How Will I Pay For A Transplant
Medicare covers about 80% of the costs associated with an evaluation, transplant operation, follow-up care, and anti-rejection medicines. Private insurers and state programs may cover some costs as well. However, your post-transplant expenses may only be covered for a limited number of years. Its important to discuss coverage with your social worker, who can answer your questions or direct you to others who can help.
The Recovery And Aftermath
Recovery from a kidney donation operation can take from two to 12 weeks depending on the persons individual progress.
Traditional open surgery
If the operation was an open nephrectomy, you may be in hospital for five to seven days, but you should be out of bed the day after the operation. Surgeons use either stitches or clips to close the incisions they made during the operation and these will be removed around 10 days after the procedure.
Before you leave hospital, a follow-up clinic appointment will be made, usually for four to six weeks later. The scars from the operation may be sensitive or sore for several weeks, and some numbness around the scar is common. There will be a permanent scar. There may also be twinges or a drawing sensation around the scars for some months, but most people feel back to normal by about 12 weeks after the operation.
If the operation was keyhole surgery, recovery time is shorter and there is usually less pain afterwards. After this type of surgery you will normally need four to six weeks of recovery time at home before resuming your normal activities. Painkillers may be needed for a while, depending on an individuals symptoms. You will be asked to come in for a follow-up appointment four to six weeks after the operation.
Getting back to normal life
You should return to exercise gradually and gently and build up any exercise routine slowly.
How Long Does A Donor Evaluation Take
An evaluation takes usually longer than one might at first suppose. An evaluation that proceeds “quickly” may take 3 months. Often, the process takes 6 months or longer. The potential donor plays a significant role in determining the length of the evaluation. Those who are readily available, able to be flexible in scheduling, and can follow up quickly on miscellaneous details can keep the process moving steadily forward.
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What Are The Risks Of Becoming A Kidney Donor
Removing a kidney from your body involves major surgery. There is a risk of complications from surgery, such as pain, infection, pneumonia, and bleeding.
A person only needs one healthy kidney to live. But doctors are learning that donating a kidney may increase the chances of certain health problems in the years after the donation. More research is being done to better understand these long-term risks.
Donating an organ can affect you and your family. Many emotional issues are involved. There may be costs such as travel expenses and lost wages.
If you are thinking about donating a kidney, your medical team will help you understand the pros and cons so you can make the decision that’s right for you.
Initial Donor Assessment And Information Session
The following is a summary of what happens, at the beginning of the journey towards becoming a living kidney donor:
- The potential donor contacts the transplant co-ordinators office for general discussion of living kidney donation. The donors blood group compatibility is now assessed and he or she is given the living donor information book. Blood may also be taken for tissue typing tests.
- Tissue typing results take at least six weeks to process and are reviewed at a large meeting of different professionals.
- Once your tissue typing results are available, you will be offered an appointment with a consultant nephrologist to discuss them. You will be offered this appointment at the same time as other family members who might have been tested You will be offered the opportunity to discuss these results individually or with your other family members present. You need to think carefully how you want to receive these results. If for example, you hear in the presence of your other family members that you are the only potential donor, you might feel great pressure to proceed with donation. In the first instance, The nephrologist will only discuss your results with you. He will not discuss them with any other family member.
- Once results are given, donors who wish to proceed are asked to contact the transplant office for an appointment to go to the next stage in the process.
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Are There Any Side Effects Of Donating A Kidney
Donating a kidney is an amazing gift. Living donors are having an operation they dont need it is mainly to benefit someone else. The risk of death is quoted as 1 in 5000. Of course, it involves a hospital stay and pain associated with an operation, and in the longer term, there is a small increased risk of high blood pressure and a small increased risk of kidney failure. These are explained in detail during medical consultations.
Information For Kidney Donors
The University of Iowa Organ Transplant Center is the states most experienced living kidney donor program, having performed more than 700 living kidney donor transplants since 1990. Living donation takes place when a living person donates an organ for transplantation to another person.
Our surgeons perform minimally invasive laparoscopic kidney donor surgery, which allows the donor to be discharged home within three days and usually return to work within two weeks.
The University of Iowa Organ Transplant Center is the only program in the state to offer blood type incompatible living kidney donation. With this program, you may still be able to be a kidney donor to your intended recipient, even if you are not a blood type match.
We have many years of experience in working with individuals who are interested in being humanitarian or non-directed living kidney donors.
