Kidney and Pancreas Transplant Program (CP)
Leaders in Kidney and Pancreas Transplantation
Our Kidney and Pancreas Transplant Program is one of the most successful in the U.S. We consistently outperform national survival rates while improving the quality of life for each person we care for. We also pioneer new treatment methods before, during, and after transplantation.
What We Offer for Kidney and Pancreas Transplant Care
- Personalized evaluation and individualized treatment for people with end-stage kidney failure and type 1 diabetes. Go to Conditions Treated
- Exceptional outcomes with a low mortality risk and outstanding kidney transplant patient survival compared to other programs. Go to Treatments
- Advanced care from a top-ranked transplant program with a history of innovation and an exciting future, including ways to achieve transplant tolerance. Go to Kidney and Pancreas Transplant Program Highlights
- Team approach from highly experienced specialists who build a treatment plan customized to you, whether you need a new kidney, pancreas, or both. Go to Your Care Team
- Easy access to care with participation with most major insurers and clinics throughout the Bay Area for transplant evaluation. Go to Accessing Care
- Clinical trials that may give you access to new therapies, including transplant protocols to reduce the need for immunosuppressive drugs. Go to Clinical Trials
Conditions Treated
Our transplant team provides careful assessment and compassionate, effective, personalized care for people living with kidney failure.
Kidney Disease and Failure
Diabetes
All Conditions Treated
Many diseases and health conditions can lead to the need for a kidney transplant. Kidney transplantation is a treatment for kidney failure that results from these conditions:
Kidney disease
With kidney disease, your body can’t remove waste as well as it should.
Kidney failure
Kidney failure is also known as end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). It is the most severe stage of kidney disease. At this stage, your kidneys no longer can support your body’s needs. Waste builds up in the blood, and you become ill.
The treatment options for kidney failure are dialysis and transplantation.
For many people, transplant is the preferred treatment because it provides better health, better quality of life, and greater life expectancy than dialysis may offer.
Diabetes is a disease that affects how your body produces and processes insulin, a hormone that helps your body process sugar (glucose). Your pancreas produces insulin.
Kidney conditions caused by diabetes
Diabetes mellitus is a major cause of end-stage renal disease (ESRD). Kidney disease resulting from diabetes is called diabetic nephropathy.
Stanford Health Care’s Diabetes Care Program works with people to help prevent or slow kidney damage due to blood sugar problems related to diabetes. But if kidney damage progresses to ESRD, a kidney transplant may be right for you.
We offer transplantation to treat kidney disease due to all types of diabetes, including:
- Type 1 diabetes due to lack of insulin production
- Type 2 diabetes, which often appears later in life as a result of your body’s inability to make or manage insulin
- Cystic fibrosis-related diabetes (CFRD)
Pancreas transplant and diabetes
People who have end-stage renal disease caused by type 1 diabetes may be eligible for a kidney and pancreas transplant. This procedure treats both the kidney disease and diabetes. We generally perform a pancreas transplant along with a kidney transplant. In some cases, we transplant a pancreas into someone who previously received a kidney transplant.
A pancreas transplant cures diabetes because the new pancreas produces the insulin your body needs. It also reduces the risk of diabetes damage to your new kidney.
Our team performs kidney transplantation to treat kidney failure resulting from many different conditions.
