Since doctors at Boston's Brigham Hospital performed the first successful living donor kidney transplant in 1954, kidney transplants have become an accepted and proven way to treat chronic kidney disease or end stage renal disease (ESRD). There are only two ways to become a kidney donor. The number of live kidney donors has increased along with improved surgical technology. However, the majority of donated kidneys come from people who are legally dead. Most people with kidney disease must be placed on a waiting list for a kidney, sometimes for several years, unless a live donor is available.
Considerations
Kidney donors who have signed an organ donation consent form prior to their death will have their organs removed only if the surviving family members consent. The U.S. Department of Health and Human Services and the United Network for Organ Sharing coordinate the transfer of donated kidneys from cadavers to transplant recipients. Selections are based on tissue matches, medical priority and body size. Cadaver donor kidneys were used in approximately 11,000 of more than 17,000 kidney transplants performed in 2006.
Features
Living kidney donors can be related to the recipient or non-related. In either case, the donor's blood type and chemistry, tissue samples and other factors determine whether the potential donor is a good match. The transplant center that serves the intended recipient will schedule a variety of tests to determine if the donor is a match. Additional tests will be conducted to find out if the donor is healthy enough to undergo surgery to remove the donated organ. Living donors are also screened for HIV, hepatitis and various other diseases that might prevent successful transplantation of the donated kidney. The transplant center must also determine if the potential donor's kidney function will be impaired after donation. Many transplant centers also require that living kidney donors undergo psychological testing.
Significance
Although almost all religious organizations and institutions approve of organ donation, increasing the number of kidney donors has proven to be challenging for the medical community. The number of available living and cadaver kidney donors is less than one-third of the number of people on the transplant waiting list. Neither a living a kidney donor nor the family of a deceased donor is ever charged for any medical expenses related to organ donation. Many organizations that work with ESRD patients also provide funds to help defray travel or miscellaneous expenses that a living donor may incur, if needed.
Misconceptions
Each transplant center has its own standards for kidney donors, assuming that the donor meets medical qualifications. With improvements in medical technology, many transplant centers accept live donors up to age 65. The risks of complications are roughly the same as from any surgery. The most common problems include pain, infection, blood clots and allergic reactions to anesthesia. The risk of death from kidney donation is small, about 1 person in 1,700.
Time Frame
Today's surgical techniques now make it possible for a living donor to have a nephrectomy followed by a two - three day hospital stay. The most advanced transplant centers use minimally invasive laparoscopic surgery with smaller incisions and less scarring. Most people are able to return to work or other normal activities within four to six weeks after donating a kidney. A donor's remaining kidney usually starts to do the work of the removed kidney immediately. Almost all transplant centers monitor living donors for medical complications after the donation.