We evaluate our potential kidney donors during a convenient one-day series of tests and meetings. All kidney donor testing is covered by the recipients health insurance. We invite you to begin completing a health screening questionnaire for kidney donors.
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How Do I Start The Transplant Process
To get a living donor transplant, you take the same steps as you would for a deceased donor transplant. You have to be on the deceased donor transplant waitlist even if you already have a living donor lined up.
You can begin the living donor transplant process when either:
- Your kidneys do 20% or less of the work of 2 working kidneys
- You start dialysis
Your transplant center will help you set up all of this and walk you through the process. This is just to give you an idea of what you might need. Heres how to start the process:
What Limitations Will I Have After I Have Donated A Kidney
Donating a kidney will not cause any limitations in your normal daily activities. After the recovery from your surgery, you will be able to resume all of your normal activities, including exercising and participating in sports.
Donating a kidney doesn’t affect a person’s fertility. For example, it won’t affect a woman’s ability to become pregnant or a man’s ability to impregnate a woman. But if a woman has donated a kidney, her risk for pre-eclampsia or high blood pressure during a pregnancy may be higher.
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During The Transplant Surgery
You will be placed on your back on the surgery table. You will be given anesthesia, a medicine to make you sleep only while the surgery is being done. The surgeon will make a cut on your abdomen, or belly area. Your new kidney will be put into your body in this area, and the donors ureter will be sewn to your bladder. Usually your own kidneys will not be removed. The surgeon will close the skin cut and you will be taken to the recovery room. This operation takes 2 to 4 hours.
Learn How To Get Started
A person who donates a kidney to someone in need is called a living donor, and a person who needs a kidney is called a transplant candidate.
Any adult who is in good health can be assessed to become a living donor. Every potential donor must have a complete medical checkup to make sure they are healthy enough to donate a kidney to a person in need.
The kidney donation process involves an operation to remove one kidney from the donor and another surgery to place the kidney into the transplant candidate. After the donation, the donors remaining kidney starts to work harder, to make up for the removed kidney. The donor should have a checkup with a doctor every year to make sure their remaining kidney is still working correctly.
Types of living donation
This type of donation occurs when a potential donor knows a transplant candidate and is a match to that person. Directed donors can be biologically related to the transplant candidate or unrelated .
Non-directed anonymous donation
This type of donation occurs when a person offers to donate a kidney that could go to anyone they match who needs a kidney transplant. A donation like this can help one transplant candidate if the kidney is given directly to someone on the waitlist. Alternatively, this type of donation might help several people through the Kidney Paired Donation program. In this program, a kidney donation from one NDAD can kick-start a chain of donor exchanges.
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Does It Matter If Hla Numbers Are A Good Match Or Not
We prefer a good match, although this is more important for deceased donor kidneys. When a deceased donor kidney becomes available, UK Transplant matches the six numbers that the donor has with the best match for all the potential recipients on the on-call register.One way of thinking of this is that it is very much like the National Lottery. That is, we all have our own six numbers and if the donor had the same six numbers as one of the recipients on the list, they would be offered that kidney.
This is called a 6-antigen match or a full house match. Just like winning the lottery jackpot, this does not happen very often. Five numbers matching is a bit more common, and four numbers matching is a bit more common again. However, we do not like to take less than four numbers matching as far as possible, unless the child has numbers that are extremely uncommon in the population and very unlikely, therefore, to be matched.
If the child is lucky enough to receive a full house 6-antigen matched kidney from a deceased donor, then this is the only match that does as well as a kidney from a parent, even though the parent may only have three numbers in common with their child. This is because the parent may have other things in common that we do not match for or even understand. It is also because the kidney is taken from the parent and very rapidly transferred into the child, with very little wait in between.
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The Following Are Examples Of Some Of The Tests You May Be Asked To Complete As Part Of The Evaluation For Becoming A Living Kidney Donor:
1. Blood Tests: to check blood type compatibility between you and the transplant candidate.
- Blood Type Compatibility Chart
Transplant Candidates Blood Type O A, B, AB, or O AB
The Rh factor in blood type is not important in compatibility.
- Tissue Typing: This blood test checks the tissue match between six codes on the transplant candidates and your white blood cells.
- Crossmatching: determines how the transplant candidate will react to your kidney. A positive crossmatch means your organ is incompatible with the candidate. A negative crossmatch means that your kidney is compatible with the candidate.
- Antibody Screen: When a foreign substance enters a persons body, a protein substance is created in response to that antigen. Results of this test will determine if the transplant candidate has antibodies in his or her body that would react to your antigens.