Our colleagues at the Stanford Health Care Kidney Clinic (Nephrology) and the Stanford Health Care Urology Clinic treat these conditions:
- Alport syndrome: inherited disorder that causes deafness, progressive kidney damage, and eye defects
- Berger’s disease (IgA nephropathy): buildup of immunoglobulin A (IgA) antibody, causing kidney damage
- Congenital nephrotic syndrome: inherited disorder that causes swelling and high protein in the urine
- Congenital renal obstructive disorders: various conditions leading to hydronephrosis (urine backup causing excess fluid in one or both of the kidneys), including:
- Megaureter
- Posterior urethral valves
- Prune belly syndrome
- Ureteropelvic junction obstruction
- Vesicoureteral reflux
- Cystinosis: inherited disorder causing problems with kidney function, leading to severe kidney stones
- Diabetic nephropathy: kidney damage due to diabetes
- Glomerulonephritis: damage to the glomeruli, tiny kidney filters, often due to an autoimmune condition
- Goodpasture syndrome: autoimmune condition in which the body attacks the lungs and kidneys
- Granulomatosis with polyangiitis: rare condition causing inflammation of blood vessels in the kidneys, lungs, nose, sinuses, and throat
- Hemolytic uremic syndrome: condition that affects blood and blood vessels and damages blood vessels in the kidneys
- Henoch-Schönlein purpura: blood vessel inflammation, most often affecting children under age 7
- Hypertension: chronic high blood pressure causing permanent kidney damage
- Interstitial nephritis or pyelonephritis: inflammation in the kidney’s small internal structures
- Lupus: chronic autoimmune disease that can injure the skin, joints, kidneys, and nervous system
- Nail-patella syndrome: genetic condition that prevents proper development of the fingernails, kneecaps, elbows, and other joints and often causes kidney disease later in life
- Nephrotic syndrome: condition that involves protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling
- Polycystic kidney disease (PKD): genetic disorder that causes numerous fluid-filled cysts in the kidneys
Many diseases and health conditions can lead to the need for a kidney transplant. Kidney transplantation is a treatment for kidney failure that results from these conditions:
Kidney disease
With kidney disease, your body can’t remove waste as well as it should.
Kidney failure
Kidney failure is also known as end-stage renal disease (ESRD) or end-stage kidney disease (ESKD). It is the most severe stage of kidney disease. At this stage, your kidneys no longer can support your body’s needs. Waste builds up in the blood, and you become ill.
The treatment options for kidney failure are dialysis and transplantation.
For many people, transplant is the preferred treatment because it provides better health, better quality of life, and greater life expectancy than dialysis may offer.
close Kidney Disease and Failure
Diabetes is a disease that affects how your body produces and processes insulin, a hormone that helps your body process sugar (glucose). Your pancreas produces insulin.
Kidney conditions caused by diabetes
Diabetes mellitus is a major cause of end-stage renal disease (ESRD). Kidney disease resulting from diabetes is called diabetic nephropathy.
Stanford Health Care’s Diabetes Care Program works with people to help prevent or slow kidney damage due to blood sugar problems related to diabetes. But if kidney damage progresses to ESRD, a kidney transplant may be right for you.
We offer transplantation to treat kidney disease due to all types of diabetes, including:
- Type 1 diabetes due to lack of insulin production
- Type 2 diabetes, which often appears later in life as a result of your body’s inability to make or manage insulin
- Cystic fibrosis-related diabetes (CFRD)
Pancreas transplant and diabetes
People who have end-stage renal disease caused by type 1 diabetes may be eligible for a kidney and pancreas transplant. This procedure treats both the kidney disease and diabetes. We generally perform a pancreas transplant along with a kidney transplant. In some cases, we transplant a pancreas into someone who previously received a kidney transplant.
A pancreas transplant cures diabetes because the new pancreas produces the insulin your body needs. It also reduces the risk of diabetes damage to your new kidney.
close Diabetes
Our team performs kidney transplantation to treat kidney failure resulting from many different conditions.
