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.
What Happens During The Kidney Transplant Procedure
Kidney transplantation involves placing a healthy kidney into the body, where it can perform all of the functions that a failing kidney cannot.
The new kidney is placed on the lower right or left side of your abdomen where it is surgically connected to nearby blood vessels. Placing the kidney in this position allows it to be easily connected to blood vessels and the bladder. The vein and artery of your new kidney are attached to your vein and artery. The new kidney’s ureter is attached to your bladder to allow urine to pass out of your body.
If Found Compatible In The Long Run This Process Of Xenotransplantation Or Transplanting Organs Between Different Species Could Help Provide An Alternative And Additional Supply Of Organs For People Facing Life
On October 19, USA Today reported that surgeons from New York have successfully transplanted a pig kidney into a brain-dead human. The team from NYU Langone Health used the kidney from a genetically engineered pig and transplanted it into a deceased donor. The function and acceptance of the new kidney were studied for 54 hours.
Dr. Robert Montgomery, who led the surgical team, told reporters that the kidney began functioning and producing large amounts of urine within minutes of being connected to the persons blood vessels. He added that the creatinine which is cleared from the blood by the kidney dropped from 1.9 to 0.8 demonstrating that the kidney was functioning optimally. Dr Montgomery is the Professor and chair of the Department of Surgery at NYU Langone Health and the Director of its Transplant Institute.
If found compatible in the long run, this process of Xenotransplantation, or transplanting organs between different species, could help provide an alternative and additional supply of organs for people facing life-threatening diseases.
Why a genetically engineered pig?
The transplant conducted on September 25, used a kidney that was obtained from a pig that had undergone editing to knock out a gene that codes for a sugar molecule called Alpha-gal. Alpha-gal is not normally found in humans and this molecule can elicit a devastating immune response in humans.
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Matching Kidney Donors With Those Who Need Themand Other Explorations In Economics
Each year, more than 100,000 people in the United States need a kidney transplant. Less than 20 percent of them get one. On average, 13 people die each day waiting for a kidney. Often relatives and friends who are eager to donate are told their blood type or immune systems are incompatible. An unrelated volunteer donor could be a life-saver, but finding those donors can be a struggle theres no nationwide system to match patients and potential donors. Though this might sound like a medical problem, its actually exactly the kind of problem an economist can help solve through an innovative use of social science.
In the news, economists are often portrayed as number crunchers hidden away in universities. But they also journey out into the world, discovering problems and then charting a course to a solution. By applying economic theories to the shortage of kidneys, scientists have been able to save lives, cut medical costs, and reduce misery. Their innovations have spurred medical progress.
Economics is about the real world, said Alvin Roth, a Stanford University economist, when he won the Nobel Prize in 2012 for his work on matching markets, including the kidney donor matching problem. We are interested in how people lead their lives. The kidney donor dilemma is the perfect challenge for social scientists, because they are adept at studying complex systems, figuring out how they go wrong and how they can be improved.
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:
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Anxiety Depression And Mental Health
Getting a transplant is usually an exciting event, but because it is also a major life change, its normal to have all kinds of emotions afterward. If youre experiencing feelings of anxiety, depression or guilt, please know that you are not alone many transplant patients experience these feelings at first, for many reasons.
- Mood changes may be a side effect of the immunosuppressant medicines you are taking.
- You may feel stressed or anxious about your new lifestyle.
- You may feel guilty about getting a kidney from a living or deceased donor.
- If you have been on dialysis for a long time, you may feel guilty about leaving other dialysis patients behind once you get your transplant.
- Your family members may also have emotional changes as they adjust to your new lifestyle.
You do not have to deal with these feelings alone. Getting a kidney transplant is a major life change, and it is normal to feel stressed and anxious about big life changes.
Reach out to your family and friends for support. Also, let your transplant team know about your emotional changes so they can help support you and adjust your medicines if needed. Your transplant team can also refer you to a mental health specialist.
Blood Type Incompatible Kidney Transplant
This program allows patients to receive a kidney from a living donor with an incompatible blood type. To be able to receive such a kidney, patients must undergo several rounds of plasmapheresis, which is similar to dialysis, before and after the transplant. Plasmapharesis removes antibodies from the patient’s blood that can lead to rejection of the transplanted kidney.
Patients require multiple treatments with plasmapheresis before transplant, and may need several more after transplant to keep their antibody levels down.
Some patients also need to have their spleens removed at the time of transplant surgery to lower the number of cells that produce antibodies. The spleen, a spongy organ about the size of a person’s fist, produces blood cells. Located in the upper left part of the abdomen under the rib cage, the spleen can be removed using laparascopic surgery.
