Where Does Your New Kidney Come From
Kidneys for transplantation come from two sources: living donors and deceased donors. Living donors are usually immediate family members or sometimes spouses. Deceased donor kidneys usually come from people who have willed their kidneys before their death by signing organ donor cards. Permission for donation can also be given by the deceased person’s family at the time of death.
All donors are carefully screened to make sure there is a suitable match and to prevent any transmissible diseases or other complications.
When Should I Call A Doctor
Having a kidney transplant puts you at risk for health problems like high blood pressure and diabetes. Youâre also more likely to get infections. This could occur at the site of your incision. Or, it could be a yeast infection or a virus that affects your whole body, like shingles.
Thereâs also a chance your body could start to attack the donor kidney. If so, you could experience:
Special Programs For Deceased Donor Transplantation
Expanded Criteria Donor Program
Although the most commonly transplanted deceased donor kidneys come from previously healthy donors between the ages of 18 and 60, kidneys from other deceased donors have been successfully transplanted. The goal of this program is to use organs from less traditional donors more effectively so that more patients can receive kidney transplants.
Kidney Transplants from Less Traditional Deceased Donor Category
- Age 60 or older
- Between the ages of 50-59 with at least two of the following conditions:
Patients who are most likely to benefit from a kidney through this program are dialysis patients who are older and have a greater risk of problems, including death, while waiting for a transplant. Accepting a kidney from an expanded criteria donor may shorten the waiting period for a transplant. Patients who are considered for this type of transplant also remain on the waiting list for standard kidney offers.
Hepatitis C Donor Program
About 8% of patients on the deceased donor waiting list have the Hepatitis C virus. By accepting a kidney from a deceased donor who also had Hepatitis C, these patients could shorten the waiting time for a deceased donor kidney.
HIV Program
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What Are The Advantages Of Living Donation
There are three advantages to living donations versus getting a deceased donor kidney:
Who Is On My Transplant Team
A successful transplant involves working closely with your transplant team. Members of the team include:
- Youyou are an important part of your transplant team.
- Your family membersthis may include your spouse, parents, children or any other family member you would like to involve.
- Transplant surgeonthe doctor who places the kidney in your body.
- Nephrologista doctor who specializes in kidney health and may work closely with a nurse practitioner or a physicians assistant.
- Transplant coordinatora specially trained nurse who will be your point of contact, arrange your appointments, and teach you what to do before and after the transplant.
- Pharmacista person who tells you about all your medicines, fills your prescriptions, and helps you avoid unsafe medicine combinations and side effects.
- Social workera person trained to help you solve problems in your daily life and coordinate care needs after your transplant.
- Dietitianan expert in food and nutrition who teaches you about the foods you should eat and avoid, and how to plan healthy meals.
Your transplant team will be able to provide the support and encouragement you need throughout the transplant process.
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Why Do Some Patients Wait Longer Than Others For A Transplant
longevity matching
How Long Do Transplanted Organs Last
If youre suffering from a failing organ, a transplant can restore your life. Transplant recipients grow up, go to school and graduate. They run marathons and run for office. They walk their daughters down the aisle and meet their first grandchildren. They eat meals they can finally enjoy.
Thats the great thing about transplantyou can go back to leading a pretty normal life, says Alejandro Diez, MD, a transplant nephrologist at The Ohio State University Wexner Medical Center specializing in kidney and pancreas transplantation. My best days are when you see a patient before and after their transplant.
And continued advancements in medicine and technology mean transplanted organs are lasting longer than everin many cases, several decades.
Just how long depends on the organ and hinges on a lot of factors, some of which patients can control. Here, well break down how long certain transplanted organs may last and what patients can do to keep themselves healthy and extend the longevity of their transplants.
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Kidney Paired Exchange Programs
Many hospitals have their own kidney paired exchanges that they arrange within the incompatible pairs at their hospitals. The nature of kidney paired exchanges is that the likelyhood of finding a compatible pair is increased when there are many incompatible pairs. There are organizations thatco-op with other hospitals to increase the likelihood of being matched with another incompatiblepair. The following organizations have agreements with many hospitals in order to increase thatlikelihood.
National Kidney Registry www.kidneyregistry.org Contact: Joe Sinacore 962-3186 The Alliance for Paired Donation www.paireddonation.org Contact: Laurie Reece 512-961-6199 United Network for Organ Sharing transplantpro.org/kidney-paired-donation/ Contact: Ruthanne Leishman 804-782-4770
How Can I Help My Child
Having a chronic condition can be hard for kids. Dialysis, surgery, and immunosuppressant therapy can add to the stress. Talk to your child about these changes and how you will work them into your routine. Make sure to find time to do fun things together with family and friends.
For teens, immunosuppressant therapy can be a challenge. These medicines can cause:
- getting acne or having acne that gets worse
- weight gain
- problems with increased blood sugars , sometimes requiring insulin
- high blood pressure
- increased risk of infection
These side effects are a major reason why teens are at risk for not taking their medicines after a transplant. This can be dangerous and even lead to rejection of the new kidney. Do not change or stop any medicines without talking to your doctor or nurse. In some cases, medicines can be changed to ease the side effects and still be effective and safe. Talk to about the importance of taking all medicines as directed, and help your child to do so.
To help:
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Treatment Locations For Haemodialysis
Haemodialysis can be done by you at home. Or, for people who need extra medical support, it can be performed at a dialysis unit in a hospital or a satellite centre. Your healthcare professionals will advise you of your available options. Haemodialysis is needed at least three times a week. At a dialysis unit, you will have permanent regular appointments for a four-to-five-hour dialysis session. If you are dialysing at home, your schedule will be tailored to your needs and may include shorter or longer sessions, with three to six treatments each week. The extra treatments will help you to feel better.If you choose to have haemodialysis at home, special plumbing will be installed and the machine will be provided, along with all the supplies you need. You will learn to manage your own dialysis. A spouse, friend, carer or partner can be trained to help you, but some people dialyse by themselves. Having dialysis at home means you can choose to dialyse when it suits you at any time during the day, or overnight while you sleep. At home, it is also possible to dialyse more often, which has health benefits.
Blood Tests And Monitoring
You will be required to visit your doctor on a regular basis. Initially, you will need to visit the hospital for tests every day for up to a month and then less frequently over time. If seeing multiple doctors for different things, please ensure that all doctors know what medications you are taking. Some medicines do interact with other medications and must be taken with care.
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How Does Kidney Transplant Work
The kidney transplant procedure, performed under general anesthesia, typically takes three to five hours. Many kidney transplants are done using a minimally invasive approach, resulting in less pain, lower bleeding risk, and a faster healing and recovery. After the surgery, a patient typically stays in the hospital for two days and is back to normal life one month after the surgery.
A Brief History Of The Animal
The dream of animal-to-human transplants or xenotransplantation goes back to the 17th century with stumbling attempts to use animal blood for transfusions. By the 20th century, surgeons were attempting transplants of organs from baboons into humans, notably Baby Fae, a dying infant, who lived 21 days with a baboon heart.
With no lasting success and much public uproar, scientists turned from primates to pigs, tinkering with their genes to bridge the species gap.
Pigs have advantages over monkeys and apes. They are produced for food, so using them for organs raises fewer ethical concerns. Pigs have large litters, short gestation periods and organs comparable to humans’.
Pig heart valves also have been used successfully for decades in humans. The blood thinner heparin is derived from pig intestines. Pig skin grafts are used on burns and Chinese surgeons have used pig corneas to restore sight.
In the NYU case, researchers kept a deceased woman’s body going on a ventilator after her family agreed to the experiment. The woman had wished to donate her organs, but they weren’t suitable for traditional donation.
The family felt “there was a possibility that some good could come from this gift,” Montgomery said.
Montgomery himself received a transplant three years ago, a human heart from a donor with hepatitis C because he was willing to take any organ.
“I was one of those people lying in an ICU waiting and not knowing whether an organ was going to come in time,” he said.
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Benefits And Risks Of Kidney Transplant
For people with kidney failure, a kidney transplant can increase your chances of living a longer, healthier life. Because dialysis can only do part of what healthy kidneys do for your body, people who have a kidney transplant usually live longer than those on dialysis. A kidney from a transplant will not work as well as kidneys in a healthy person. But your health may be almost as good as a person with healthy kidneys as long as you closely follow your doctors orders after the transplant surgery.
Also, when you get a kidney transplant, you may avoid some of the complications that people on dialysis often have, such as bone problems and heart disease.
A kidney transplant can improve your quality of life. After your kidney transplant, you may have:
- More energy
- Fewer limits on what you can eat
- More free time from not having to go to dialysis
- More flexibility to travel
- Greater ability to work and hold a job
Risks with a kidney transplant are the same as with any major surgery. Risk does not mean these things will happen, it means they could happen. Some of the risks are infection, bleeding, or damage to other organs. Also, the three connections between your new kidney and your body the artery, vein, and ureter , might leak or become blocked. Read more about the kidney transplant surgery here.