Our colleagues at the Stanford Health Care Kidney Clinic (Nephrology) and the Stanford Health Care Urology Clinic treat these conditions:
- Alport syndrome: inherited disorder that causes deafness, progressive kidney damage, and eye defects
- Berger’s disease (IgA nephropathy): buildup of immunoglobulin A (IgA) antibody, causing kidney damage
- Congenital nephrotic syndrome: inherited disorder that causes swelling and high protein in the urine
- Congenital renal obstructive disorders: various conditions leading to hydronephrosis (urine backup causing excess fluid in one or both of the kidneys), including:
- Megaureter
- Posterior urethral valves
- Prune belly syndrome
- Ureteropelvic junction obstruction
- Vesicoureteral reflux
- Cystinosis: inherited disorder causing problems with kidney function, leading to severe kidney stones
- Diabetic nephropathy: kidney damage due to diabetes
- Glomerulonephritis: damage to the glomeruli, tiny kidney filters, often due to an autoimmune condition
- Goodpasture syndrome: autoimmune condition in which the body attacks the lungs and kidneys
- Granulomatosis with polyangiitis: rare condition causing inflammation of blood vessels in the kidneys, lungs, nose, sinuses, and throat
- Hemolytic uremic syndrome: condition that affects blood and blood vessels and damages blood vessels in the kidneys
- Henoch-Schönlein purpura: blood vessel inflammation, most often affecting children under age 7
- Hypertension: chronic high blood pressure causing permanent kidney damage
- Interstitial nephritis or pyelonephritis: inflammation in the kidney’s small internal structures
- Lupus: chronic autoimmune disease that can injure the skin, joints, kidneys, and nervous system
- Nail-patella syndrome: genetic condition that prevents proper development of the fingernails, kneecaps, elbows, and other joints and often causes kidney disease later in life
- Nephrotic syndrome: condition that involves protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling
- Polycystic kidney disease (PKD): genetic disorder that causes numerous fluid-filled cysts in the kidneys
close All Conditions Treated
A transplant is a surgical procedure to replace a diseased organ with a healthy one from another person who is either living or deceased. Your doctors will work with you to determine which type of kidney transplant is right for you.
KIDNEY AND PANCREAS TRANSPLANT PROGRAM HIGHLIGHTS
People choose Stanford Health Care because we provide highly individualized care to deliver outstanding outcomes after a transplant.
Building on our long history of innovation, our team is revolutionizing transplantation. We are committed to new developments that minimize side effects of long-term immunosuppression and safely increase transplant opportunities.
We are one of a handful of U.S. academic medical centers leading clinical research in transplant tolerance. Tolerance makes it possible for some organ recipients to stay healthy without the immunosuppressive drugs usually necessary after transplantation.
Ever since our doctors performed the first kidney transplantation in California in 1960, we’ve become one of the top U.S. kidney and pancreas transplant programs. To see statistics related to kidney transplantation, visit the Scientific Registry of Transplant Recipients (SRTR).
We are committed to new developments that minimize side effects of long-term immunosuppression and safely increase transplant opportunities.
Transplant Types
Our kidney and pancreas transplant team offers treatments to people with kidney disease, diabetes, or both.
Deceased donor kidney transplantation
The donor organ comes from a deceased donor with healthy kidneys.
Living donor kidney transplantation
A healthy person may donate a kidney for transplantation. Living kidney donors are usually blood relatives, but spouses and friends also can donate.
A living donor kidney transplant dramatically shortens your waiting time and provides longer transplant kidney life than deceased donor transplantation. It also provides flexibility in scheduling your surgery date.
You may receive a kidney directly from a donor or through a donor exchange program if you and your donor do not have compatible blood types or tissue types. Learn more about paired kidney exchanges and kidney donor chains.
Pancreas transplantation
A pancreas transplant may be an option for some people with type 1 diabetes.
A healthy pancreas from a donor will produce insulin and achieve a natural control of your blood sugars. After the transplant, the new pancreas makes insulin for you, and you no longer need to take insulin.
You may be a candidate for:
- Pancreas and kidney transplant: We typically perform simultaneous pancreas and kidney transplant (SPK), in which you receive a kidney and pancreas from the same donor. This procedure cures diabetes and relieves kidney failure.
- Pancreas transplant after kidney transplant: If you have already received a kidney transplant and you have difficult-to-control diabetes, you may be eligible for a pancreas transplant.
Desensitization Treatments
When you receive an organ transplant, such as a kidney, your body considers the new kidney to be foreign. This situation is especially true when you receive a donor organ from someone with a different blood type. These transplants are called ABO-incompatible transplants.
When you receive the new kidney, your immune system reacts by producing organ-rejecting antibodies. To prevent organ rejection, your doctor prescribes immunosuppressive medications after a transplant.
