are eligible for kidney transplant.

We assist you with arranging blood work pre transplant or donation testing, pre admission clinics, general monitoring, education for both donors and recipients and linking patients with internal and external service providers for care and assistance. We continue this care after your transplant.

You may see us for:

• Assistance in getting ready for a kidney transplant or preparing for kidney donation
• An education session for all potential recipients, donors and their families.
• When you attend transplant assessment clinics
• Information about becoming a potential donor
• After care following your kidney transplant or donation

We have one of the highest number of patients listed for transplantation, and are able to list patients for transplantation more swiftly than any other unit in Victoria (Victorian KPIs).

We have research projects looking at:

• Post-transplant viral infection
• The use of marginal deceased donor organs and kidneys from donors with acute kidney injury
• Outcomes of kidneys from donors after cardiac death
• Reduction of perioperative graft vascular complications
• Reducing the risk of recipient kidney malignancies
• The outcomes of treatment of antibody-mediated rejection
• Post-transplant kidney bone disease
• Mineral trafficking after transplantation

We lead the transplant collaborative in finding a way to introduce standardised consent forms across the state and looking at other transplant related issues.