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What Needs To Match In Order To Donate A Kidney

Kidney Offering And Matching

What Kidney Donors Need to Know: Before, During and After Donation | Q& A with Dr. Fawaz Al Ammary

When an organ donor is notified to NHS Blood and Transplant the following details are recorded: their renal function, blood group, and tissue type. The donor information is then added to the national database which identifies the most suitable recipient for the kidney.

Suitability is determined by a complex mathematical process which gives priority based on the following factors, each of which are given points:

  • The compatibility of the blood group
  • Length of time on the waiting list one point for every day waiting
  • The similarity of the donor and recipients tissue types the better the match the more the points
  • Whether the recipients tissue type is unusual such that it would be particularly hard to find a transplant for that person. Difficult to match patients are awarded more points in order not to miss the rare chance of a transplant
  • Whether the recipient has developed antibodies that reduce the likelihood of a match. This is called sensitisation – highly sensitised patients get more points.
  • The age of the recipient children get more priority

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.

What Processes Do You Have To Go Through To Be A Living Kidney Donor

The decision to donate a kidney is just the first step on a journey that may eventually lead to a kidney transplant operation.

Everyone who wants to donate is asked to go through a number of tests and examinations. These checks are designed to ensure that you are healthy enough to give a kidney, that your kidneys are currently working well and that you are physically and emotionally prepared for the donation. Your safety and well-being is always the priority for the medical teams and you should be aware from the beginning that there may be a number of reasons why you might not be suitable to donate. The tests and checks can take several months , which include medical, surgical and psychological assessments.

In England, Wales and Northern Ireland, no minimum age limit is specified under the Human Tissue Act 2004, but most donors will be over the age of 18 years. In Scotland, the law specifies that the donor has to be over 16. There is no upper age limit, and there have been donors in their 70s and 80s.

Throughout the process, anonymity and confidentiality are necessary, and most altruistic donors never meet the person who receives their donated kidney. It is, however, possible for both parties to contact each other after the transplantation, but only if both parties are willing.

Tests and examinations before the operation

General physical health
Psychological health
Urine tests
Blood tests
Glucose tolerance test
Blood pressure monitoring
Kidney tests
ECG
Chest X-ray

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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.

Why Choose Uw Health

WSJ.com

The UW Health Transplant team has been serving living kidney donors for more than 50 years. We are nationally respected for our surgical expertise and outstanding patient outcomes. Our team focuses on thorough patient education and creating personalized donation plans to support your needs.

We are the largest and most active living kidney donation program that works with the National Kidney Registry. We are a Center of Excellence for most insurance networks and a certified living kidney donor center for adults and children. U.S. News & World Report ranks University Hospital as Wisconsins top hospital.

About

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Special Note: Paternity Test

It is important for you to understand that tissue typing is similar to what is sometimes called paternity testing. That is, the results may help to confirm the biological parents of the child.

We ask that you consider this carefully and before agreeing to the test, we would want you, as a family, to decide who should be told if the results are unexpected. That is, if the tests were to show that one or other of you is not the blood parent, would both of you, one of you or neither of you want to be told?

If you have any questions or concerns about this, you must discuss them either with the doctor or nurse or your family doctor before undergoing the blood test. We ask that you consider this carefully.

Wife Seeks Kidney Donor For Husbands 30th Birthday

Katrina Clarketimer

All Robert Slater wants for his 30th birthday is a new kidney. His wife is trying to help him get just that.

Slater, 29, was born with a rare genetic condition called Fabry disease, which causes a buildup of proteins in the bodys cells that can lead to kidney failure, which is potentially life-threatening. Over the last two years, Slaters condition has worsened.

Hes now sicker than ever.

I get sick every day, without fail, Slater said in an interview with The Spectator. Its hard to keep down food a lot of the time and its just because my body is poisoning itself. It cant filter out this poison because the kidneys arent working correctly.

Healthy peoples kidneys function at close to 100 per cent. Slaters function is at 15 per cent.

Ultimately, he needs a new kidney. But until hes even more ill, or on dialysis, he cant get on a donor list. The only way to get a kidney now would be for someone to come forward, get tested to see if theyre a match, and voluntarily donate a kidney.

Thats where his wife, Stella, comes in.