To reduce the risk of rejection, Stanford Health Care’s Kidney Transplant Program provides a rigorous desensitization program before your kidney transplant. Your desensitization protocol may include:
- IVIG infusions: We give you a high dose of intravenous immunoglobulin (IVIG) over several months. These treatments reduce organ-rejecting antibodies in your blood so that you are more likely to find a healthy, successful match.
- Plasmapheresis for ABO-incompatible transplants: If your donor has a different blood type than yours, your body will attack the new organ. We remove antibodies in your blood against the donor blood type so you can receive the donor kidney.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. Our doctors and surgeons lead several efforts to discover and evaluate new options to improve care for kidney transplant donors and recipients.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
Tolerance induction protocol
Stanford Health Care doctors are leaders in pioneering a tolerance induction protocol for kidney transplant. Similar to a stem cell transplant (bone marrow transplant), this method implants stem cells from your kidney donor along with the kidney.
Unlike stem cell transplant for cancer, tolerance induction seeks to create a hybrid, or mixed, immune system. This hybrid system combines your immune cells and your donor’s. The goal is to reduce the risk of kidney rejection and eliminate the need for immunosuppressant medications. When effective, recipients can take fewer immunosuppressive medications after their transplant—and ideally, take none at all.
Clinical studies of tolerance induction began in 2000 at Stanford Health Care. This work demonstrated that tolerance induction can be achieved in 80% of human leukocyte antigen (HLA)-identical living donor pairs. HLA-identical pairs can only be siblings. Each sibling pair has a one in four chance of being HLA-identical. This protocol is under trial at other transplant centers in the U.S. and internationally.
The protocol has been adapted for use in HLA-mismatched living donor pairs in another clinical study. Select donor-recipient pairs who qualify and live within two hours of Stanford Health Care may be eligible to participate. If you have a living kidney donor, please feel free to talk to our kidney transplant team about whether you might be a candidate.
Other clinical trials
As a Stanford Health Care patient, you may be eligible to participate in open clinical trials to evaluate new breakthroughs. Open trials refer to studies that are currently recruiting participants or may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
Stanford Health Care’s Kidney Transplant Program has a long history of excellent outcomes for kidney transplant recipients:
- The survival rate for our kidney transplant recipients one year after transplant is 100%, the nation’s highest.
- Our kidney transplant recipients’ three-year survival rate is 97%—well above the national average.
- People who receive a kidney transplant at Stanford Health Care have a higher survival rate three years after transplant than the national average at one year post-transplant.
These results speak to the consistency and thoroughness with which we care for patients over time. To learn more about statistics related to kidney and pancreas transplantation, visit the Scientific Registry of Transplant Recipients.
Kidney transplant recipients at Stanford Health Care have the nation’s highest survival rates at one year and three years after transplant.
What to Expect as a Donor
As a kidney donor, you’ll undergo a complete medical and psychological evaluation to ensure your safety and compatibility. If you're not compatible, there are other options available for donation, including paired and chain donor transplantation.
The kidney donor and recipient usually stay in the same unit the night before surgery, then move to separate units after the surgery.
As the donor, you can expect to stay in the hospital for two to three days after surgery. We schedule a follow-up appointment with you one week after discharge, with the focus on wound healing and pain management.
Additional follow-up appointments are scheduled at two months, six months, one year, and two years after surgery.
Before
During
After
Donor Candidacy Evaluation
The first step in preparing you to donate a kidney is to determine whether you're a compatible donor.
- You'll undergo a thorough evaluation to determine compatibility and ensure your safety.
- If the evaluation finds you to be an incompatible donor, there are still options available for donation, such as paired or chain transplantation.
Preparing for Kidney Transplantation
We perform comprehensive evaluations of both the kidney donor and recipient prior to transplantation in order to ensure the safety of both of you.
There are no special courses of treatment you need to go through prior to surgery like the recipient does. You'll be scheduled to arrive at the hospital a day prior to surgery, along with the kidney recipient, to undergo one final evaluation. Normally, you stay in the same unit with the recipient the night before surgery.
