Get On The Waiting List
If your tests show you can have a transplant, your transplant center will add your name to the waiting list. Wait times can range from a few months to years. Most transplant centers give preference to people whove been on the waiting list the longest. Other factors, such as your age, where you live, and your blood type, may make your wait longer or shorter.
A transplant center can place you on the waiting list for a donor kidney if your kidney function is 20 or lesseven if you arent on dialysis. While you wait for a kidney transplant, you may need to start dialysis.
Who Can Donate A Kidney
People can choose to donate their kidneys when they die or they can donate one kidney while they are still alive .
If you donate a kidney, you can usually live safely with your one remaining kidney without complications. Living donors are usually relatives, partners or close friends. To read more about organ or tissue donation after death or to register as a donor, visit www.donatelife.org.au.
What Is Done To Prevent Rejection
To allow the transplanted kidney to survive in your body, you will be givenmedicines for the rest of your life to fight rejection. Each person mayreact differently to medicines.
New antirejection medicines are continually being developed and approved.Your healthcare team will tailor medicine regimes to meet your needs.
Usually several antirejection medicines are given at first. The doses ofthese medicines may change often, depending on your response. Becauseantirejection medicines affect the immune system you will be at higher riskfor infections. A balance must be maintained between preventing rejectionand making you very susceptible to infection.
Some of the infections you will be especially at risk for include oralyeast infection ,herpes, and respiratory viruses. Avoid contact with crowds and anyone who has aninfection for the first few months after your surgery.
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What Tests Do Potential Donors Complete
A potential living donor must meet basic medical criteria and undergo a thorough medical evaluation before being accepted as a donor. Before completing a full evaluation, a potential donor has a preliminary blood test to determineblood- and tissue-type compatibility. Usually, the potential donor is also asked to report approximately 5 blood-pressure readings.
While various transplant centers have their own donor testing procedures, in general, if the preliminary blood test results are acceptable, the center will proceed with any other preliminary tests that may be needed. A full evaluation includes a medical history review, thorough physical, urine collections, glucose-tolerance test, chest X-ray, EKG, and any other tests deemed necessary by the transplant team. Any abnormaliities that may be found are investigated further. Occasionally, a potential donors own lifespan is significantly improved when the evaluation uncovers a previously unknown health condition and leads to treatment for it. The final test is a CT scan that allows a detailed look at the potential donors kidneys.
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:
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What Are The Risks For Kidney Transplant
As with any surgery, complications can occur. Some complications mayinclude:
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Blockage of the blood vessels to the new kidney
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Leakage of urine or blockage of urine in the ureter
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Lack of function of the new kidney at first
The new kidney may be rejected. Rejection is a normal reaction of the bodyto a foreign object or tissue. When a new kidney is transplanted into arecipient’s body, the immune system reacts to what it thinks as a threatand attacks the new organ. For a transplanted organ to survive, medicinesmust be taken to trick the immune system into accepting the transplant andnot attacking it as a foreign object.
The medicines used to prevent or treat rejection have side effects. Theexact side effects will depend on the specific medicines that are taken.
Not everyone is a candidate for kidney transplantation. You may not beeligible if you have:
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Current or recurring infection that cannot be treated effectively
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Cancer that has spread from its original location to elsewhere in the body
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Severe heart or other health problems that make it unsafe to have surgery
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Serious conditions other than kidney disease that would not get better after transplantation
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Failing to follow the treatment plan
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your transplant team before theprocedure.
How Long Does The Process Take
The donation process depends on how many tests are required of the donor and how quickly he or she is able to complete them. The average donor work up may take six months or more for completion and may depend on test results, which may indicate additional evaluation is required. A transplant date cannot be set until the donor has completed the entire work up and has been evaluated by the surgeon. The transplant center does its best to accommodate the needs of the donor and recipient, but appointment times may be limited.
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Kidney Testing: Everything You Need To Know
If you have diabetes, your doctor will likely recommend you have one or more kidney tests to check the health of your kidneys.
If you have diabetes, you have a higher risk for chronic kidney disease. Your doctor will likely recommend you have one or more kidney tests to check the health of your kidneys. The sooner you know the health of your kidneys, the sooner you can take steps to protect them. Knowledge is powerlearn about what these tests do and what your results could mean.
Chronic kidney disease is a condition in which the kidneys become damaged over time and cannot filter blood as well as they should. Diabetes is a leading cause of CKD, which often causes no symptoms until your kidneys are badly damaged.
The good news is that if you find and treat kidney disease early, you may be able to keep CKD from getting worse and prevent other health problems such as heart disease. But the only way to know how well your kidneys are working is to get tested.