How To Get On The Kidney Transplant List
Getting on the kidney transplant waiting list is a three-step process.
Step 1: Receive a referral from your doctor. Schedule an appointment with your nephrologist to talk about the possibility of getting a kidney transplant. If your doctor thinks youre a good candidate, he or she will refer you to a local transplant center.
If you live in the Puget Sound region, youll likely be referred to Swedish Medical Center, UW Medical Center or Virginia Mason.
Step 2: Get evaluated by transplant specialists.Meet with the transplant specialists at your referred transplant center. They will evaluate your condition further and decide whether youre healthy enough to proceed. They will also help identify any special needs you may have during and after the transplant. Specifically, you must be cancer free, a non-smoker and have no active infections. If you are severely overweight, you may be required to lose weight prior to being considered for a transplant.
Step 3: Undergo blood tests and health screenings.Receive a series of medical screenings to confirm your eligibility. This includes blood tests to determine your unique blood and tissue types, a dental exam and cancer screenings. If the lab results look good, youll be placed on the national transplant waiting list.
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The Screen The List And The Match
Organ transplants are one option when a particular organ is failing. Kidney failure, heart disease, lung disease and cirrhosis of the liver are all conditions that might be effectively treated by a transplant. For problems with the heart, the lungs and other highly sensitive organs, a transplant is typically the course of last resort. But if all other avenues have been explored and the patient is willing and able, transplantation is a good, viable option.
Kidneys and livers may be transplanted from a living donor, since people are born with an extra kidney and the liver is regenerative. Even a lung can be transplanted from a living donor, but this is still very rare. For these procedures, a patient will generally find a willing donor in a friend or family member. If the donor is a match, they can proceed directly to the surgery stage. A smaller number of living transplants come from charitable people donating for the general good.
If a patient needs a heart transplant, a double lung transplant, a pancreas transplant or a cornea transplant, they will need to get it from a cadaverous donor. Generally, acceptable donors are people who are brain dead but on artificial life support. Even though they are technically dead, their body is still functioning, which means the organs remain healthy. Organs will deteriorate very quickly after the body itself expires, making them unusable for transplant.
What Should I Eat Or Avoid Eating With A Kidney Transplant
You have more choices about what to eat after you receive a kidney transplant than you would if you were on dialysis. However, you will need to work with a dietitian to develop an eating plan that can change in response to your medicines, test results, weight, and blood pressure.
Read more about kidney failure and eating, diet, and nutrition.
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What Happens During A Kidney Transplant
A kidney transplant requires a stay in a hospital. Procedures may varydepending on your condition and your healthcare provider’s practices.
Generally, a kidney transplant follows this process:
You will remove your clothing and put on a hospital gown.
An intravenous line will be started in your arm or hand. More catheters may be put in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for catheters include under the collarbone area and the groin blood vessels.
If there is too much hair at the surgical site, it may be shaved off.
A urinary catheter will be inserted into your bladder.
You will be positioned on the operating table, lying on your back.
Kidney transplant surgery will be done while you are asleep under general anesthesia. A tube will be inserted through your mouth into your lungs. The tube will be attached to a ventilator that will breathe for you during the procedure.
The anesthesiologist will closely watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
The skin over the surgical site will be cleansed with an antiseptic solution.
The healthcare provider will make a long incision into the lower abdomen on one side. The healthcare provider will visually inspect the donor kidney before implanting it.
The renal artery and vein of the donor kidney will be sewn to the external iliac artery and vein.
The donor ureter will be connected to your bladder.
Should I Stay On Dialysis Or Have A Kidney Transplant
When your kidneys no longer function properly due to kidney failure, your nephrologist usually offers you 2 options: dialysis or kidney transplant. Many times patients are on dialysis while they wait for transplantation, so its important to understand what that involves.
Our patients sometimes find dialysis to be restrictive, because appointments and maintenance take up a lot of time. Plus, dialysis only replaces part of your kidneys function. Its imperative that your nephrologist monitors you closely alongside your primary care provider to help ensure youre receiving exceptional care.
With a successful kidney transplant, many of our patients are able to live more normally than with dialysis. Thats because life on dialysis means you are dependent on dialysis, which acts as your artificial kidney. With a kidney transplant, life is completely different. In my experience, it can help people get their lives back, and thats truly a gift.
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