Joyce Steigerwalt of Tamaqua needs a kidney transplant.

A kidney transplant places a healthy kidney into a person with kidney failure. It is one of the most common transplant operations in the United States. One donated kidney is needed to replace the work previously done by two kidneys.

A person needs a kidney transplant when she has end-stage kidney disease which occurs when the kidneys no longer remove wastes and excess fluids, and manage (such as sodium and potassium) and minerals. They also no longer make hormones that keep bones strong and blood healthy.

As a result, harmful wastes build up in the body. Blood pressure may rise, and the body may hold on to excess fluid and not make enough red blood cells.

The most common cause of end-stage kidney disease in the U.S. is diabetes. However, there are many other causes of chronic renal failure and end-stage kidney disease.

A donated kidney may come from a living related donor (related to the recipient, such as a parent, sibling, or child), a living unrelated donor (such as a friend or spouse), or a deceased donor (a person who has recently died and who has no known chronic kidney disease.)

The procedure today is done under general anesthesia with either a short surgical cut (mini-nephrectomy) or laparoscopic techniques.

The surgeon makes a cut in the lower belly area and places the new kidney inside the lower belly. The artery and vein of the new kidney are connected to the artery and vein in the pelvis. Blood flows through the new kidney, which makes urine just like the kidneys did when they were healthy. The tube that carries urine (ureter) is then attached to the bladder.

The old kidneys are left in place, unless they are causing high blood pressure, infections, or are too large for the body. The wound is then closed.

Kidney transplant surgery takes about three hours. People with diabetes may also have a pancreas transplant done at the same time. This will usually add another three hours to the surgery.

If the transplant team believes you are a good candidate for a kidney transplant, you are put on a national waiting list.

Your place on a waiting list is based on a number of factors. Key factors include the type of kidney problems you have, how severe your heart disease is, and the likelihood that a transplant will be successful.

Joyce wears a pager and if a kidney becomes available, she will be notified immediately. She has everything ready to go to the hospital.

If she receives a donated kidney, she will need to stay in the hospital for about 3 - 7 days. Afterward, she will need close follow-up by a doctor and regular blood tests for the next couple of months.

The recovery period is about six months. She will need to have regular checkups with blood tests and x-rays for many years.

People who receive a transplanted kidney may reject the new organ. This means that their immune system sees the new kidney as a foreign substance and tries to destroy it.

In order to avoid rejection, almost all kidney transplant recipients must take medicines that suppress their immune response for the rest of their life. This is called immunosuppressive therapy. The medicines may also cause high blood pressure and high cholesterol and increase the risk for diabetes.

But Joyce sees all of that as a small price to pay if it gives her a few more years to continue her work for the Lord.