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Transplant Recipients | Finding a Living Donor


Find Your Living Donor
When your kidneys fail, you have two treatment options: a kidney transplant or dialysis therapy. In most cases, a kidney transplant is the best form of treatment for end-stage kidney disease. And, as the following information will show you, the sooner you receive a kidney transplant the better. As you are no doubt aware, the wait list for deceased donor kidney transplant continues to grow each year along with the wait times. This is why you are highly encouraged to seek out someone who is willing to donate a kidney to you. Please keep in mind that anyone who is willing to donate a kidney has the potential to help you receive a living donor kidney transplant—whether they are compatible with you or not.
Transplant Timing
Research shows that a transplanted kidney works longer the less time that is spent on dialysis or by avoiding it all together. As wait times for a deceased donor kidney transplant continue to increase, having a living donor is the most common and best way to get transplanted and requires little or no dialysis. A transplant from a living donor is preferable to a deceased donor for many reasons including improved kidney function.
Dialysis Complications
While dialysis is a lifesaving treatment, it basically just removes waste and excess fluid, while a functioning kidney does this and much more. Dialysis only offers about 10% of what a functioning kidney does. Over time this can have a significant impact on the body causing other serious health problems and complications including:
• Heart Disease
• Anemia
• Bone Disease
• Nerve Damage
• Infection
• High Blood Pressure
Longer Life with a Transplant
Patients who receive a kidney transplant typically live longer than those who stay on dialysis. The differences in the projected life expectancy between transplant recipients and dialysis patients are shown in the table below from the Journal of the American Society of Nephrology:
Age        Dialysis      Transplant
18-34     27.2 yrs       41.5 yrs
35-49     6.71 yrs       18.03 yrs
50-59     5.12 yrs       11.18 yrs
60-64     4.32 yrs       7.84 yrs
65+        3.69 yrs       7.6 yrs
Initial testing between a donor and a recipient is to determine blood group compatibility. In the United States, approximately one of every three donors is blood type incompatible with their intended recipient. Next, testing is done to determine immunological compatibility. This testing defines if there are no barriers (negative crossmatch) or if there are barriers and how strong these barriers are (positive crossmatch). Recipients may develop immunological barriers making it more difficult to accept a kidney transplant. Recipients who have these barriers are called “sensitized” patients. Sensitization occurs by having exposure to tissue that is non-self. The dominant causes are a history of a previous transplant, pre-transplant blood transfusions, or a history of pregnancy. Testing is done on a recipient to determine if they are sensitized and if so, the degree of their sensitization. How strongly a recipient is sensitized helps transplant centers determine how difficult it may be to find an immunologically compatible donor.
Desensitization therapies are available to help lower a transplant candidate’s immunological response and increase the chance of getting a kidney transplant sooner. Successful desensitization could potentially allow a recipient three opportunities for kidney transplant: with their original living donor, with a deceased donor, or with a donor from a kidney paired donation program. Your transplant team will determine the need for desensitization therapy and if you’re a candidate.