The patient has a proper donor for the kidney transplantation. This donor may be a living person or cadaver (died).
The initial condition of the kidney transplantation is the blood group compatibility of the donor and recipient. rH factor is not significant for kidney transplantation. The blood group compatibility is shown in the below table.
|ABO Blood Compatibility Table|
|Recipient blood group||Donor (who can donate kidney) blood groups|
|Rh+ (positive)or Rh- (negative) doesn’t prevent kidney transplantation.|
Kidney Transplantation From Living Donor
It is the transplantation of the kidney to the patients in need of kidney transplantation taken from a health person. The spouse of the patient she/he has been married for minimum 2 years, 4th degree relatives or in law may be the donors. In addition to this, the living voluntary donor candidate not being a relative should be approved by the ethical committee.
A detailed medical evaluation is carried out for the volunteer donor candidate and whether there is a condition or problem preventing the taking of a kidney is examined.
In the medical evaluation process;
• Functions and structures of vital organs such as heart, lung and digestive systems are evaluated. This evaluation is carried out by the nephrologist in the organ transplantation team and under his leadership.
• Functional conditions, structures, condition of veins feeding the kidney, urinary tracts are controlled for the kidneys.
• The psychologist assesses the psychological condition and whether he is a volunteer or not and there is social pressure for the donor is questioned.
If it is approved, it may be decided that the volunteer person can donate the kidney.
Persons below the age of 18 can’t be a kidney donor. For a person to be a kidney donor, he/she needs to be volunteer. Ethical principles require the living donors being a volunteer without any pressure and non-acquiring material gain for the transplantation. Living donation should be a gift with extraordinary value and when a proper donor is found, it should be implemented immediately.
Kidney Transplantation From a Cadaver
Cadaver donor is the person followed at intensive care, subject to respirator due to cerebral death following traffic accident, cerebral hemorrhage, brain tumour or heart attack and having the diagnosis of cerebral death medically. Consent of the families of the persons with cerebral death is mandatory for the organ transplantation.
Investigations conducted must show that organ donor patient do not have any infectious disease, cancer or kidney disease that can be found by the existing facilities.
Kidney excised under suitable conditions and protected in special fluids must be transplanted to the recipient as soon as possible after being taken from the person with cerebral death. Chronic renal failure patients should be registered in ministry of health national organ and tissue transplantation coordination system for the kidney transplantation from a cadaver. For this purpose, they need to apply to a kidney transplantation center. If no problem is found as a result of examinations performed at this center, you will be registered in ministry of health national waiting list. Unfortunately, since organ donation from cadaver is extremely low in our country, there are long waiting lists.
Advantages Of Kidney Transplantation From a Living Donor
• Quite higher success rates have been achieved with living donors compared to the cadaver. Therefore, better results can be obtained in short and long term than cadaver kidney.
• Living donation may enable some patients to avoid long waiting list and even dialysis.
• Compatible early function and easy control is achieved.
• Long waiting time is no longer applicable for the transplantation operation.
• Less suppressive medication is necessary to suppress immune system.
• The donor experiences emotional earning
• Rate of kidney transplantation increases in the world.
Not some of the kidney functions like in dialysis treatment but all of the kidney functions are recovered by successful operations of kidney transplantation from living donor and cadaver. The rate of 1-year life expectation is 95% for kidney taken from living donor and it is 85% for 5-year life expectation. Rate of 1-year life expectation for kidney taken from cadaver is 83% and it is 68% for 5-year life expectation.