Friday, October 25, 2013

Transplant basics 101


Happy Friday Kidney Warriors! As we continue throughout October I want to remind everyone here in New York we are having the Campaign 4 Life! initiative to improve donor rates for the state. As you know New York has some of the worst in the country. So I hope you took my challenge and your out there raising awareness and getting people to sign up on the registry. In a recent posting by Alliance for Donation/Donate Life New York State we are still only at 21.7% of all adults over the age of 18. We really need to do better! Here's my challenge to you; I challenge each of you to get just 10 people to sign up on the registry. Imagine what we could all do together. 

Now before we go much further let's go back to some transplant basics. A transplant becomes necessary when a patient enters Stage 5 of kidney disease. 




Once in Stage 5 there are two options: Transplant or Dialysis. Unfortunately not every patient can receive a transplant and must stay with dialysis. Some exclusions from a kidney transplant include; other medical conditions such as a history of cancer, a patients weight or BMI, ongoing infection, or a severe psychiatric disease. That is why it's so important for a full evolution of a candidate to allow them to become a recipient. This evolution is done by a team of health care professionals who are called your Transplant Team. These  professionals include a social worker, a nephrologist, a transplant coordinator, and of course a transplant surgeon. It's important to choose a transplant center and team you feel comfortable with and understands your personal needs along the journey to transplant. 

When a candidate is accepted they can receive a kidney from one of the following sources:
  1. Deceased/Cadaver Donor ~ This is a kidney which comes from a person who has just died and the family has given permission for the kidneys to be donated for transplant. 
  2. Living Related Donor ~ This is a kidney which comes from a blood relative such as a mother, father, sister or brother. 
  3. Living Unrelated Donor ~ This is a kidney which comes from a non~related person such as a friend or spouse. 
Currently, most of our transplants done here in the U.S. are done from deceased donors. Due to that fact, there is a shortage of organs for donation that is why we have such a large waiting list, today we have 98,419 waiting for kidney transplants. However, there are definite advantages to doing a living transplant whether they are related or not. These include; having control over timing of transplant, helps avoid the need for dialysis, and reduces the wait time. The advantage of doing a living related donor transplant is it tends to be a better match and lessens the chance of rejection. Because only one kidney is needed to do a kidney transplant it makes living donation possible. Most recipients do not have their native kidneys removed and end up having multiple kidneys even as their native kidneys no longer function. 

A kidney transplant comes with some significant risks attached and should addressed with the transplant team. One of the biggest risks is the risk of rejection. This means the recipients immune system destroys the transplanted tissue. Immunosuppressant drugs are used to prevent the recipients immune system from discovering the new kidney. These drugs will be used for the life of the transplant. Unfortunately, anti~rejection  drugs come with their own side effects which include; bone thinning, diabetes, high blood pressure,, and weight gain. Rejection is how I lost my transplant after five and half years. It was a very difficult time for me and I would advise if your also considering doing a living donor transplant whether related or not that the risks should be discussed with all parties involved. This was one topic that was not covered by my transplant team and in the end I wish it had been. I think a donor should be prepared in case the transplant rejects or fails. 

I hope you enjoyed the basics of kidney transplant and I look forward to your questions on this issue. Although the transplant process is quite complicated, I hope this helps you understand the initial processes involved. This was a considerable decision in my life and I know it changed it completely. I hope this entry helps you make your decision! 

Keep on fighting, you Kidney Warriors! 

~Kidney Blogger







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