Last updated: Dec-10-2004
DISCLAIMER
I am a patient, not a doctor
This information is based upon my own experience
Any medical advice should be approved by your physician
Note:
To be a kidney transplant candidate you should be in good physical condition, no drug or alcohol abuse, non-smoker and not over-weight.
To receive a kidney, both recipient and donor must have the same blood type and in addition, type O can donate to all others and type AB can receive from all others. Positive or negative RH doesn't matter. See below for new developments.
For a better success, 6 antigens are checked for a match between donor and recipient.
More antigen matches are for the better. A close family member is more likely to be a good match but with today's anti-rejection drugs a spouse is accepted even with a zero match.
Six matches are called a perfect match, it happens but it is rare.
There is a shortage of organs in the Western world.
Those who can find a live donor, relative or friend, can have their transplants sooner.
Those who can't may wait for many years.
To get a cadaver transplant you should enroll and be on the waiting list.
Your neph or social worker can give you the details.
Eligibility for transplant depends on the policy in your country. In some countries you cannot enroll before you start dialysis.
The allocation of organs in the US is done by UNOS (United Network for Organ Sharing).
Go to: UNOS
and select "View Data Reports".
The allocation is based on regions, not necessarily state lines.
A patient can be listed in more than one region, but being on the list in two hospitals in the same region is useless.
There are different waiting periods in different regions.
Rare blood types usually wait less and O-types wait the longest.
Also younger patients have precedence.
Organs are not moved between regions unless there is a perfect match (all 6 antigens).
If a perfect match is found you are called regardless of your place on the waiting list.
Best of all, if you are a celebrity your chances are better...
Selling organs is illegal in the US and in many other countries (but it's done nevertheless).
If you need any advice, your nephrologist should be the most reliable source.
Roughly one third of kidney transplants today come from live donors.
During the last few years the number of live donors in the US is gradually exceeding the number of deceased donors (source: www.unos.org/data/). Transplants from live donors are more successful, but because of the long waiting list on one hand, and the new efficient anti rejection drugs on the other hand, transplant centers are willing to take a kidney from a live donor with just blood type match and without any antigen match.
Although the rate of donation from cadavers has leveled off, the need for donated kidneys is increasing dramatically.
Since not always a family member is match, a few hospitals are doing swapping-kidneys transplants, that is, the donor from family A donates a kidney to the recipient from family B, and vice versa.
Furthermore, some hospitals have incompatible kidney transplant programs, that is, donor and recipient have different blood types or recipient has high level of anti-bodies.
To learn more go to:
John Hopkins Hospital
If you, or someone you know, consider being a live donor, there is a lot of info collected by Amy Peck who donated a kidney to her husband, at: Living Organ Donors
For years hospitals didn't accept non-family donors, but this is changing now.
There is a growing trend of donating kidneys by extraordinary people who see it as a mission.
Some of these stories are covered by the media and inspire others to do the same.
While this is not going to solve the shortage of organs, these people are heroes; they should be praised and they deserve recognition and admiration.
One case that I know is about a lady received a kidney from a member of her church. She came home and found a message on her answering machine........
Another woman received hers from a stranger she met at the clinic. Well, he is not a stranger anymore, they got married.
And there is the story of Pat who donated a kidney to Mike, a perfect stranger and surprisingly a perfect match. A White Muslim woman donating a kidney to an African American Christian in a Jewish hospital.
Selling organs is illegal in the US and in many other countries, but it is still done, including the operation, in many foreign countries, while the law looks the other way.
Regardless of legality, the important question is whether going abroad for transplant is good for you.
Buying a kidney in a foreign country is very risky. Patients that do that are not familiar with the complexity of transplant.
I would be quite scared, for any surgery, to go to a hospital and a surgeon that I have never heard of and whose credentials I don't know, and we are talking major surgery here.
In foreign countries everything is different: you have a language barrier, you can't imagine the difference in the care you get, and if something goes wrong, God forbid, you're on your own...
Neither Medicare nor your health insurance is going to pay.
You'll have to pay for travel, lodging, food, hospital, surgery, medications, and for the sucker that was tempted to "donate" his/her kidney for pennies.
And of course, you never know whether you're giving your money to a bunch of crooks.
The reasons that people consider such a risky course are:
While there are many who argue for the legalization of selling organs, kidneys specifically, this is not a solution for most kidney patients, not to mention patients waiting for other organs.
In a few European countries there is an "assumed consent", that is, if somebody dies and his/her organs can be used, it is assumed that s/he gave consent, unless otherwise stated.
(Despite that, in Europe they have waiting lists even if you have a live donor).
Regretfully, "assumed consent" is not catching up in the US.
The largest source for all kinds of organs is cadavers. It is not our fault or our desire that people die, but if their organs are not used, they die too.
There should be a common understanding that cadaver organs are available for donation unless it is otherwise expressed in writing. (We already have a common understanding that we bury the dead and do not keep them in the living room).
Before such an understanding becomes common, the cadaver donations can be encouraged by certain incentives, such as paying burial expenses, but this still looks like a dream.
With an "assumed consent", instead of stating on your driver's license that you want to be a donor you would state that you don't.
This would be much more fair, because:
Here is my suggestion for a driver's license renewal: