Preparing and Waiting for a Kidney Transplant
Being assessed for a kidney transplant can bring hope, uncertainty and a lot of information.
This page explains what the assessment involves, how the deceased donor waiting list works, how to stay ready and what to expect if a kidney becomes available.
Demonstration page — draft for clinical, operational and patient review
This page has not yet completed Auckland Renal Transplant Group approval. Do not use it as a substitute for advice from your renal or transplant team.
Prototype version 0.1 | 20 July 2026
The seven most important things to know
You do not need to remember everything today.
Click the phone button below to call the Renal Transplant Co-ordinators during working hours if you're not sure.
1. Complete the tests requested by your renal and transplant teams.
2. Keep dialysis, renal clinic and other health appointments.
3. Once you are active on the deceased donor waiting list, complete the required monthly tissue-typing blood sample.
4. Keep vaccinations, dental care and recommended health screening up to date.
5. Tell the transplant team if your health, medicines, hospital admissions, address or telephone numbers change.
6. Make a practical plan for travel, work, children, dependants, pets and support after transplantation.
7. Stay contactable. A kidney may become available at any time of the day or night.
Assessment does not guarantee that transplantation will be the safest or best treatment for you.
Waiting time cannot be predicted. The waiting list is not a simple numbered queue.
A telephone call about a kidney does not guarantee that the operation will proceed.
A transplanted kidney may work straight away, may take time to begin working, or may not work.
Anti-rejection medicines and regular follow-up are needed for as long as the transplant is functioning.
You can ask questions, involve your whānau and reconsider your decision at any stage.
Quick contact line
Questions while you are being assessed or waiting?
Call the Renal Transplant Coordinators on
0800 RENAL T —
0800 736 258
Monday to Friday, 8.00am to 4.30pm.
Kidney transplantation: what it can offer and what it asks of you
A kidney transplant is one treatment for advanced kidney failure. A healthy kidney from a donor is placed into your body to do the work your own kidneys can no longer do. Your own kidneys are usually left in place.
For many people, a successful transplant can reduce or remove the need for dialysis and improve energy, freedom and quality of life. A transplant is not a cure. It involves major surgery, lifelong anti-rejection treatment and ongoing partnership with your transplant team.
What a transplant requires
A major operation and general anaesthetic
Anti-rejection medicines every day
Frequent blood tests and clinic visits, especially at first
Ongoing attention to infection, cancer screening and general health
Acceptance that the kidney may be slow to work, may develop complications or may eventually fail
What a transplant may offer
Freedom from regular dialysis for many people
Better energy and wellbeing for many people
Fewer restrictions on food and fluids
More flexibility for work, travel and whānau life
Improved fertility for some people
Where a kidney can come from
Deceased donor kidney
A deceased donor kidney is donated after a person has died. The timing cannot be predicted. A kidney must be suitable for you, and final checks continue even after you are called to hospital. The donor and donor family remain confidential.
Living donor kidney
A healthy person may volunteer to be assessed as a kidney donor. The donor has a separate assessment, and their health, safety and independent decision-making come first. If someone is considering donation, speak with your transplant coordinator or visit kidneydonor.org.nz.
Your transplant assessment
The assessment helps the team understand whether transplantation is likely to benefit you and whether surgery and anti-rejection treatment can be undertaken safely. Not everyone needs exactly the same tests. Your renal team will tell you which assessments apply to you and who will arrange them.
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Blood tests assess your general health, blood group, previous infections and how your immune system may respond to a donor kidney. Tissue-typing and antibody tests help the transplant service assess compatibility. You may need repeat samples while being assessed and while waiting.
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Kidney failure, diabetes, age and time on dialysis can increase heart and blood-vessel risk. You may need an ECG, chest X-ray, heart scan, exercise or medicine-based heart test, or review by another specialist. The purpose is to understand whether surgery is safe and whether any treatment is needed first.
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Anti-rejection medicines reduce your ability to fight infection. It is therefore important to complete recommended vaccinations before transplantation where possible. Tell the transplant team about previous infections, tuberculosis exposure, hepatitis, recent antibiotics or any current symptoms. Discuss any live vaccine with the transplant team before receiving it.
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Dental infection can become more serious after transplantation. Arrange dental review and treatment if requested, maintain regular dental care and tell the team about tooth pain, gum infection or planned dental work.
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You may need breast, cervical, bowel, prostate, skin or other screening depending on your age, anatomy and health history. The team may ask for screening to be completed or updated before you can proceed.
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Item descriptionA transplant surgeon may assess your abdomen, blood vessels, previous operations and surgical risk. Weight, body composition, nutrition, mobility and fitness are considered together. The team will discuss any individual goals that could make surgery and recovery safer.
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Your medicines and health conditions will be reviewed. Some problems may need treatment or stabilisation before transplantation. Always tell the team about new medicines, pharmacy products, supplements, allergies, hospital admissions or changes in your health.
