Kidney transplant

Today, kidney transplantation is the procedure of choice for treating patients with end-stage renal failure. However, the aim is not only to achieve an optimal organ function rate, but also to achieve a state of health for the recipient (and his or her family) as before the illness.


Every year, between 80 and 100 kidney transplants are performed at the USZ, sometimes in combination with other organs such as the pancreas, heart, lungs, liver or islet cells. In addition to the transplantation of organs from deceased patients, around a third of kidneys come from living donors.

After the first year, over 90% of the kidneys are still functioning, and transplant function rates are still over 80% after five years. As the tissue properties of the transplant differ from those of the recipient, there is always a risk of rejection. In order to keep this risk as low as possible, precise knowledge of the genetic match and compatibility between donor and recipient is necessary. It is also necessary to take medication that suppresses the immune system. This immunosuppression must be very individually adjusted in order to keep the risk of infections, tumors and rejection crises as low as possible. This requires close monitoring.

Our clarification and treatment options

The Nephrology Clinic cares for patients before, during and after transplantation. This is a team effort together with many specialist disciplines here at the USZ as a maximum care hospital and, of course, very closely with the referring colleagues.

In order to achieve an optimal state of health for the patient and his or her family, we attach great importance to individualized care. We also offer special consultations where patients and their families have the opportunity to talk to the head nephrologist and, depending on their needs, specialists from other teams, such as those for tissue properties, ethics, urology, pharmacology, living donation, tumors or infections.

To ensure good monitoring, we have established a close-knit aftercare program. In our nephrology outpatient clinic, we see all newly transplanted patients regularly in the first year after transplantation, then at one-year intervals and in close cooperation with our referring colleagues.

A very important focus, also in our clinic’s research, is the clarification and follow-up care of living donors. We have established a cross-over program that enables optimal compatibility for donors and recipients. Optimal kidney function is the key to a safe, low-risk donation for the living donor and to good long-term function in the recipient. Here we carry out precise kidney function diagnostics and also determine the function beforehand. Immunological clarification and care is highly specialized and we work very closely with our tissue typing laboratory to keep the risk of a rejection reaction as low as possible. We are also developing therapy options here that will hopefully mean that immunosuppressive therapy will no longer be necessary in the long term due to the development of tolerance.

After a kidney transplant, patients are dependent on medication for the rest of their lives to prevent their bodies from rejecting the foreign organ. This weakens your immune system. A new procedure could change this. The University Hospital Zurich was the first clinic in Europe to transplant not only her brother’s kidney but also parts of his immune system into a patient. The woman has now been living entirely without immunosuppressive medication for more than a year.

If the kidneys no longer function and the toxins are no longer filtered out of the blood, the only option is dialysis or a kidney transplant. However, in order for the foreign organ to be accepted by the body, the patient’s own defenses must be strongly suppressed in the form of immunosuppressive drugs.

As a result, immunosuppressed patients are significantly more susceptible to infections of all kinds, which generally reduces their quality of life. It is particularly serious that almost every second recipient of a foreign organ will develop cancer during their lifetime. “The many infections and cancers among organ recipients are to a certain extent the price we pay for progress in transplant medicine,” says Thomas Fehr, Head of Internal Medicine at the Cantonal Hospital of Graubünden and consultant physician at the University Hospital of Zurich.

A completely new approach developed in the USA tackles this problem at its root: Patients are not only implanted with the foreign organ, but also with a part of the donor’s immune system in the form of bone marrow stem cells. The initial burden of the therapy is naturally greater due to the double transplantation. However, the additional burden is worthwhile for the recipient, as the medication can be reduced quickly and eventually possibly discontinued altogether.

The University Hospital Zurich recently became the first clinic in Europe to successfully apply this procedure. Two patients were transplanted as part of a clinical trial based on the results from the USA. The first patient has been living without any immunosuppressive medication for more than a year. In the second patient, the transplant was less recent; she only needs a single medication.

The effect of the new procedure had previously been investigated in various constellations in a broad-based study at Stanford University. The best results were achieved when the kidney and stem cell donor was a sibling. In this group, immunosuppression was completely reversed in 16 out of 22 patients. However, much more research is needed before the new method becomes an option for anyone who needs an organ. This is because at present, not only does a sibling need to be willing to donate, but also their immunological match – which only applies in around one in four cases. For this reason, the clinical study is being continued at the University Hospital Zurich with the aim of making the new procedure applicable to a larger number of patients.

For patients

As a patient, you cannot register directly for a consultation. Please get a referral from your primary care physician, specialist.

For referrer

Easily assign your patient online.

University Hospital Zurich
Department of Nephrology
Rämistrasse 100
8091 Zurich

Tel. +41 44 255 33 84
Assign online

Responsible Department