When Is A Kidney Donation Needed
A kidney transplant is used to treat kidney failure , a condition in which kidneys can function at only a fraction of their normal capacity. People with end-stage kidney disease need either dialysis or a kidney transplant to stay alive.
Causes of kidney failure may include diabetes, polycystic kidney disease , chronic uncontrolled high blood pressure , or chronic glomerulonephritis .
Your Weight May Affect Whether You Can Receive A Transplant
When you meet with your doctor or your transplant center, you may be advised to bring your body mass index down to 30 or less. Although BMI is flawed, and it is not an accurate measure of health for everyone, in this case the goal BMI would correspond to less than 203 pounds for a person who is 5 feet 9 inches tall, according to the National Institutes of Healths BMI calculator. The reasoning? A BMI of 30 or greater is a sign of obesity, which puts a person at greater risk for poor wound healing, infection, and kidney rejection, the National Kidney Foundation notes. For obese people, their surgical risk goes up and it can be technically harder to do a transplant on this group, adds Klassen.
Just know that the goal should be a healthy approach to weight loss and its important to meet with a registered dietitian nutritionist so that you arent missing out on key nutrients or doing anything extreme that puts your health in jeopardy, according to the National Kidney Foundation your doctor may discuss weight loss surgery with you, too.
Who Can Get A Kidney Transplant
Kidney patients of all agesfrom children to seniorsare able to consider a transplant. For most people, getting a transplant can be a good treatment choice.
Every person being considered for transplant will complete a full medical and psychosocial evaluation at a transplant center to make sure they are a good candidate. The evaluation helps find any problems, so they can be corrected before transplant. You must be healthy enough to have the operation. You must also be free from cancer and infection.
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When Can I Go Back To Work After My Kidney Transplant
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 your surgeon. When the time approaches, your provider will give you a return to work letter. This will let your employer know when you may begin working and what limitations you have if any.
Will I Be Able To Obtain Insurance Coverage After Donation
Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.
However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.
If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.
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How Does The Evaluation Process Work
The evaluation process for a transplant is very thorough. Your healthcare team will need to know a lot about you to help themand youdecide if a transplant is right for you. Medical professionals will give you a complete physical exam, review your health records, and order a series of tests and X-rays to learn about your overall health. Everything that can affect how well you can handle a transplant will be checked.
One thing you can do to speed the process is to get all the testing done as quickly as possible and stay in close contact with the transplant team. If youre told you might not be right for a transplant, dont be afraid to ask why. You can also consider doing an evaluation at another center if one center says no. Remember, being active in your own care is one of the best ways to stay healthy.
If someone you know would like to donate a kidney to you, that person will also need to go through a screening evaluation to find out if he or she is healthy enough to donate.
If its your child who has kidney disease, transplant can be the best treatment for them. Transplantation allows children and young adults to develop in as normal a way as possible in their formative years. If your child has kidney disease, youll want to give serious thought to getting a transplant evaluation for him or her.
If the evaluation process shows that a transplant is right for you or your child, the next step is getting a suitable kidney.
New Approaches Try To Train The Body To Welcome The Replacement Parts
TRANSPLANT TOLERANCE An emergency liver transplant saved 53-year-old Trent Jackson, but he has struggled to keep his body from rejecting the donated organ.
Matthew Rakola
Trent Jacksons life changed abruptly in early 2015. The computer engineer thought he had the flu. His then-wife, Donna Sylvia, thought differently. His skin was turning a dark golden yellow, almost brown, like he was getting some kind of weird tan, she says. On Wednesday, January 28, Sylvia and Jacksons brother Todd finally persuaded Jackson to see a doctor.
Sylvias suspicions were confirmed: Jacksons liver had failed. His kidneys shut down, too. Doctors rushed him by air ambulance from Columbia, Md., to Johns Hopkins Hospital in Baltimore. There, he scored 39 on a 40-point scale that gauges how likely a person in liver failure is to die without a liver transplant in the next three months.
People in his condition are often considered too sick for surgery, Jackson says. But on February 15, he got a new liver. I guess they decided that other than being mostly dead, I was pretty healthy.
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What Factors Go Into Recipient Selection
When matching patients waiting on the kidney transplant list to available donor organs, we factor in a patients age, overall health, and urgency of need. Jared has struggled with kidney disease for most of his life. Aside from that, he is healthy, which makes him a good candidate for transplant procedures due to the likelihood of positive outcomes.
In the 1990s and earlier, donor organs simply didnt last as long as they do today. Our processes, approaches, and medications have improved substantially. As such, the need for repeated transplantations is reduced. However, there is no threshold for the total number of organs a patient can receive in a lifetime
What Are The Benefits Of Kidney Transplant
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 unrestricted diet and 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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How Long Do Kidney Transplants Last
There are a number of factors which affect how long a transplanted kidney lasts.
These include whether or not the kidney came from a living donor, how well the kidney is matched in terms of blood group and tissue type, and the age and overall health of the person receiving the donation.
If you have a kidney transplant that fails, you can usually be put on the waiting list for another transplant. You may need dialysis in the meantime.
Exercise And Weight Loss
Once youve started to recover from the effects of surgery, you should try to do regular physical activity.
Adults should do at least 150 minutes of moderate-intensity exercise every week. This includes any activity that increases your heart and breathing rate it may make you sweat, but you are still able to hold a normal conversation.
Examples include:
Choose physical activities that you enjoy, as youre more likely to continue doing them.
Its unrealistic to meet these exercise targets immediately if you have not exercised much in the past. You should aim to start gradually and then build on it.
If youre overweight or obese, you should try to achieve a healthy weight. This can be safely done through a combination of eating a healthy, calorie-controlled diet and regular exercise. Aim for a body mass index of 18.5 to 25.