With Slaters birthday just around the corner on March 7, Stella realized the best gift she can give her husband is his health. For that, he needs a new kidney.

Slaters illness has been difficult on both of them.

I feel bad for what shes going through, Slater said, echoing Stellas comments that neither of them realized he would get so sick so fast just two years into marriage.

What to know about kidney donation:

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    What Happens After Surgery

    Your doctor will prescribe medications to help manage your pain. Theyâll also want you to get up and start moving around shortly afterward.

    As with any operation, there are possible aftereffects, like pain and infection. When you only have one kidney, there’s a greater chance of long-term issues like high blood pressure. Talk to your doctor about the possible problems you might face.

    After donation, you should be able to live a pretty normal life. You’ll have to take pain pills for a short time after surgery. Your remaining kidney will grow bigger to help make up for the one thatâs gone. Your doctor may want you to make a few changes in your physical activity. They might tell you to avoid contact sports like football or soccer in order to protect your kidney.

    Becoming A Living Kidney Donor

    Donating a Kidney to Anyone in Need

    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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    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.

    What Must Match Between A Donor And The Recipient

    Ideally, blood types should be compatible. This is quite complicated, but in general, a person who has blood types O can donate to anyone – O is a universal donor. However, someone with blood type A can only donate to someone with blood type A, blood type B to B, and AB to AB. As for the recipient, a person with blood type O can only receive an O kidney, however, someone with blood type A can receive both an A or O kidney and someone with blood type B can receive both a B or O kidney.

    • Paired exchange

    In living donation, if the donor and recipient do not match, then apaired exchangecan be arranged. This is where another donor and recipient pair are found and the donors then donate to the other recipients. That way, everyone that needs a kidney gets one. In some cases a long chain of recipient/donor pairs can be devised so everyone involved gets a compatible transplant. In some cases, direct transplants can be organised despite incompatible blood groups. A special treatment to remove the blood group antibodies from the recipient will then be used in this case.

    • Tissue matching requirements

    Some people have other tissue matching requirements to ensure compatibility this is called HLA matching. In addition, from the recipients perspective a younger kidney is better than an older kidney, and, if someone is very big then ideally, they should have a kidney from someone of a similar size.

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    Finding A Kidney Donor

    Once your doctor has determined that youre a good candidate for a kidney transplant, youll need to be matched with a kidney donor who is compatible with you in tissue and blood type. There are several ways to go about finding a kidney donor.

  • Talk to family and close friends about kidney donation. Because youll need to find a compatible kidney donor, a blood relative may be your best matchthough a kidney could also come from a close friend, acquaintance, or co-worker. Talking openly about your donor search can help identify possible donors.
  • Place your name on the kidney transplant waiting list to receive a donor kidney. Even if you might find a donor on your own, its important to register on the donor list as a backup. With todays advanced donor-matching technology, its possible to find a good match with a living or deceased donor. For more information on how to get started, talk to your social worker.
  • Register for a paired kidney exchange program. If you have a potential donor who turns out not to be a match for you, a paired kidney exchange programsometimes called a kidney swapcan match pairs of recipients and their incompatible donors so that you each receive compatible kidneys.
  • Living Donor Kidney Transplantation

    Kidney Transplant: Before the surgery

    Living donor kidney transplants are the best option for many patients for several reasons.

    • Better long-term results
    • No need to wait on the transplant waiting list for a kidney from a deceased donor
    • Surgery can be planned at a time convenient for both the donor and recipient
    • Lower risks of complications or rejection, and better early function of the transplanted kidney

    Any healthy person can donate a kidney. When a living person donates a kidney the remaining kidney will enlarge slightly as it takes over the work of two kidneys. Donors do not need medication or special diets once they recover from surgery. As with any major operation, there is a chance of complications, but kidney donors have the same life expectancy, general health, and kidney function as most other people. The kidney loss does not interfere with a woman’s ability to have children.

    Potential Barriers to Living Donation

    • Age < 18 years unless an emancipated minor
    • Uncontrollable hypertension
    • Bilateral or recurrent nephrolithiasis
    • Chronic Kidney Disease stage 3 or less
    • Proteinuria > 300 mg/d excluding postural proteinuria
    • HIV infection
    • Shorter recovery time in the hospital
    • Quicker return to normal activities
    • Very low complication rate

    The operation takes 2-3 hours. Recovery time in the hospital is typically 1-3 days. Donors often are able to return to work as soon as 2-3 weeks after the procedure.