- Blood tests to screen for transmissible disease: These tests determine whether you have HIV, hepatitis, cancer, and other transmissible diseases.
2. Urine Tests: A 24-hour urine sample is collected to examine your kidney function.
3. Chest X-Ray and Electrocardiogram : These tests screen for heart and lung disease. Depending upon your age and medical history, further testing may be needed.
4. Radiologic Testing: These tests allow physicians to view your kidneys, including their blood supply. Tests can include a CAT scan, MRI, and arteriogram.
6. Gynecological screening: Female donors receive a gynecological examination.
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Where Would The Transplant Take Place
The transplant will take place at the hospital where you currently receive care. You can choose to travel to your matched donors hospital, if they are unable to travel and their kidney cannot be shipped.
There are two options.
- You can have your surgery at the hospital who entered you into the KPDPP. Your kidney will be shipped to your matched candidate.
- You could travel to your matched candidates hospital for surgery.
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What Does A Full Evaluation Involve
Financial consultation Psychological evaluation Medical Tests
- Medical history. You will be asked to give a complete and thorough history of any illnesses, surgeries, and treatments youve had in the past. You will also be asked about your familys medical history. If any problems or abnormalities are found, they will be investigated further.
- Physical exam. You will be given a physical examination to make sure you are healthy enough to donate a kidney.
- Chest X-ray and electrocardiogram . These tests are done to check for heart or lung disease.
- Radiological testing. These tests allow physicians to look at your kidney, including its blood vessel supply.
- Urine testing. A 24-hour urine sample is collected to make sure you have good kidney function.If it is found that your kidney function is low, they will most likely advise against donation.
- Gynecological examination. Female donors may need to have a gynecological exam and mammography.
- Cancer screening. You may also be given some cancer screening tests, which may include a colonoscopy, prostate exam, and skin cancer screening.
Compatibility TestsOther Blood Tests
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How Do I Know If My Kidney Is A Match For The Recipient
The transplant team will check your blood type as well as the recipient blood type to see if they are compatible. A unique blood test also needs to be done which is called crossmatch.
It is possible that the recipient of the kidney has an allergy to the donated kidney so the recipient’s body may reject the donated kidney. Such allergy is due to some substances called antibodies which are present in the recipient’s blood. In order to make sure that the recipient does NOT have those antibodies against your kidney tissue, the crossmatch test is performed. Briefly, a sample of your blood is combined with a sample of the recipient’s blood. If the recipient has antibodies to the donor, this will cause a “positive” reactivity during the crossmatch test. This may mean your recipient is incompatible to you. In the case that you and your recipient are not compatible, you may participate in UCLA’s Kidney Exchange Program. This program allows the recipient and donor to enter a paired exchange registry, where the donor will donate to another recipient that is matched, and the recipient will recieve a matched kidney from a compatible donor in return.
Does The Donor Need Follow
Yes, the donor will need to have a follow-up visit 3 months after the surgery to see the transplant nephrologist for a follow-up evaluation. It will also be necessary for some follow-up testing, which will include a CBC, routine blood chemistries, urinalysis, urine culture, 24-hour urine for protein and creatinine, and a Glofil test. The transplant recipients insurance will pay for these follow-up tests.
It is recommended that the donor have annual follow-up examinations with their primary care physician. This examination may include a urinalysis, routine blood chemistries and blood pressure check. The donor will be financially responsible for the annual follow-up examinations.
There are usually no restrictions to activity. Some physicians may recommend that the donor refrain from contact sports following the donation of a kidney.
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Positive Crossmatch And Sensitized Patients
About 30% of transplant patients are sensitized. This means that they have harmful antibodies which will attack foreign tissue, such as the transplanted organ from a living donor. These antibodies develop through a previous exposure to foreign tissue, such as through pregnancy, previous transplants, or blood transfusions. Sensitized patients may wait three to four times longer than unsensitized patients for a compatible deceased donor kidney.To test a recipient for these antibodies, a sample of their blood is mixed with a sample of the potential donors blood. This test is called a crossmatch, and shows how a recipients antibodies react with the potential donors. Test results can be either positive or negative. It may seem confusing at first, but a positive crossmatch means that a donor and recipient are not compatible.
A positive crossmatch results in the recipients antibodies attacking the donors which means the kidney is not suitable for transplant.
A negative crossmatch means that the recipients antibodies do not attack the donors which means the kidney is suitable for transplant.