|
.jpg) Kidney transplantation is a procedure that places a healthy kidney from another person into your body. This one new kidney does all the work that your two failed kidneys once did, yet cannot do anymore.
A surgeon places the new kidney inside your body between your upper thigh and abdomen. The surgeon connects the artery and vein of the new kidney to your artery and vein (typically, to ones supplying blood to one of your legs). Your blood flows through the new kidney and makes urine, just like your own kidneys did when they were healthy. The new kidney may start working right away or may take up to a few weeks to make urine. Your own kidneys are left where they are, unless they are causing infection or high blood pressure.
Types of Transplants
There are three different types of transplants: living-related, living-nonrelated and cadaver. Each of these types of transplants has the chance to work as long as the blood and tissue type match (see immediately below).
- A living-related donor is a blood relative who agrees to give you one of his or her kidneys. It is important to remember just because you're related doesn't mean you two will be a match. Blood and tissue type are tested to determine if the kidney is a good match.
- A living-nonrelated donor is a person who isn't related to you. The person is tested for blood and tissue type. If the person is a match, he or she may donate a kidney to you. The donor can be a friend, spouse or coworker who agrees to this donation. During the last several years, this has become a more common type of transplant.
- Cadaver donors are those people who have recently died and whose family has donated their organs (such as lungs, heart, liver and kidneys) for others to use. This is the most common type of transplant today. With a cadaveric transplant, your name is put on a national list. When a kidney becomes available, your blood and tissue type are compared to the cadaver kidney. Finding just the right kidney may take a short time or several years.
The Matching Process
There are two key criteria that are used to match kidneys: blood type and tissue type.
Blood type is the easy one, because there are only 8 different blood types (A, B, O and AB, all in positive and negative types), and the donated organ's blood type must be the same as the potential recipient's.
The tissue type works differently. There are primarily 6
different antigens (or antibodies) that are used to match donated
organs with potential recipients, and just about any combination
of these antigens can match between the two (although some antigens
are much more important to match than others, which is why a 2 match
for one person might actually be a better match than a 3 match for
another). Vastly simplified, most kidney transplant recipients find
out around the time of their transplant what type of match the organ
is to them, which ranges from a 1 to a 6 (perfect match). The greater
the match, the less chance there will be that the recipient's body
will attempt to reject the transplanted organ. More information
can be found at the following links:
The National Organ Transplant Waiting List
The national organ transplant waiting list is administered by UNOS (United Network for Organ Sharing). The following paragraphs are from the UNOS Web site and briefly describe how it works.
"Today and every day, an average of 56 people in the United States will get a second chance at life by receiving a transplantable organ. To accomplish its mission, UNOS manages the world’s most comprehensive medical database to evaluate and match, often with split-second timing, donated organs as they become available with the more than 70,000 people all over the country who are currently waiting for them."
"All patients accepted onto a transplant hospital's waiting list are registered with the UNOS Organ Center, where a centralized computer network links all organ procurement organizations and transplant centers. Staffed 24 hours a day, 365 days a year, the Organ Center is responsible for assisting transplant centers throughout the U.S. with matching, transporting and sharing organs. The Organ Center was established in 1982 as the Kidney Center. The name was changed in 1984 to reflect the increased transplantation of other organs. The Organ Center works to decrease organ wastage, increase sharing, lower transportation costs and provide data on organ sharing."
The computer program generates a list of potential recipients ranked according to objective medical criteria (i.e. blood type, tissue type, size of the organ, medical urgency of the patient as well as time already spent on the waiting list and distance between donor and recipient.) Each organ has its own specific criteria."
"After printing the list of potential recipients, the transplant coordinator contacts the transplant surgeon caring for the top-ranked patient to offer the organ. Laboratory tests designed to measure the compatibility between the donor organ and recipient are necessary for some transplants. A surgeon will not accept the organ if these tests show that the patient's immune system will reject it. If the organ is turned down, the next center on the potential recipient list is contacted, and so on until the organ is placed."
OPTN and UNOS Statistics
View or Download in PDF Format
25 Facts about organ donation and transplantation
From
the National Kidney Foundation's Web site
What's Involved with Transplant Surgery?
Here's what usually happens once a donor becomes available (and any necessary permission form next of kin is given):
- Recipients are chosen whose tissue type and blood type are most like those of the donor. A large, networked computer system aids in the search.
- Organs are removed from the donor with appropriate respect, in a surgical process.
- Organs are preserved and readied for transportation to transplant surgery sites.
- Recipients are prepared for surgery as organs are transported to each surgery site. The transplant team removes the malfunctioning organ and replaces it with the donor organ. (Except in the instance of kidney transplantation, where the new kidney is placed elsewhere in the body and the malfunctioning organs are left in place). The surgery typically takes from 3 to 6 hours. Afterwards, a carefully monitored recovery program begins.
Organs from donor can help save the lives of people!
After Surgery
After surgery is complete, the first step is waiting for the kidney to start. This could be anywhere between almost instantaneously to several weeks. After the kidney has started functioning, the patient will be in the hospital for approximately 1-3 weeks, depending on the state of the patient. While in the hospital, kidney function is closely monitored as is the potential for infection. Self-monitoring practices are taught, as well as how to properly take medications to prevent infection and rejection. As with any surgical procedure, you will be weak for a period after the surgery. However, you will get stronger and soon feel well enough to return to work. It is common for a transplanted kidney to function for 8-10 years or more after a transplant.
About Rejection
Rejection is a major concern after the transplant. Rejection is the body's normal response to tissue that is not its own. In other words, the body tries to reject the transplanted kidney. For this reason, the patient must take medications to try and prevent rejection from occurring. Taking the prescribed medications reduces the risk of rejection, but makes the transplant recipient more susceptible to infection. Infection is always a concern to the transplanted patient. Careful monitoring is important for quick detection and treatment.
Transplantation Drugs
In 1990, only 5 pharmaceutical agents were available for prevention of acute allograft rejection. Traditional medications that are prescribed to transplant patients include Cyclosporine, Imuran and Prednisone. By June 2001, the number of immunosuppressants had grown to 12. Today, research has expanded that number even more, and your physician's recommended drug regimins may include Prograf, Cellcept, and/or other non-steroid medications.
If you have questions about transplantation medicines, please
contact us or talk to your physician.
Transplantation and Diet
Diet for transplant patients is less limiting than it is for dialysis patients (dialysis and diet link). You may still have to cut back on some foods, though. Your diet probably will change as your medicines, blood values, weight and blood pressure change.
- You may need to count calories. Your medicine may give you a bigger appetite and cause you to gain weight.
- You may have to limit eating salty foods. Your medications may cause salt to be held in your body, leading to high blood pressure.
- You may need to eat less protein. Some medications cause a higher level of wastes to build up in your bloodstream.
Personal Transplantation Success Stories!
We are developing a selection of personal success stories about people that have been in someway involved with the National Kidney Foundation of East Tennessee. Below is the start of this information. Please read, enjoy, and spread the work that organ donation is a life-saving gift that cannot be measured in any way!
|
