Where does my new organ come from?
Organs for kidney transplantation come from two sources: living donors and deceased donors.
Deceased Donor Kidney Transplant
A deceased donor is an individual who has recently passed away of causes not affecting the organ intended for transplant. Deceased donor organs usually come from people who have decided to donate their organs before death by signing organ donor cards. Permission for donation also may be given by the deceased person’s family at the time of death.
A deceased donor kidney transplant occurs when a kidney is taken from a deceased donor and is surgically transplanted into the body of a recipient whose natural kidneys are diseased or not functioning properly.
Types of Deceased Donor Organs
There are several different types of deceased donor kidneys. These names are used to describe certain anatomic, biological, and social features of the donor organs. You may decide not to receive any or all of these organs, and you may change your mind at any time.
- Standard Criteria Donors (SCD): These kidneys are from donors under age 50 and do not meet any of the criteria below that are assigned to Expanded Criteria Donors.
- Expanded Criteria Donors (ECD): These organs come from donors over age 60 or age 50-59 that also have at least two of the following criteria - history of high blood pressure, the donor passed away from a CVA (stroke) or had a creatinine higher than the normal laboratory value (1.5 mg/dl). About 15-20% of the donors in the United States are Expanded Criteria.
- Donation after Cardiac Death (DCD): These donors do not meet the standard criteria for brain death. Their hearts stopped before the organs were removed. Donation after Cardiac Death occurs when continuing medical care is futile, and the donor patient is to be removed from all medical life-sustaining measures/supports.
- Double Kidney Transplants (Duals): During the year we may have access to donors that are at the more extreme limit of the Expanded Criteria Donor. Research has found that using both of these kidneys in one recipient is preferable to only one.
- Donors with High-Risk Social Behavior: These donors are individuals who at some point in their life practiced high-risk behavior for sexually transmitted disease, drug use, or were incarcerated. All of these donors are tested for transmissible disease at the time of organ recovery. You will be informed of the high-risk behavior.
All of these kidneys supply suitable organs for transplant, and all are expected to provide good outcomes with good organ function. However, the outcomes may be 5-10% less than that achieved with Standard Criteria organs. Accepting a kidney that is not considered Standard Criteria may substantially reduce your waiting time.
Living Donor Kidney Transplant
A living donor transplant is a procedure during which a kidney is removed from a healthy donor and surgically placed in an individual with kidney failure. The living donor often is an immediate family member (parent, sibling, or child). The living donor can also be an uncle, aunt, cousin, or even a spouse or friend. Living donor kidneys can also come from strangers, Good Samaritans that want to help someone in need of a kidney.
A living donor transplant has many advantages over a deceased donor kidney transplant, the most important being a significantly higher success rate. Additional reasons include:
- A kidney from a living donor generally functions immediately after transplant. A deceased donor kidney might take several days or weeks to function normally.
- The living donor transplant can be scheduled, allowing the recipient and donor preparation time. You will not know when a deceased donor kidney will be available, and surgery must be performed very soon after it is available.
- There may be a reduced risk of rejection, especially if the kidney is donated by a blood relative.
- You might possibly shorten the amount of time you have to wait to receive a kidney transplant. The average wait time for a deceased donor kidney could be three to five years.
Who would be a good living donor candidate?
Biological siblings generally make the best living donors due to matching. However, with the advancements in drugs and treatment for rejection prevention, anyone can be considered a donor if they have a compatible blood type. Most healthy individuals between the ages of 18 and 60 are potential donors. All living donors are evaluated individually. You should discuss donation with immediate and extended family members, friends, co-workers, and friends of friends. The success of kidney transplants using unrelated living donors is nearly as high as living related donors.
All potential kidney donors must demonstrate that the decision to donate is made freely, electively and without coercion or valuable compensation.
The recipient and donor teams function separately. Living donors will have their own coordinator, physicians, and social worker. The Living Kidney Donor Office is unable to answer recipient questions about their living donors. Recipients should contact the pre-transplant office locally at 216.444.6996 or toll-free 800.223.2273 ext. 46996 with questions regarding this process.
If you are interested in being evaluated as a potential living donor, please contact the Living Kidney Donor office for additional information locally at 216.445.3150 or toll-free 800.223.2273 ext. 53150. More information is also available in the Living Donor section of this website.