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Westfield Man To Receive Kidney Transplant From Wife’s Cousin
“I would do anything to see him get this kidney and I don’t know what I would do without you, said Wanda Lafogg.
WESTFIELD, MA — A Westfield man has been battling stage 5 kidney disease for nearly three years. We spoke with Robert Lafogg and his wife, Wanda, back in January 2020 when they were hoping for a donor. Now, Robert is going to receive that lifesaving transplant.
“I would do anything to see him get this kidney and I don’t know what I would do without you, said Wanda Lafogg.
Robert Lafoggs wife, Wanda, spoke with Western Mass News in January 2020, desperately hoping someone would come forward to donate their kidney to her husband.
Now, nearly two years later, shes breathing a sigh of relief.
Its like Christmas time, when you’re that little kid and you’re waiting for that special toy to come on Christmas morning, Wanda Lafogg added.
Robert was diagnosed with stage 5 kidney disease in January 2019. A few people came forward to try to help, but bloodwork and tests showed they werent the right match.
Its been hard, the dialysis. Ive watched a couple people pass away at dialysis. Its been hard, Robert Lafogg explained.
Keeping Your New Kidney Healthy
To keep yourself healthy, and to make sure your new kidney works well, the following are extremely important:
- Take your immunosuppressants and other medicines exactly how your doctor told you.
- Know the signs of infection or possible kidney rejection, then contact your transplant team right away if this ever happens.
- Avoid being around people who are sick.
- Drink plenty of water to stay hydrated.
- Eat foods low in salt, fat, and cholesterol.
- After you are cleared by your doctor, start an exercise routine such as walking, or biking.
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Making A Kidney Dialysis Choice
The type of dialysis treatment you choose to have may be influenced by a number of factors including:
- personal lifestyle
- personal preference
- health and medical suitability.
If you need to have dialysis, your healthcare professional will discuss the pros and cons of the different options with you, your family, and your healthcare team. It is usually possible to change between dialysis options if one treatment no longer suits.
Us Surgeons Test Pig Kidney Transplant In A Human
Health editor, BBC News online
US surgeons say they have successfully given a pig’s kidney to a person in a transplant breakthrough they hope could ultimately solve donor organ shortages.
The recipient was brain-dead, meaning they were already on artificial life support with no prospect of recovering.
The kidney came from a pig that had been genetically modified to stop the organ being recognised by the body as “foreign” and being rejected.
The work is not yet peer-reviewed or published but there are plans for this.
Experts say it is the most advanced experiment in the field so far.
Similar tests have been done in non-human primates, but not people, until now.
Using pigs for transplants is not a new idea though. Pig heart valves are already widely used in humans.
And their organs are a good match for people when it comes to size.
During the two-hour operation at the New York University Langone Health medical centre, the surgeons connected the donor pig kidney to the blood vessels of the brain-dead recipient to see if it would function normally once plumbed in, or be rejected.
Over the next two-and-a-half days they closely monitored the kidney, running numerous checks and tests.
Lead investigator Dr Robert Montgomery told the BBC’s World Tonight programme:“We observed a kidney that basically functioned like a human kidney transplant, that appeared to be compatible in as much as it did all the things that a normal human kidney would do.
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Special Programs For Living Donor Kidney Transplantation
Many patients have family members or friends who wish to donate a kidney but are not able to because their blood type or tissue type doesn’t match the recipient. In such cases, the donor and recipient are said to be “incompatible.” UCSF offers several programs to help these patients receive a kidney.
When Can I Go Back To Work
Many kidney transplant patients are able to return to work within a few months following a successful surgery. However, various aspects of the recovery process can affect the timing of your return.
You will need to discuss returning to your job with the Transplant Team. When the time approaches, a return to work letter will be provided. This will let your employer know when you may begin working and what limitations, if any, you have.
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How Do I Prepare For A Kidney Transplant
To get a kidney from an organ donor who has died , you must beplaced on a waiting list of the United Network for Organ Sharing .Extensive testing must be done before you can be placed on the transplantlist.
A transplant team carries out the evaluation process for a kidney. The teamincludes a transplant surgeon, a transplant nephrologist , one or moretransplant nurses, a social worker, and a psychiatrist or psychologist.Other team members may include a dietitian, a chaplain, and/or ananesthesiologist.
The evaluation includes:
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Mental health evaluation. Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can greatly affect the outcome of a transplant. The same kind of evaluation is done for a living donor.
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Blood tests. Blood tests are done to help find a good donor match, to check your priority on the donor list, and to help the chances that the donor organ will not be rejected.