For recipients, the hospital course for living donor kidney transplantation is similar to that for patients receiving a kidney from a deceased donor. However, you have the benefit of being able to schedule the date of your surgery. Both donor and recipient are admitted to the hospital one day prior to surgery for final evaluation and testing.
On the day of surgery, the kidney donor undergoes surgery first, with the recipient following immediately afterward.
Kidney Donor Surgical Procedure
Advances in medical technology in recent years have led to increasingly less invasive procedures for kidney donors. More often than not, donor kidneys are removed using laparoscopic techniques.
- During surgery, your physician makes a series of small incisions in your lower abdomen and inserts the laparoscope—a tiny tube with a light and a camera—to access the kidney.
- Your doctor navigates and inspects the region on a TV-like monitor that receives images from the camera.
- The laparoscope images are magnified when they appear on the monitor, allowing your doctor to see even greater tissue detail than is possible during traditional surgery.
The major advantage of laparoscopic kidney surgery is that your doctor can now perform the same surgeries that used to require large open incisions with just a few tiny incisions about the size of a dime and an 8-centimeter incision below your belly button. Laparoscopic surgery reduces pain and scarring, and significantly reduces the length of your hospital stay and the time it takes for you to recover from surgery.
Care After Transplant
After surgery, you and the recipient stay in separate units. Your hospital stay is normally three to five days and we strongly encourage you to have visitors.
Upon discharge from the hospital, we arrange a follow-up appointment for one week after you go home. This outpatient visit focuses on issues of ongoing wound healing and pain management. But within a few weeks, you should be able to return to normal activities and see no changes in your life.
Donor Candidacy Evaluation
The first step in preparing you to donate a kidney is to determine whether you're a compatible donor.
- You'll undergo a thorough evaluation to determine compatibility and ensure your safety.
- If the evaluation finds you to be an incompatible donor, there are still options available for donation, such as paired or chain transplantation.
Preparing for Kidney Transplantation
We perform comprehensive evaluations of both the kidney donor and recipient prior to transplantation in order to ensure the safety of both of you.
There are no special courses of treatment you need to go through prior to surgery like the recipient does. You'll be scheduled to arrive at the hospital a day prior to surgery, along with the kidney recipient, to undergo one final evaluation. Normally, you stay in the same unit with the recipient the night before surgery.
For recipients, the hospital course for living donor kidney transplantation is similar to that for patients receiving a kidney from a deceased donor. However, you have the benefit of being able to schedule the date of your surgery. Both donor and recipient are admitted to the hospital one day prior to surgery for final evaluation and testing.
On the day of surgery, the kidney donor undergoes surgery first, with the recipient following immediately afterward.
close Before
Kidney Donor Surgical Procedure
Advances in medical technology in recent years have led to increasingly less invasive procedures for kidney donors. More often than not, donor kidneys are removed using laparoscopic techniques.
- During surgery, your physician makes a series of small incisions in your lower abdomen and inserts the laparoscope—a tiny tube with a light and a camera—to access the kidney.
- Your doctor navigates and inspects the region on a TV-like monitor that receives images from the camera.
- The laparoscope images are magnified when they appear on the monitor, allowing your doctor to see even greater tissue detail than is possible during traditional surgery.
The major advantage of laparoscopic kidney surgery is that your doctor can now perform the same surgeries that used to require large open incisions with just a few tiny incisions about the size of a dime and an 8-centimeter incision below your belly button. Laparoscopic surgery reduces pain and scarring, and significantly reduces the length of your hospital stay and the time it takes for you to recover from surgery.
close During
Care After Transplant
After surgery, you and the recipient stay in separate units. Your hospital stay is normally three to five days and we strongly encourage you to have visitors.
Upon discharge from the hospital, we arrange a follow-up appointment for one week after you go home. This outpatient visit focuses on issues of ongoing wound healing and pain management. But within a few weeks, you should be able to return to normal activities and see no changes in your life.
close After