KIDNEY TRANSPLANT CRITERIA

Kidney Transplant Criteria

Kidney transplant criteria

Kidney transplant criteria include a number of elements that take into account both the recipient's and donor's requirements.  Before a kidney transplant surgery can be performed, there must be adequate preparation and planning, to maximize the chances of a successful operation.  Failure to properly plan and prepare for a kidney transplant could lead to frustration, disappointments and excessive financial burdens.

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There are many considerations that must be looked at, from both the patient's (recipient) and the kidney donor's perspectives. These include medical, psychological, logistical and financial considerations.

Kidney Transplant Criteria - For The Recipient

Not all cases of renal failure require a kidney transplant... only patients who have been diagnosed with chronic end stage renal disease.  This is the most severe stage of kidney failure, where the kidneys have suffered irreversible damage and can no longer perform their function.

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Normally, it takes a long time (many years) for a patient with chronic renal failure to develop end stage renal disease.  This can only be diagnosed after a doctor has performed a series of kidney function tests, over an extended period of time. If a patient is diagnosed with end stage renal disease, a doctor may recommend a kidney transplant, if the patient meets the relevant transplant criteria.

Patient's Health

Firstly, the patient's health has to be assessed.  The patient must be in satisfactory physical condition before undergoing a transplant operation.  A doctor might be hesitant to recommend a kidney transplant to someone who has another life-threatening disease, such as heart failure.  It all depends on whether the doctor believes that the patient can survive a kidney transplant surgery, and whether such a surgery will improve the patient's overall health condition.

Recipient's Age

Kidney transplant criteria also include consideration of the recipient's age.  Some statistics suggest that the rate of successful kidney transplant among older patients (over 75 years) tend to be lower than for those below the age of 75 years.  Ultimately though, the doctor must consider the patient's overall physical health and whether the patient's quality of life would improve by a kidney transplant.

FinanCE 

 and LogistICS

In addition to the medical and physical factors that must be considered before a transplant, there are also financial and logistical considerations.  It is important for a patient to be aware of the cost of a kidney transplant surgery, including the cost of hospitalization and other post-surgery care, such as dietitian's services and dialysis.

Depending on where the patient lives, they may have to travel to another country for the surgery if it is not performed in their country of residence.  Transportation and accommodation must also be considered.

 Donated Kidney

Finally, of all the criteria for a kidney transplant previously mentioned, perhaps the most important is the availability of a donated kidney.  It can take many years before a suitable donor is found.

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The requirement for kidney transplants continues to increase while the availability of donated kidneys is not enough to supply the demand.  Often, a patient's best prospect of obtaining a donated kidney is from a close relative or friend.

Kidney Transplant Criteria - for a Donor

A kidney transplant donor (kidney donor) is someone who is willing and able to donate one or both of their kidneys, for kidney transplant.  A kidney donor may be either alive or deceased (dead).  The criteria for a donor depend on whether the donor is living or deceased.

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Before someone dies, he or she can volunteer or agree to donate their kidneys (and other organs) to a compatible recipient, after the donor's death.  Basically, the following two (2) kidney transplant criteria are required for a deceased donor.

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  • The donated kidney must be healthy. When someone agrees to donate their organs, after their death, they must undergo medical tests (while they are alive) to determine whether their organs are healthy enough to be of benefit to a potential recipient. An assessment of the health of their organs can also be done after they die, but the window of opportunity for such assessments is usually very limited.

 

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When a donor's heart stops beating permanently and they are declared to be dead, there is a race against time to remove and preserve their donated organs. This is critical since these organs stop receiving oxygen and other life sustaining chemicals, once the heart stops beating. Once this happens, the quality of their organs begins to degenerate. If this degeneration takes place over an extended period (a few hours), the donated kidneys and other organs may not be useable. 

 

It should be noted that someone who is brain dead can also be considered to be medically dead, although their heart continues to beat. It is much easier to remove a kidney (or kidneys) from a brain dead donor, without compromising the health of the organs, than a non-heart beating donor. With a donor who is brain dead, their heart continues to pump and maintains circulation throughout the body. Their organs continue to receive oxygen and other vital chemicals to sustain their health. This allows more time for the donated organs to be removed and properly preserved, than would be the case with a non-heart beating organ donor.

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  • The blood and tissue profiles must be similar to the recipient. Compatibility of blood and tissue profiles of the kidney donor and the recipient reduces the risk of the transplanted kidney being rejected by the recipient's immune system. Normally, information on the blood and tissue profile of the deceased donor is obtained before their death.

 

The basic kidney transplant criteria for a living and a deceased donor are similar, i.e. the donated kidney must be healthy and the blood and tissue profiles of the donor and recipient must be similar.  With a living donor, however, there are other considerations such as their physical health and their age.  Once all the kidney transplant criteria for donor and recipient have been satisfied, the chances of a successful kidney transplant operation are maximized.