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Why might a transplanted kidney from a deceased donor take time to begin working?

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Kidney transplant — transplant British surgeon Andrew Ready flushing a donated kidney during a transplant at Queen Elizabeth Hospital, Birmingham, England, 2006.

A transplanted kidney from a deceased donor may take time to begin working because the organ often undergoes a phase of acute renal failure, which is independent of immune rejection. This delay occurs because the kidney tissue may have suffered damage due to ischemia—a period of being deprived of its blood supply—during the time between the donor's death and the transplantation surgery.12

During this period, the tissues of the transplanted kidney require time to adjust and recover from the injury. While the organ is repairing itself, the patient may require temporary treatment with an artificial kidney (dialysis) for two to three weeks. In general, while kidneys from living donors often function immediately, cadaver kidneys may take up to two weeks to become functional as the tissue regenerates.341