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Issues For Patients Waiting For a Deceased Donor Kidney

Issues For Patients Waiting For a Deceased Donor Kidney

There are many issues and concerns that need to be considered when someone is on the Kidney Transplant Waiting List and you receive a phone call from the Transplant Team that a Deceased Kidney Donor is available for you.  Your initial reaction is typically a feeling of exuberance and relief.  However, there are many considerations that need to be evaluated before you immediately decide to say “YES” because it may not be the best decision at the time.  Every offer to receive a Deceased Kidney Donor has to be carefully evaluated to make sure you are making the right decision.  Below are several important facts to be aware of in making your decision:

  • A deceased-donor kidney transplant is when a kidney from someone who has recently died is removed with consent of the family or from a donor card and placed in a recipient whose kidneys have failed and no longer function properly and is in need of kidney transplantation.
  • The donated kidney is either stored on ice or connected to a machine that provides oxygen and nutrients until the kidney is transplanted into the recipient. The donor and recipient are often in the same geographic region as the transplant center to minimize the time the kidney is outside a human body.
  • Several factors need to considered when accepting a deceased kidney donor especially knowing Kidney Donor Profile Index (KDPI). If the kidney is not coming from a healthy individual, accepting the kidney could potentially present with many future complications including kidney rejection.
  • A Living Donor Kidney transplant is always a better alternative to Deceased Donor Kidney Transplant.
  • Overall, about two-thirds of the approximately 25,000 kidney transplants performed in 2022 in the U.S. were deceased donor kidney transplants and the remaining were living donor kidney transplants.
  • The demand for deceased-donor kidneys far exceeds the supply. The waiting list has grown from nearly 58,000 in 2004, 92,000 in 2017 and over 100,000 in 2023.
  • People with end-stage kidney disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
  • For most people with advanced kidney disease or kidney failure, a kidney transplant is the preferred treatment. Compared with a lifetime on dialysis, kidney transplant offers a lower risk of death, better quality of life and fewer dietary restrictions than dialysis.
  • The health risks associated with kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and side effects of taking immunosuppressive medications needed to prevent your body from rejecting the donated kidney. These risks include higher rates of infection and some types of cancer.
  • Everyone waiting for a deceased-donor organ is registered on a national waiting list maintained by the Organ Procurement and Transplantation Network (OPTN). The United Network for Organ Sharing (UNOS), a private nonprofit group, administers OPTN through a contract with the U.S. government.
  • The deceased donor’s blood type, height, weight, the hospital zip code and other data are entered into UNOS’ national computer system to begin the organ allocation process. Appropriate candidates are found for whom the donor’s organs are the best match. Timing is especially important at this step and during recovery.
  • Additional factors used in matching deceased-donor kidneys include blood and tissue type matching and how long the candidate has spent on the waiting list. The federal government monitors the system in an effort to ensure that everyone waiting for an organ has a similar chance.
  • Some people rarely may get a match within several months while most others typically wait several years (3-7 years on average). While on the list, you will have periodic health checkups to ensure that you are still a suitable candidate for transplantation.
  • When a compatible deceased donor kidney becomes available, you will be notified by your Transplant Center. You must be ready to go to the hospital immediately for final transplant evaluation.
  • If the results of the final transplant evaluation are satisfactory, the kidney transplant surgery can proceed immediately.

Declining a Deceased Kidney Donor that you are not comfortable with is not the end of the world.  It's better to decline a deceased kidney donor that is coming from someone who's health was not the best and has a high KDPI rating which is a warning sign.  Many times, if you decline a kidney that comes from someone that was not healthy, there will be other offers in the future.  Your feelings of desperation, frustration, stress and uncertainty should not affect your decision if your gut tells you it's not a good decision to accept the kidney that is being offered.  Stay positive and make the right decision for you.







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