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    What Are The Common Matching Factors

    Blood type and body size factor into a match.

    Other factors include:

    • how bad the patients medical condition is
    • the distance between the donor’s and the patients hospital
    • the patient’s waiting time and
    • if the patient is available. For example:
    • If they cant contact the patient.
    • If the patient has an infection or other reason that they cant do the transplant.

    The most important factor is the organ itself. Some organs can survive outside the body longer.

    Theres a different policy for each organ. Read about how the system decides who gets which organs.

    How Can My Donor Kidney Help

    Every 10 minutes, another person is added to the national transplant waiting list and 82% of patients waiting are in need of a kidney. On average, a living donor kidney can function anywhere between 12 to 20 years, and a deceased donor kidney can improve quality of life for 8 to 12 years. Plus, patients who receive preemptive kidney transplant see a number of benefits .

    Per Mayo Clinic, other benefits include lower risk of rejection of the donor kidney, improved survival rates, improved quality of life, lower treatment costs, and avoiding the restrictions and complications of dialysis.

    Kidney transplant recipients can expect to spend several days to a week in the hospital. Transplant recipients may take a number of medications after transplant, many for the rest of their lives. The medications help reduce the risk of complications after transplant.

    By signing up to become an organ, eye, and tissue donor, you can make a difference in the lives of more than 75 people. Register to become a donor.

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    Living Kidney Donation Is Safe

    If you are healthy, donating a kidney wont make you more likely to get sick or have major health problems. Like any surgery, the procedure does have some risks. But overall, living kidney donation is safe. In most cases, donating a kidney will not not raise your risk of kidney disease, diabetes, or other health problems.

    Incompatible Living Donor Transplant

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    Ideally, to be eligible for transplantation, kidney donors and recipients should have compatible blood and tissue types. Too often, however, willing live donors do not meet these medical criteria. While it remains preferable to receive a kidney from someone who is fully immunologically compatible, recipients can be successfully transplanted from a donor with mismatched antibodies.

    When antibodies are present, the blood of the recipient and donor react to each other, much like an allergic reaction. In the past, this reaction has caused the recipient’s body to reject the donor organ. Today, we can successfully transplant from an incompatible donor if the recipient’s blood is first “cleaned” of antibodies through a process known as plasmaphereis.

    First, the amount of antibodies present must be quantified. This level helps to determine the number of treatments required. Next, the recipient’s blood is separated into cells and plasma . The plasma is removed and replaced with a commercially available plasma substitute. Removing the plasma removes the antibodies. In essence, plasmapheresis is similar to dialysis it removes antibodies just as dialysis removes waste products.

    Depending on the level of antibodies present, plasmapheresis may be performed anywhere from 2-10 times. Most patients receive the treatment every other day, for up to three times a week. Once the quantity of antibodies drops to a low enough level, the recipient can undergo the transplant.

    Transplant Procedure

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    Are Transplants From Living Donors Always Successful

    Although transplantation is highly successful, and success rates continue to improve, problems may occur. Sometimes, the kidney is lost to rejection, surgical complications or the original disease that caused the recipient’s kidney to fail. Talk to the transplant center staff about their success rates and the national success rates.

    Am I Healthy Enough To Donate A Kidney

    Your doctor will do some tests to find out for sure. Theyâll check your blood and urine, and may also do an ultrasound or take X-rays of your kidneys. You may not be able to donate if you have medical issues like diabetes or high blood pressure.

    If your doctor gives you the green light, theyâll schedule you for surgery. You can expect to take 4 to 6 weeks to recover. Be sure to line up someone to help you during that time.

    You don’t usually have to change your routine or even your diet to get ready for surgery.

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    Am I Eligible To Become A Kidney Donor

    You need to undergo a comprehensive evaluation if you decide to donate one of your kidneys to a family member such as your spouse, children, siblings, and parents or to a friend or altruistically to a stranger. You are NOT eligible to become a kidney donor if the doctors assessment suggests that kidney donation is not safe for you.

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