Kidney Transplants - Types and Advantages

What Is a Kidney Transplant?

A kidney transplant is a surgical operation in which a healthy kidney from a deceased donor or a healthy living donor is placed or transplanted into a person's body whose kidneys are not functioning correctly anymore. When the functions of the kidneys get impaired, harmful substances and wastes accumulate within the body leading to high blood pressure and kidney failure, also known as end-stage kidney disease. In end-stage kidney disease, the kidneys lose around ninety percent of their working ability. The various causes that cause end-stage kidney disease include:

• Diabetes.

• Uncontrolled chronic high blood pressure.

• Chronic glomerulonephritis is an inflammation and scarring of the tiny filters (glomeruli) present within the kidneys.

• Polycystic kidney isdease is an inherited kidney disorder in which multiple cysts are formed in the kidneys leading them to enlarge and lose their function over time.

How Many Types of Kidney Transplants Are There?

Kidney transplants are of two types. They are:

• Deceased donor kidney transplant.

• Living donor kidney transplant.

What Are Living Donor Kidney Transplants?

In living donation, the kidney is donated by a healthy living individual to another person who needs a kidney for survival. Around six thousand organ transplants are made by living donors.

Types of Living Donor Transplants:

• Direct Donation - Direct donation is a common type of living donation. In this type of donation, the donor knows the specific person receiving the donation. The donor can be either related or non-related. The related donor is a biological relative like a parent, brother, sister, or adult kid. The non-related donor is a biologically unrelated person having a personal or social connection with the donor, such as a spouse, friend, or co-worker.

• Non-Direct or Altruistic Donation - In a non-direct donation, the donor does not know the person donating their organ. Instead, the match is made based on their medical compatibility. Some donors even choose to avoid meeting their recipients.

• Paired Donation or Paired Exchange - Paired donation involves two or more pairs of living kidney donors whose blood types do not match. The recipients trade donors so that each receives a kidney from a donor with a compatible blood type. This kind of exchange involves multiple living kidney donors or transplant candidate pairs from various centers or parts of the world.

What Are the Advantages of Living Donor Transplant?

The advantages of a living donor transplant are as follows:

• Schedule the Surgery - A living donation makes it possible to time the transplant surgery at a feasible time for both the donor and the recipient.

• Decreased Risk of Organ Rejection - Organ rejection risks are minimized in living donor surgery because of better genetic matching.

• Immediate Working - The kidneys work immediately after being removed from a healthy owner and transplanted.

• Shorter Waiting Time - A living donor transplant might reduce the time spent on dialysis or years of waiting for a deceased donor organ.

What Are Deceased Donor Kidney Transplants?

Deceased donors are mostly people dying from accidents or sudden death or wishing to be organ donors. The donated organs are matched to the waiting recipients by a national registry called the organ procurement and transplantation network (OPTN). The present kidney allocation system was implemented in December 2014 to provide recipients with longer functions with their transplanted kidney by matching the donated kidney with the most extended potential life. The recipient has the longest possible life with that kidney. Once listed for the transplant, the recipient will be allocated an estimated post-transplant survival score (EPTS) that ranges from zero to one hundred. This score is based on estimating how long the recipient would need a functioning kidney compared to the other candidates. The EPTS is determined with the help of a mathematical formula that takes into consideration four factors:

• Does the recipient have diabetes?

• The current age of the individual.

• Is the recipient on dialysis? If yes, then for how long.

• Has any organ transplantation been done previously?

Each one of the available kidneys is assigned a kidney donor profile index or KDPI score- a percentage score ranging from zero to one hundred. The KDPI score is associated with how long the kidney will function compared to the other kidneys. The KDPI is calculated based on the factors such as:

• Age.

• Height.

• Weight.

• Ethnicity.

• Cause of Death is loss of heart function, brain function, or stroke.

• History of blood pressure.

• History of diabetes.

• Hepatitis C exposure.

• Serum Creatinine where the creatinine is the waste produced due to the normal wear and tear of the muscles. This provides information about the kidney function of the individual.

What Are the Different Types of Deceased Kidney Transplants?

There are various types of deceased kidney transplants. They are:

• Standard Criteria Donors (SCD) - These kidneys are from donors under the age of fifty years.

• Expanded Criteria Donors (ECD) - These kidneys come from donors who are above the age of sixty or fifty, having at least two of the following criteria, a history of chronic high blood pressure in which the donor passed away from stroke or had a creatinine higher than the average value.

• Donation After Cardiac Death (DCD) - These donors do not meet the criteria for brain death. Their heart stopped working before the kidneys were removed.

• Double Kidney Transplants (Duals) - The deceased donor's kidneys are transplanted. It has been researched that using both kidneys is preferred over one.

• Donors With High-Risk Social Behavior - These donors indulged in drugs, had sex with multiple partners or were imprisoned. In addition, these donors are tested for transmissible diseases during organ recovery.

Conclusion

A kidney transplant is a surgery carried out to replace a diseased kidney with a healthy one. After a few criteria are met, the kidneys can be transplanted from two types of donors: a deceased organ donor or a living kidney donor. Each of the transplant types has its pros and cons. However, people can live a healthy everyday life with one kidney and a lifelong intake of anti-rejection medications.