Read more about exercise and losing weight safely.
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What Does Kidney Transplant Surgery Involve
You only need 1 working kidney to be healthy, so only 1 kidney is transplanted during surgery. Your 2 original kidneys will usually remain in place and the new donor kidney will be placed in another area of your abdomen. The ureter attached to the donor kidney will then be attached to your bladder. If the kidney transplant surgery is successful, your new kidney will take over the tasks of filtering your blood and making urine, just like your own kidneys did before you had kidney disease.
How Does Someone Become A Deceased Donor
A deceased donor is someone who has just died and had previously given permission to donate their healthy organs. For a person to be a deceased organ donor, they must die in a way that allows blood and oxygen to flow through their organs after their brain activity has ended such as through a head injury.
- Organs such as their kidneys, liver, lungs, heart, pancreas, intestines, hands and face
- Tissues such as the clear part of their eye , skin, bone and veins
One donor can save eight lives and enhance the lives of 75 more.
How do I give permission to be a deceased donor?
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Jareds Story: 4 Kidney Transplants In 30 Years
In 1990, 19-year-old Jared Rumbos kidneys failed. He received a kidney transplant that year the first of four hed receive over the next three decades.
Jareds first new kidney lasted five years. The second, which he received in 1995, did not work. In 1996, Jareds younger sister volunteered as a living kidney donor. He resisted her offer for some time and begrudgingly accepted when his health took a turn for the worse. That kidney lasted 20 years, until 2016.
For the next two years, Jared underwent regular, ongoing dialysis sessions an experience he describes as akin to a full-time job. I was strapped to a dialysis machine three days a week, Jared recalls. There is only one option if you dont do it, and its not a very good one.
When Jareds local hospital in Tyler, TX, dissolved its transplant program, UT Southwestern transplant doctors reached out. Our team worked with Jareds local kidney doctors to provide the care he needed close to home. It meant the world to me that the doctors came to me, Jared says. I would have had to stay at another hospital for two months until I got my transplant.
Jareds story is both hopeful and complex. Lets begin with the elephant in the room: How can one patient qualify for four kidney transplants in a lifetime?
One Of The Longest Lasting Transplanted Kidneys In The World
Thanks to Patty, Butch survived.
I went from being dead to being alive, Butch said.
Since kidney transplants were so new then, referred to as radical surgeries in newspaper accounts at the time, doctors initially gave Butch a 10% chance of surviving one year. He was one of the first patients ever to receive a new anti-rejection medication called antilymphocyte serum.
They didnt know if it would kill or cure, Butch said.
But he eagerly participated in early medical trials.
I didnt have any other choice.
After the transplant, Butch had to stay for weeks in the hospital, then months in Denver as nurses and doctors monitored his new kidney. Butchs team warned him he might never walk again after suffering extensive neuropathy from swelling before the transplant.
Within weeks, however, Butch proved them wrong. On breaks with his dad away from the hospital, Butch practiced walking at Denvers old airport where there were lots of chairs to rest.
Once he had survived a year, his team theorized that his transplanted kidney might make it just 10 years.
Butch made it much, much longer.
This year marks 56 years since the transplant, and an unassuming farmer now boasts one of the longest lasting transplanted kidneys in the world.
Butch, 80, and Patty, 79, are alive and well and living still in their hometown in Missouri. Patty and her husband live on the old home place, the farm where they grew up. Butch and his wife, Louise, live less than a mile away.
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Us Kidney Transplant Survival Rates Continue To Improve
For Journalists
Want to Make an Appointment or Need Patient Information?Contact UPMC atGo to Find a Doctor to search for a UPMC doctor.
8/18/2021
CAPTION: Sundaram Hariharan, M.D., professor of medicine and surgery, University of Pittsburgh School of Medicine, and senior transplant nephrologist, UPMC.
200 Lothrop Street
How Will I Pay For A Transplant
Medicare covers about 80% of the costs associated with an evaluation, transplant operation, follow-up care, and anti-rejection medicines. Private insurance through your job and state insurance programs may cover some costs as well. However, your post-transplant expenses may only be covered for a limited number of years. Its important to discuss insurance coverage with your social worker and the transplant financial coordinator, who can answer your questions or direct you to others who can help.
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What Happens If Someone With Lupus Nephritis Who Needs A Kidney Transplant Doesnt Have A Friend Or Relative Who Is A Match
There are over 200 known transplant centers in the US. Its recommended that a person receive a referral from their primary care provider, so they can choose a center that will be the right fit for them. Then the person with the transplant team will determine their eligibility and requirements for placement on the transplant list. In addition, there are a variety of options if a person cannot find a suitable, living kidney donor. One is to be placed on the deceased donor transplant list where kidneys are obtained from people who die and have indicated they would like to be organ donors. Such kidneys are registered with national organ procurement organizations and go to individuals on the list with the best match. Another option is that a person can go onto a match list with other transplant patients who have donors. In this case, even if your donor is not a match, they can donate to a person who is a match. Then if you are a match, that persons donor can donate to you.
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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 providers 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.
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What Happens After A Kidney Transplant
Most people spend about three days in the hospital after a kidney transplant. This way, your medical team can keep a close eye on you and make sure youre recovering well.
Your new transplanted kidney may start working immediately. Or, you may need dialysis temporarily until it starts working. This might take several days or weeks.
Youll also need to start taking medications to keep your immune system from rejecting your new transplanted kidney.
What will my kidney transplant scar look like?
Your scar will be about 2 to 5 inches long, on the right or left side of your lower abdomen.
How long does a kidney transplant last?
How long a kidney transplant lasts can vary from person to person. In general, kidneys donated by a living person last longer than kidneys donated by a deceased person. On average, however, transplanted kidneys last approximately 10 years.