What Is Paired Kidney Exchange
When a person is in need of a kidney and has a willing donor , but that Donor A is either a poor match to Recipient A or not a match at all, the NKR can find a recipient who is in need of a kidney and has a donor who is willing to donate, but is either a poor match or not a match at all to Recipient B, but is a match to Recipient A and have them swap. In traditional KPD, Donor A is a match and gives to Recipient B and Donor B is a match and gives to Recipient A. This is a swap. In a paired exchange chainthe most common form of NKR paired exchangea Good Samaritan Donor , most likely a family voucher donor, gives to Recipient B, Donor B gives to Recipient C and Donor C gives to someone else in a similar situation to Donor and Recipient B and C. Many donor-recipient pairs are choosing to participate in the Voucher Program instead of the traditional paired exchange process because it is more convenient, especially when the donor will be the recipients caretaker after the transplant.
What Should I Expect From Surgery And Kidney Donation Recovery
Kidney donation surgery is done under general anesthesia and typically takes about 2 to 3 hours. During the surgery, your medical team will monitor your heart rate, blood pressure, and blood oxygen level. Surgeons usually do laparoscopic surgery, which is less invasive. This type of surgery uses smaller incisions, causes less scarring, and can mean a shorter kidney donation recovery time. Afterward, its common to stay in the hospital for a few days.
Risks For The Living Kidney Donor
A donated kidney from a living person is likely to remain healthy for longer than one from a deceased donor. However, there is some risk to the donor. The surgery lasts for about three hours and will be followed by a hospital stay of four or five days. The surgery can have complications, but people can usually resume their everyday lives after six to eight weeks.Donating a kidney is not likely to cause any long-term health problems, unless the remaining kidney becomes injured or diseased.
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Who Is Eligible For A Transplant
Because many more people need transplants than there are kidneys available, a patient must meet standardized criteria in order to be eligible for a transplant. Criteria are based on lab tests that measure the amount of a waste product, called creatinine, in a person’s blood. The results of this test, along with age, race, and gender variables, are calculated using a mathematical formula. The formula yields what is known as the “glomerular filtration rate” . GFR is roughly equal to the amount of an individual’s working kidney function. In other words, a person with a GFR of 92 has roughly 92% kidney functioning. GFR is expressed as ml/min.
Chronic kidney disease doesnt usually cause the kidneys to fail all at once. Instead, the disease progresses over a period of years . Doctors estimate disease progression by using a standard guideline that divides the course of disease into 5 stages. The stage that a person is in is determined by his or her GFR. Factors such as diet, hydration, and medications can affect test results, so ones GFR can vary slightly from time to time. GFR also varies by age, race, and gender. On average, though, a normal persons GFR is usually in the range of 90-120.
Stages of Chronic Kidney DiseaseT
What Does A Kidney Transplant Surgery Involve For The Recipient
Before the transplant, the patient will be put under general anesthesiathey will be asleep for the entire procedure. The surgeon then makes an incision in the recipients abdomen and places the donated kidney inside. The new kidney is then connected to the recipients blood vessels and bladder. Once this is done, the surgeon closes the incision. The patients original kidneys are usually left in place unless there is a medical reason to remove them. The operation typically takes three to five hours.
Kidney transplantation is a fairly common surgical procedure, with over 20,000 performed in the United States every year. This type of surgery generally has a high success rate and a low rate of complications. Kidney transplants from living donors generally last two to three times as long as those from deceased donors. Furthermore, those facilitated by the National Kidney Registry have superior outcomes at three, five and seven years compared to average U.S. living donor transplant outcomes. Having the largest donor pool allows the NKR to find better matches for recipients.
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How Do I Find A Living Kidney Donor
If you need a living kidney donor, you can sometimes find a donor by asking friends and family members. If you are unable to find a donor among people you know, we recommend finding a transplant center that participates in our Champion Microsite Program, which is a free service that helps kidney patients build a simple website to tell their story and find a donor. The site is sharable via social media and comes with 250 free business cards with the patients name and microsite URL that can be given out by the patient.
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Who Donates Kidneys For Transplantation
There are two sources for kidney transplants. One is from a living donor, and the other is from a non-living donor. Patients who have had kidneys donated from living donors usually enjoy higher success rates than those who receive organs from non-living donors, since there is less chance for rejection.
A living donor must be in good health and free from diabetes, high blood pressure, cancer, kidney or heart disease. Living donors usually are between 18 and 60 years old. The living donor must undergo a series of tests to determine if they are truly compatible with the recipient. The decision to become a living donor is completely voluntary, and the donor can change his or her mind at any time. Living donors sometimes feel pressure from their families or guilty if they are reluctant to go through with the procedure. They also may feel angry if the recipients body rejects the donated organ. Living donors should discuss their feelings with a transplant professional before making a final decision.
