We imagine a kidney transplant would involve swapping out the unhealthy kidney for the healthy one. In fact, in most cases, surgeons leave the kidney inside the patient's body and add the healthy kidney somewhere near their pelvis.
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Native kidneys can be removed before transplantation, but there are several reasons doctors don't like to do this. First, removing the kidneys is a major operation that can require six to eight weeks of recovery. Second, if the person who needs a kidney transplant isn't already undergoing dialysis, removing kidneys require dialysis to begin immediately. Third, some people require blood transfusions either during or after kidney removal. Those transfusions can result in the development of antibodies that can attack and destroy a new kidney. If those antibodies develop, they could prevent a successful transplant.
https://www.chicagotribune.com/news/ct-xpm-2007-10-14-0710100349-story.html
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