Kidney transplant: Types of donors
The names of the different types of transplants refer to the kidney donor. There are three types of transplant organs:
- Living related
- Living unrelated
A cadaveric transplant is a kidney removed from someone who has died. Cadaveric kidneys are only removed after a series of tests have established that the donor is brain dead. This means that the part of the brain called the brainstem, which controls breathing, has permanently stopped working. A brain-dead patient is only being kept alive by a life-support machine.
Depending on your country, your local transplant center or a regional or national agency maintains a waiting list for cadaveric transplants. (The United Network of Organ Sharing (UNOS) maintains a national waiting list for the US.) Each country also has its own system for matching and distributing cadaveric kidneys. An available kidney is not given to the person who has been waiting the longest, but to the patient best suited to receive it. The wait, therefore, could be one day or several years.
A patient may be taken off a waiting list if they are ill, have an infection or traveling abroad. Removal from the transplant waiting list can be temporary or permanent. Patients who are on the waiting list may not receive a lot of notice that a kidney is available. It must be possible to contact them at all times, and they must be prepared to go to the hospital at short notice.
Once at the hospital, some final tests will be done to assure the best possible chance of a successful transplant. If the patient has a cold, for instance, he or she may be sent home, since this illness would reduce the chances of the operation being successful.
Looking after yourself while on dialysis will increase your chances of being fit for a transplant when the right kidney becomes available.
In living related transplants, a living relative donates a kidney for transplant. A living related transplant is more likely to work than a cadaveric transplant because it is more likely to be a better match than from an unrelated donor.
The relative needs to consider the decision to donate a kidney very thoroughly especially since there is no guarantee the transplant will work. Most donors and recipients receive in-depth counseling before a final decision is reached.
If a kidney patient has a relative who is at least 18 years old, healthy, and willing to donate a kidney, they should speak to the transplant coordinator at their unit. A number of tests will then need to be arranged for both the patient and the donor.
Sometimes an unrelated person will donate a kidney for transplant. It is usually someone close to the patient, such as a husband, wife, partner or close friend. It is illegal in many countries to buy or sell organs.
As with a living-related transplant, both the donor and recipient will be given a number of tests and will receive in-depth counseling.
State-of-the-art procedures for kidney transplantation include:
- Cadaveric renal transplantation
- Cadaver-donor kidney transplantation
- Living donor kidney transplants (from both related and unrelated donors)
- Laparoscopic donor Nephrectomy
Types Of Liver Transplant
There are three options for liver transplantation: cadaver donor transplantation, living donor transplantation, and auxiliary transplantation.
The donor liver is obtained from a person who is diagnosed as brain dead, whose family volunteers to donate the organ for transplantation. People who receive cadaver donors wait on the institutional / regional list until a suitable donor becomes available. The waiting times vary.
A healthy family member, usually a parent, sibling, or child, or someone emotionally close to you, such as a spouse, volunteers to donate part of their liver for transplantation. The donor is carefully evaluated by the team to make sure no harm will come to the donor or recipient.
Part of the liver of a healthy adult donor (living or cadaver) is transplanted into the recipient. The patient’s diseased liver remains intact until the auxiliary piece regenerates and assumes function. The diseased liver may then be removed. This technique is rarely used now.
Points To Remember
- Liver transplantation is surgery to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor.
- If your liver stops working as it should, you may need a liver transplant.
- In adults, the most common reason for needing a liver transplant is cirrhosis. Cirrhosis can be caused by many different types of diseases that destroy healthy liver cells and replace them with scar tissue. Some causes of cirrhosis are long-term infection with the hepatitis C virus, drinking too much alcohol over time, and autoimmune and other liver diseases.
- In children, the most common reason for needing a liver transplant is biliary atresia. In biliary atresia, bile ducts in the liver are missing, damaged, or blocked. As a result, bile backs up in the liver and causes cirrhosis.
- Your doctor will decide whether you need to go to a liver transplant center to be evaluated by a liver transplant team. The transplant team will examine you and run blood tests, x rays, and other tests to help decide whether you would benefit from a transplant.
- People with the most urgent need for a new liver to prevent death are at the top of the national waiting list. Many people have to wait a long time to get a new liver.
- Most livers come from people who have just died. This type of donor is called a deceased donor. Some transplants involve living donors who donate part of their liver, usually to a family member.
- Liver transplant surgery can take up to 12 hours. You will stay in the hospital about 1 to 2 weeks after surgery.
- Problems after surgery may include bleeding, infections, and rejection of the new liver.
- Rejection occurs when your immune system attacks the new liver. After a transplant, it is common for your immune system to try to destroy the new liver.
- After a liver transplant, you must take anti-rejection medicines for the rest of your life to keep your body from rejecting your new liver.
- Liver transplants usually work. Most people are able to return to work and other normal activities after a transplant.