About Living Donor Kidney Transplantation
What is living kidney donation?
The kidney used in transplantation can come
from a deceased or from a living donor. Living
donors can be:
- "Living-related" (or "blood
relatives") -- such as siblings,
parents, children, aunts, uncles, or cousins;
or
- "Living-unrelated" -- also called
"emotionally-related" donors, such
as spouses, in-laws, adoptive parents or children,
or very close friends.
The living donor must be in good health and willing
to be considered a donor. With the availability
of newer and more potent immunosuppressive
medications, the results from all living donors
are about the same whether they are "blood"
or "emotionally" related.
Kidneys from a living donor of either type have
a better chance of long-term survival than those
from a cadaver donor. Also, there is a large
and growing shortage of cadaver organs. The
average patient on the waiting list for a cadaver
kidney transplant will wait three to five years.
With kidneys from a living donor, these long
waiting times can be eliminated.
Who is eligible for living kidney donation?
Patients with kidney disease can receive
a transplant from a living donor when kidney
failure is advanced, but before dialysis is absolutely
necessary. Recent studies show that kidneys transplanted
before the patient starts dialysis or has been
on dialysis less than six months have a greater
success rate than those transplanted after the
patient has received dialysis for more than six
months.
Are there risks to the donor?
The risk to a living kidney donor is real
but very small. Dialysis is necessary when kidney
function falls to 10 percent or less of normal.
A healthy person has 100 percent of kidney function.
If a person donates one of his or her two kidneys,
kidney function falls to about 75 percent; the
remaining kidney immediately starts working better
and grows larger. At 75 percent of kidney function,
kidney donors still have seven or eight times
more kidney function than they need to stay off
dialysis.
Kidney donation is viewed as a very positive
experience by the vast majority of people who
have donated. The risks involved in kidney donation
are discussed in great detail with any potential
living kidney donor before going ahead with the
process of evaluation.
After donor transplantation surgery
The donor's diet and activity will not be
restricted after donation. After recovering
from surgery, kidney donors can work, drive,
exercise, and participate in sports as usual,
and will not need any new medications. Kidney
donors can also continue in all types of occupations,
including military duty. (They may not be able
to get into the military or be hired by police
departments, fire departments, or the FBI. Additionally,
persons on active duty in the military may be
limited in their assignments following donation
which could impact on their career.)
Donating
a kidney does not change life expectancy nor
does it increase the chances of the donor developing
kidney disease. Young women who are kidney donors
can go through pregnancy and childbirth at no
greater risk to them or their baby than if they
had two kidneys.
Reviewed by Robert
Grossman, MD
Last updated January 2007
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