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Diagnostic tests. Diagnostic tests may be done to check your kidneys as well as your overall health status. These tests may include X-rays, ultrasound, kidney biopsy, and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.
The transplant team will weigh all the facts from interviews, your medicalhistory, physical exam, and tests to determine your eligibility for kidneytransplantation.
These steps will happen before the transplant:
What Are The Benefits Of Kidney Transplantation
A successful kidney transplant gives you increased strength, stamina, and energy. After transplantation, you should be able to return to a more normal lifestyle and have more control over your daily living. You can have a normal diet and more normal fluid intake.
If you were dependent on dialysis before the transplant, you’ll have more freedom because you won’t be bound to your dialysis schedules.
Anemia, a common problem with kidney failure, might be corrected after transplantation. If you have hypertension , you could be on fewer blood pressure medications after transplantation.
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Have Your Kidney Transplant
During kidney transplant surgery, a surgeon places a healthy kidney into your body. Youll receive general anesthesia before the surgery. The surgery usually takes 3 or 4 hours. Unless your damaged kidneys cause infections or high blood pressure or are cancerous, they can stay in your body. Surgeons usually transplant a kidney into the lower abdomen near the groin.
If youre on a waiting list for a donor kidney, you must go to the hospital to have your transplant surgery as soon as you learn that a kidney is available.
If a family member or friend is donating the kidney, youll schedule the surgery in advance. Your surgical team will operate on you and your donor at the same time, usually in side-by-side rooms. One surgeon will remove the kidney from the donor, while another prepares you to receive the donated kidney.
Recovering From The Transplant Surgery
- After the transplant surgery, you will recover in the hospital where you will be watched closely. You will usually spend several days recovering in the hospital.
- In some cases, you may start making your own urine right away. Sometimes, especially with deceased donor kidneys, this will take a bit of time. If your new kidney is not producing urine right away, you will need to stay on dialysis until this starts happening.
- Your transplant team will adjust your immunosuppressant medicines, and watch you closely for signs that your body is accepting the new kidney.
- Usually the transplant team will recommend that you get up and start slowly moving around one day after your surgery.
- Once you have recovered enough to safely go home, you will be released from the hospital and continue recovering at home.
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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.
Donor Eligibility And Evaluation
Potential donors must meet certain criteria to be considered. They must be at least 18 years old and must not have any of the following:
- Uncontrollable hypertension
- History of pulmonary embolism or recurrent thrombosis
- Bleeding disorders
- Chronic lung disease with impairment of oxygenation or ventilation
- History of melanoma
- Bilateral or recurrent kidney stones
- Chronic kidney disease of stage 3 or less
- Proteinuria, or high levels of protein in the blood (more than 300 mg/d, excluding postural proteinuria
- HIV infection
The donor must be in excellent health, well informed about transplantation and able to give informed consent. Before donating a kidney, the person must successfully complete a full medical, surgical and psychosocial evaluation.
The evaluation will include tests to ensure that the donor and recipient have compatible blood and tissue types. Some patients have several family members who are compatible potential donors. In other families, none are suitable. UCSF offers several programs to help patients with willing but incompatible donors .
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Genetic Modification Opens New Possibilities
According to NYU Langone, doctors used the kidney of a pig produced by regenerative medicine company Revivicor.
A human gene was added to the pigs to produce a protein called CD46 that moderates the action of the immune system. Additionally, a gene that produces a sugar called alpha-gal was knocked out in the donor pig.
The most recent pig transplant has been genetically altered to attempt to fool the immune system into considering the graft as human, said Teperman. If there is no modification of the graft, a hyperacute rejection with immediate graft loss might occur.
Known as a GalSafe pig, it was approved by the
When Can I Return To My Regular Activities
You can resume your previous activities as soon as you feel better and you might even feel good enough to add some new activities. A daily exercise program will continue to improve your health and help you maintain a positive attitude.
You will not injure yourself or your new kidney if you follow some of these general guidelines:
- Avoid lifting heavy objects and strenuous physical work for at least six to eight weeks following surgery. It is important that you do not lift anything heavier than 20 pounds for two to three months, and nothing heavier than 40 pounds for four to six months from the date of your surgery.
- Avoid driving for at least six weeks following surgery. Plan ahead so a friend or family member can help out during this time. When you are in a moving vehicle, always use your seat belt.
- Exercise is encouraged. We recommend beginning with stretching exercises and walking. Other excellent exercises include jogging, hiking, bicycling, tennis, golf, swimming and aerobics. All of these can help you regain your strength and may be started gradually after your incision has healed.
- As a general rule, rough contact sports should be avoided since they might cause injury to your transplanted kidney. If you have doubts about any activity, please ask the Transplant Team.
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