Deceased Donor Kidney Transplant Procedure
Overview
A deceased donor kidney transplant occurs when a kidney from someone who has recently died goes to a patient whose own kidneys are no longer functioning. Before removal, the donor’s consent comes from family agreement or a donor card. Transplant centers carefully handle the kidney, either placing it on ice or connecting it to a special device for oxygen and nutrients until the surgery.
Transplant teams usually perform the procedure between people in nearby locations, which helps lower the time the kidney spends outside a living body. This process supports better health for the recipient by reducing the risk of complications.
Key Facts:
- Patients typically need only one working kidney.
- Deceased donor kidneys are a common resource for those with kidney failure.
- Living donor transplants are another option, since a healthy person can function well with one kidney.
- About two-thirds of U.S. kidney transplants each year use organs from deceased donors.
Comparison of Kidney Transplant Sources
| Source | Used in Transplants (%) | Can Donor Live After Donation? |
|---|---|---|
| Deceased Donor | ~67% | No |
| Living Donor | ~33% | Yes |
The demand for kidneys from deceased donors is much higher than the number available. In 2021, over 139,000 people waited for a kidney transplant in the United States.
Reasons for Kidney Transplant Surgery
Doctors often recommend a kidney transplant for those whose kidneys have stopped working. This surgery removes waste from the blood when the kidneys cannot do it. People can find relief through two main options:
- Dialysis: A machine cleans the blood.
- Kidney Transplant: A new kidney is placed in the body.
Many prefer a transplant, either from a living donor or a deceased donor. This option can result in lower chances of death, allow for easier diets, and improve everyday life compared to ongoing dialysis. Waiting times vary, especially for deceased-donor kidney transplants.
Possible Health Issues
Kidney transplants from deceased donors come with several possible health concerns, much like living-donor operations. Some risks are common to most surgeries, such as:
- Pain and discomfort
- Infection at the surgery site
- Excessive bleeding
- Blood clots
Other concerns relate to how the body handles the new kidney:
- Organ rejection, often shown by fever, tiredness, less urine, or tenderness
Doctors may prescribe medicines to stop rejection, but these drugs can have side effects like weight gain, more infections, acne, hair changes, or even cancer. People with hepatitis C or those who needed dialysis before may face higher risks and should be monitored closely.
Getting Ready for the Kidney Transplant Process
Preparing for a kidney transplant involves several important steps. The process starts when a doctor refers someone to a transplant center, or when the person selects a suitable transplant center from options provided by their insurance company.
Selection of the center can depend on personal preference, location, and provider recommendations. At the transplant center, staff conduct detailed evaluations to make sure the patient qualifies for a transplant. The evaluation includes:
- Physical examination
- Imaging tests like CT scans, X-rays, or MRIs
- Bloodwork to determine blood type and tissue match
- Cancer screening
- Mental health assessment
- Review of social and financial support systems
- Additional tests depending on personal health history
Once all tests finish, the transplant team decides if the person is eligible for transplant surgery. If a living donor is not available or not compatible, the patient joins the national transplant waiting list for a deceased donor kidney. Kidney matching considers blood type and other compatibility factors to increase the chances that the transplanted kidney will work well.
Criteria for Donor Kidneys
| Donor Category | Description |
|---|---|
| Standard Criteria Donor (SCD) | Healthy kidney donors who meet strict health and age guidelines. These kidneys have the best expected function. |
| Expanded Criteria Donor | Donors who may be older or have certain health conditions. These kidneys are sometimes offered to older patients or those with other risk factors. |
The placement on the list and the time spent waiting depend on how closely the donor and recipient match for blood type, tissue type, and how long the patient has waited for a transplant. Patients need regular checkups to confirm that they remain healthy and able to have surgery.
The Organ Procurement and Transplantation Network (OPTN) monitors the process, ensuring fair and balanced access to kidney donation opportunities. Staff use all information and test results to find the best possible donor match when a kidney becomes available.
What You Can Expect During the Process
When someone matches with a deceased-donor kidney, the transplant center contacts them quickly, day or night. The person should travel to the center as soon as possible. The transplant team checks that the kidney from a potential donor is healthy and a good fit. They also check on the patient’s current health to make sure it is safe to move forward.
If everything looks good, the team schedules surgery right away. In the operation, the surgeon puts the new kidney in the lower abdomen. The new kidney’s blood vessels connect to the patient’s blood vessels. The ureter, a tube from the kidney, attaches to the bladder so urine can leave the body. In most cases, the person’s own kidneys remain in place.
After surgery, patients usually stay in the hospital for several days to a week. Care teams at the transplant center explain medicines the patient will need to take. Patients also receive advice about warning signs to watch for and when to call their healthcare provider.
| Factor | What Happens |
|---|---|
| Notification | Contacted anytime for a matching kidney. |
| Evaluation | Health and kidney match checked by team. |
| Surgery | Kidney placed & connected in the lower abdomen. |
| Hospital Stay | Several days to a week post-surgery. |
| Follow-Up | Medicines and signs of problems explained. |
Findings
Following a kidney transplant, the new organ takes over blood filtration and waste removal, so patients no longer need dialysis. Doctors prescribe several types of medication, including anti-rejection drugs to prevent the immune system from attacking the donor kidney. Because these medicines can lower the body’s natural defenses, doctors often add antibacterial, antiviral, and antifungal medicines to reduce infection risk.
| Factor | Description |
|---|---|
| Kidney Donor Profile Index | Doctors use this to assess the likely function and durability of the donor kidney. Lower KDPI usually suggests better outcomes. |
| National Registry | The registry tracks and analyzes kidney transplant data and outcomes to improve practices. |
Patients need to check their skin regularly for changes and should visit a dermatologist, as their medication can increase the risk of skin cancer. Ongoing cancer screenings for other types are also important. Patients must take all medicines exactly as prescribed to prevent rejection.