Typically, the donor is admitted to the hospital the day before the kidney donation for all the necessary tests.
There are risks involved in any surgery. All patients have some pain after the operation, and it is possible for donors to develop infections or bleeding. Living donation also may have long-term risks, and its important for both the donor and recipient to know what these are.
Insurance typically covers 100 percent of the donors expenses.
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When Would The Donor And Recipient Surgeries Not Happen On The Same Day
- If the number of pairs in the swap is very large it might be necessary to schedule the surgeries over multiple days. The surgeries may happen out of sequence which means the donor surgery can happen before the recipient surgery.
- When kidney exchanges involve a non-directed donor , a kidney swap chain often begins. When kidney exchanges involve a non-directed donor , the swap becomes an open-ended chain, which often results in an end-of-chain donor without an immediately paired recipient. This donor is referred to as a bridge donor and will be informed of this prior to the beginning of the transplant chain. A bridge donor will then begin a new chain and the surgery can happen a few days to a few weeks later. Although you may withdraw from the program at any time, we do strongly urge bridge donors fulfill their commitment to the program and start a chain at a future date.
Comparison Of Living Donor And Deceased Donor Kidney Transplantations
The timeframes in this table are average estimates. Please speak to your kidney care team for more detailed information about how long your transplant might last and possible waiting times.
| Whats being compared? | ||
|---|---|---|
| Sometimes, but this is less likely due to the waiting time | ||
| Transplant surgery times can be planned in advance? | Yes surgery is usually during the day | No surgery often takes place at night |
| Chance of the transplanted kidney working within a day of the surgery | Higher. The kidney has come from someone who is fit and well, so it almost always works straight away. | Lower. The kidney has come from someone who has died, so it takes longer for the kidney to wake up and start working. |
| Risk from the donated kidney | Lower. The health of the donor is easier to thoroughly check before donation. The donor is unlikely to have had major health issues. | Higher. It is more difficult to thoroughly check the health of the donor, and because the donor is more likely to have had major health issues. |
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Religion And Organ Donation
Virtually all religious denominations approve of organ and tissue donation as representing the highest humanitarian ideals and the ultimate charitable act.
For more information, visit the A to Z Guide.
COVID-19 patients can become kidney patients.
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Living Kidney Donor Faqs
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Who can be a donor?
Any healthy person can be a kidney donor. The donor does not need to be a family member. The donor can be a friend, an acquaintance, spouse, in-law, or even a stranger.
The donor must be:
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At least 18 years old
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Appropriate candidate for general surgery
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Meet medical, social, and psychological criteria set by UNOS
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Able to give informed consent
How long is the surgery, and how long will I be in the hospital?
Each surgery, one for the donor and one for the recipient, lasts approximately three – five hours. The donor is in the hospital for one to three days.
What is the long-term risk of being a donor?
There is very little risk to being a kidney donor, either short-term or long-term. Short-term, the risk of dying from the surgery is about 0.03% . Major complications are unusual. In the long term, having been a donor does not influence the risk of kidney failure, high blood pressure or diabetes. Recent studies show that kidney donors have longer life expectancy than predicted.
How will I live with one kidney?
It is safe to live with one kidney and you will be able to resume all of your regular activities after surgery. Your remaining kidney will grow slightly larger to compensate for the donation of the other kidney. You will have scheduled follow-up visits with the transplant team to monitor your kidney function after surgery and will have lab work done 6 months, 1 year, and 2 years after your donation.
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What Is Living Donation
Living donation takes place when a living person donates an organ for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister .
Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, spouse or an in-law . Thanks to improved medications, a genetic link between the donor and recipient is no longer required to ensure a successful transplant.
In some cases, living donation may even be from a stranger, which is called anonymous or non-directed donation.
Receiving A Kidney From A Living Donor
A living donor is someone who has agreed to donate their kidney to you while they are still alive. This is possible as nearly everyone has two kidneys, but can lead normal healthy lives with just one kidney. A living donor will need an operation to remove one of their kidneys so it can be transplanted into you.
On average, approximately 30 out of 100 kidney transplants are from living donors.
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Being A Living Kidney Donor
If you have two healthy kidneys, you may be able to donate one of your kidneys to enhance or save someone else’s life. Both you and the recipient of your kidney can live with just one healthy kidney.
If you are interested in living kidney donation:
- Contact the transplant center where a transplant candidate is registered.
- You will need to have an evaluation at the transplant center to make sure that you are a good match for the person you want to donate to and that you are healthy enough to donate.
- If you are a match, healthy and willing to donate, you and the recipient can schedule the transplant at a time that works for both of you.
- If you are not a match for the intended recipient, but still want to donate your kidney so that the recipient you know can receive a kidney that is a match, paired kidney exchange may be an option for you.
Another way to donate a kidney while you are alive is to give a kidney to someone you do not necessarily know. This is called living non-directed donation. If you are interested in donating a kidney to someone you do not know, the transplant center might ask you to donate a kidney when you are a match for someone who is waiting for a kidney in your area, or as part of kidney paired donation. You will never be forced to donate.
You Dont Have To Be Related To Someone To Donate A Kidney To Them
In fact, one in four living organ donors is not biologically related to the recipient . Spouses, in-laws, close friends, church members, and even members of the same community can all be living donors.
It’s true that family members have a higher chance of being a good match. But living donor transplants are more successful compared to kidneys from deceased donors because these kidneys come from living donors.
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Who Can Be A Candidate For Living
Any person in good health can be evaluated as a living donor the donor can be a blood relative or unrelated to the recipient.
The best possible donors for a transplant are siblings , parents or children of the recipient. The next preferred donors are other relatives . Other donors that can be considered are unrelated donors and non-directed donors .
Donors must be greater than 18 years old. They must not have a history of cancer, diabetes or chronic kidney stones. They must also be a compatible blood type. Patient pairs that are not blood type compatible may be eligible for paired exchange transplant.
Who Makes A Good Donor For Kidney Transplant
Kidney donors do not need to be related to the recipient, although they often are related. They can be friends, coworkers, members of the same religious group or other organization, or any other type of relationship. While many people are willing to be living donors, not everyone can become a living donor. Donors are carefully and thoughtfully evaluated in order to avoid unwanted medical or psychological outcomes.
While the individual circumstances of each potential donor are considered and testing must be done to determine compatibility, all potential donors must be:
- At least 18 years of age
- Genuinely willing to donate
- In good general health and reasonably physically fit
Certain medical conditions can make it likely a person will not be healthy enough to be a kidney donor but many other conditions may be acceptable . It is best to ask rather than assume someone cannot be a donor.
Individuals considered for living kidney donation are usually between 18 and 65 years of age. Gender and race are not factors in determining a successful match. Hypertensive donors over the age of 50 may be eligible under certain conditions. While the risk to the donor is minimal, there is always some degree of risk associated with any surgical procedure. The procedure is done laparoscopically which helps minimize discomfort and ease recovery after the procedure. Donors undergo an education process about the operation and its risks, and are able to confidentially decide not to donate at any time.
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Find A Transplant Center
The next step is to find a kidney transplant center by checking with the United Network for Organ Sharings Directory of Transplant Programs.
Before you contact a transplant center, check to see how it stacks up to other centers in terms of kidney transplant outcomes, such as patient and graft survival, and waitlist activity. The Scientific Registry of Transplant Recipients has national data on these issues.
Each transplant center has its own criteria that potential recipients must satisfy in order to get on the waitlist. You can get on the waiting list at multiple centersit’s called “multiple listing”but remember you may incur additional costs for testing and evaluation. Be aware that matching kidneys first go to local residents, then regional residents, and then they are made available nationally.
What Are The Requirements For A Kidney Transplant
If you have advanced kidney disease, you may be eligible for a transplant. You will need to be evaluated by a transplant center, which will do a number of tests to determine whether you are a good candidate for a kidney transplant. In general, qualifications for kidney transplant include having chronic irreversible kidney disease, being on dialysis now or being close to needing dialysis. You may be ineligible for a kidney transplant if you have an additional life-threatening disease, a history of chronic drug or alcohol abuse, or a serious psychiatric disorder.
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Guide To Living Kidney Donation
Donating a kidney so someone can live a life free of dialysis is one of the greatest gifts a person can give. This unselfish act to a relative, loved one, or friend gives the donor an opportunity to greatly improve the quality of life for someone they love or want to help.
In our community and across the country, thousands of people are in need of a kidney transplant. The United Network for Organ Sharing Wait List continues to grow every year, while the number of deceased donor organs has remained steady over the past decade. The shortage has prompted a nationwide effort to increase living organ donation.
This guide will explain the process involved in the testing and acceptance of a potential donor. It is intended to answer questions for those considering donation, as we understand this is an emotional, personal and sometimes difficult decision.