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The team will discuss support, transport, accommodation, work, caregiving responsibilities and your ability to attend frequent follow-up. Social workers, Māori health services, Pacific health services and other support teams may be involved. Asking for help does not count against you; it helps the team plan safe care.tion
How the decision is made
When the required assessment is complete, your results are reviewed by the transplant team. The team considers the likely benefits, the risks of surgery and anti-rejection treatment, and whether any health or practical issues need attention first.
You may be told that you are:
• suitable to proceed toward transplantation
• likely to be suitable after more tests or treatment
• temporarily not ready
• unlikely to benefit enough from transplantation, or that the risks are currently too high
If transplantation is not recommended, your renal care continues. Your team will discuss other treatment and support with you.
Joining and staying on the waiting list
Being accepted for transplantation and being active on the waiting list are not always the same thing. Before activation, all required assessments and tissue-typing samples must be complete. The transplant team will tell you when you are active
While you are active
Complete the required monthly tissue-typing blood sample.
Keep dialysis and renal appointments.
Keep your telephone numbers, address and support-person details current.
Tell the team promptly about illness, infection, hospital admission, surgery, pregnancy, travel or a major change in medicines.
Attend repeat review and testing when requested.
Sometimes you may be temporarily inactive
You may be temporarily suspended from receiving offers if proceeding would not be safe—for example during an infection, hospital admission, incomplete assessment, new heart symptoms or another important change in health. Temporary suspension does not necessarily mean you have permanently lost your opportunity for transplantation. Your renal physician will explain what needs to happen before reactivation.
How a kidney is matched
The waiting list is not a simple numbered queue.
A donor kidney must be suitable for the individual recipient.
Matching may consider blood group, tissue and antibody compatibility, waiting time, donor and recipient factors, national allocation rules and whether transplantation can be performed safely at that time.
Some people wait longer because finding a compatible kidney is more difficult.
Stay as ready as you can
You cannot control when a kidney becomes available, but there are practical steps that can help you remain well and ready for transplantation.
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Continue dialysis exactly as advised. Good dialysis supports your general health and transplant readiness.
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Smoking increases the risks of heart disease, infection, wound problems and cancer. Tell the team if you smoke or vape so they can help you stop.
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Complete recommended vaccinations before transplantation where possible. Check with the transplant team before receiving a live vaccine.
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Keep your teeth and gums healthy and treat dental infection promptly.
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Regular walking or other suitable activity can help strength and recovery. Ask for advice if symptoms or disability limit exercise.
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Follow individual advice from your renal team and dietitian. The aim is to improve health and surgical safety, not to judge appearance.
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Continue cancer screening, GP care, diabetes treatment, blood-pressure care and prescribed medicines.
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Tell the transplant team about fever, infection, new heart or breathing symptoms, hospital admission, surgery, pregnancy, new cancer investigation or major medicine changes.
When a kidney may be available
When the team calls
1. Listen carefully and write down the instructions.
2. Tell the doctor immediately about any fever, infection, antibiotics, hospital visit, new symptoms or change in your health.
3. Follow instructions about eating, drinking, dialysis and medicines exactly. Do not guess whether you should fast or omit medicines.
4. Confirm where and when to arrive and who may come with you.
5. Contact the team if you are delayed or cannot travel as planned.
What to bring
1.An up-to-date list of your medicines
2.Your regular medicines if the team asks you to bring them
3.Identification and any transplant information you have been given
4.Comfortable, loose-fitting clothing phone and charger
6.Essential toiletries and personal items
7.Contact details for your support person
The operation may not go ahead
Final checks of the donor kidney and your health continue after you arrive.
Occasionally the kidney is unsuitable, the final compatibility test is not acceptable, or proceeding would not be safe.
This can be deeply disappointing, but it does not usually mean you have lost your place on the waiting list.
Arriving at Auckland City Hospital
The transplant team will tell you exactly where to come.
You will usually be admitted to Ward 71 at Auckland City Hospital, but follow the instructions given during the telephone call.
After you arrive, you may have:
A medical examination and review of recent health changes
A blood tests and final compatibility testing
An anaesthetic assessment
Dialysis if needed
Discussion with the transplant surgeon and consent for the operation
There may be a period of waiting while final information is checked.
What happens during the operation?
You will have a general anaesthetic. The operation usually takes several hours. The donor kidney is usually placed in the lower right or left side of your abdomen. Your own kidneys are usually left in place. The donor kidney blood vessels are joined to blood vessels in your pelvis, and the donor ureter—the tube carrying urine—is joined to your bladder.
A temporary ureteric stent may be placed to support the join to the bladder. You will also have a urinary catheter, intravenous lines and sometimes a wound drain. Your surgeon will explain anything that is different for you.