If you have diabetes, you know how important it is to prevent complications like CKD. Your doctor will want to check your kidney health, usually by testing your urine and blood.
Becoming A Living Kidney Donor
To be a living kidney donor, you must be of good physical and mental health. You would typically be between the ages of 18 and 60 years, and you must be free of any diseases that could affect the health of the person receiving the kidney. A specialist medical team will test to make sure you are a matching blood and tissue type. A close match is more likely with genetically related donors.
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Why Might I Need A Kidney Transplant
You may need a kidney transplant if you have end stage renal disease. This is a permanent condition of kidney failure. It often needsdialysis. This is a process used to remove wastes and other substances fromthe blood.
The kidneys:
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Remove urea and liquid waste from the blood in the form of urine. Urea is made when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the blood to the kidneys.
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Balance salts, electrolytes, such as potassium and sodium, and other substances in the blood
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Produce erythropoietin, a hormone that aids the formation of red blood cells
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Regulate blood pressure
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Regulate fluid and acid-base balance in the body to keep it neutral. This is needed for normal function of many processes within the body
Some conditions of the kidneys that may result in ESRD include:
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Repeated urinary infections
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Polycystic kidney disease or other inherited disorders
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Glomerulonephritis, which is inflammation of the kidney’s filtering units
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Hemolytic uremic syndrome, a rare disorder that causes kidney failure
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Lupus and other diseases of the immune system
Other conditions, such as congenital defects of the kidneys, may result inthe need for a kidney transplant.
There may be other reasons for your healthcare provider to recommend akidney transplant.
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.
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What If More Than One Person Offers To Donate
Blood testing will begin with only three donors, to determine compatibility with the recipient. If you have more than three people who are willing to donate, they may contact the donor department to discuss their options. Once compatibility tests have been completed the recipient and donors must discuss which donor he/she will proceed with. The donor coordinator can help families decide which donor may be best for them.
Common Kidney Donor Questions
Becoming a kidney donor is an important decision that requires careful thought. The process may seem scary, but it is a safe procedure performed by experienced surgeons. By understanding what to expect, more people may become kidney donors.
Reasons that someone may become a kidney donor include:
Yes. This is more common than receiving a kidney from a stranger and can be preferred. When you are genetically related, youre more likely to be a compatible kidney donor. If you are not a compatible match with your chosen recipient, you may consider orchestrating a paired exchange. Your recipients healthcare team can help you find others to pair with.
Becoming a living kidney donor requires a thorough health exam and being tested to check for potential compatibility between you and your recipient. If youre considering becoming a donor, contact a physician in your area. Talk with your intended recipients care team if you wish to donate to someone you know.
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What Does A Full Evaluation Involve
Financial consultationPsychological evaluationMedical 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
Considering A Kidney Transplant
If you have serious kidney failure, a kidney transplant may be an option. A transplant may offer you both a longer, dialysis-free life, and a better quality of life.
Your healthcare team will assess whether you are medically suitable for a kidney transplant.
To decide whether you want a transplant, it is important to understand your condition and the potential benefits and risks of the procedure. You also need to be willing to undertake the self-care that will be required for the rest of your life after the operation. Read more about the questions to ask your healthcare team.
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What Are The Side Effects Of Anti
Some anti-rejection medicines may change your appearance. Your face may get fuller, you may gain weight, or you may develop acne or facial hair. Not all people have these side effects.
Anti-rejection medicines weaken your immune system, which can lead to infections. In some people over long periods of time, a weakened immune system can increase their risk of developing cancer. Some anti-rejection medicines cause cataracts, diabetes, extra stomach acid, high blood pressure, and bone disease.
When used over time, these medicines may also cause liver or kidney damage in some people. Your transplant team will order regular tests to monitor the levels of anti-rejection medicines in your blood and to measure your liver and kidney function.
What Will Be Expected Of The Donor
The donor will be assigned a nurse coordinator who will be responsible for educating them through the donation process. The coordinator will work only with the donor and cannot disclose any health information to their family or the recipient. It is very important for donors to keep the recipient informed of the process as it moves along.
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What Can The Donor Expect After Surgery
If the kidney donor has had an open nephrectomy, the donor will have a larger incision than if he/she has laparoscopic surgery. Pain medication after surgery will help with the discomfort. The nurses will remind the patient to breathe deeply and cough frequently. This helps prevent pneumonia. The donor will be getting out of bed soon after surgery to help prevent lung or other problems.
To make sure that the donor receives adequate fluids and nourishment, intravenous fluids will be given until normal oral intake is established.
A catheter will be placed in the bladder for 24 hours following the surgery.
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
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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