Kidney Transplant Frequently Asked Questions

Who is a candidate for kidney transplantation?
Kidney transplantation is the treatment of choice for people with kidney failure. This allows patients to stop dialysis, decrease their fluid and diet restrictions, and enjoy a much better quality of life.

What does it mean to be on a kidney transplant waiting list?
Those who are on the list are waiting for a non-living donor kidney to become available from a transplant center. According to the National Kidney Foundation, it is difficult to predict how long a person will be on the waiting list, but, on average, waits of two years or more are not uncommon.

A patient can be on multiple lists. One of the criteria usually is that you are able to travel to the transplant center within six to 10 hours. This may increase your chance of getting a transplant, but not significantly.

Everyone on a regional list also is on a national list kept by the United Network for Organ Sharing (UNOS). This means that when your nephrologist places you on his/her transplant center’s list, you also are placed on the national list kept by UNOS.

When a kidney becomes available in any area, information is sent to UNOS and a list is generated of individuals who potentially would be recipients for that kidney. If the kidney is a perfect match for someone on the national list, it will be offered to that person no matter where they are located.

How do you qualify for placement on the waiting list?
To qualify for placement on the kidney transplant waiting list, a potential recipient must be relatively healthy and not have cancer or infection. The patient also must be able to comply with treatment and medication requirements.

Who decides who receives a kidney when one becomes available?
Many things are taken into consideration. The blood and tissue types have to match. Other considerations are how long a person has been on the waiting list and his or her medical condition.

Once a kidney becomes available, UNOS searches its database of people waiting for transplants and tries to find a local recipient. If a local recipient is not found, the search is expanded regionally and then nationally.

When the list of potential recipients is produced, the medical condition is assessed. Then the transplant surgeon and the nephrologists offer the kidney to the recipient and the recipient decides whether he or she wants to accept it.

What is a perfect match kidney?
Usually, a perfect match is from a brother or sister, but sometimes it is from the national registry. The chance of getting a perfect match from a living-related brother or sister is much higher than from the national registry.

What are antibodies and how does rejection occur?
Antibodies are proteins your immune system makes when it comes into contact with something foreign to your body. When you get an infection, such as a cold or an infection from a wound, your body makes antibodies to fight that infection. Antibodies protect your body. When you have an organ transplant, your body reacts as it would to an infection. Thus, your antibodies try to destroy the organ. Some people have a lot of antibodies, and it is harder to find an organ match.

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 recipient’s 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.

Shortly before the operation, an IV line is connected to a vein in the donor’s arm for medication and fluid. A catheter is inserted to drain urine from the bladder. The kidney is removed, and the donor then proceeds to recovery. Several hours after the operation, the donor is encouraged to walk around. The IV and catheter remain in place for a few days; as soon as the donor is able to eat and drink, the IV is removed. Typically, the donor goes home in five to eight days. He or she usually can return to work in about four weeks.

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 it’s important for both the donor and recipient to know what these are.

There are benefits, too. Living donation keeps the recipient off the national waiting list, and surgery can be scheduled at a planned time rather than as an emergency operation. The recipient also can start taking anti-rejection drugs two days before the surgery to decrease the risk of rejection. Transplants from living donors usually are more successful because there is a better tissue match. There also is a psychological benefit. The recipient can feel better knowing that the gift came from a loved one, and the donor knows he or she has made a tremendous contribution to the life of the recipient.

Insurance typically covers 100 percent of the donor’s expenses.

For a patient appointment with a kidney transplant surgeon, call (314) 747-9889.