There is no cure for kidney failure, but patients have several different treatment options to choose from. Dialysis options include hemodialysis or peritoneal dialysis, and transplant options include deceased donor transplant and living donor transplant. It is critically important that patients with chronic kidney disease understand each of their options and then choose the option that is best for them. Below, we provide benefits and risks of transplantation as well as other factors that patients, their families, and their potential donors should take into consideration.
Transplantation: Benefits, Risks, and Other Considerations
A kidney transplant dramatically increases the life span of a patient by about 10 years and improves their quality of life. Dialysis, while clearly a life-saving treatment, it is a less-than-perfect replacement for an actual human kidney. Dialysis creates ongoing damage to the body, leading to other life-threatening complications, such as heart disease. While many transplant patients start on dialysis, the good news is that any harm done by dialysis is halted after transplant. In addition, people who undergo a transplant will no longer require weekly dialysis treatments or have the side effects of dialysis such as nausea, vomiting, low blood pressure, muscle cramping, and itchy skin.
A transplant is considered a major operation and although rare, death can occur. Other risks include infection, bleeding, and damage to surrounding organs.
Transplant recipients are required to take immunosuppressant medications for the rest of their lives and make frequent visits to their nephrology doctor to minimize the chance of organ rejection. Medications can have side effects. Visit transplantliving.org for a full list of potential side effects.
Source: USRDS, 2014.
Deceased vs. Living Donor Transplantation
Deceased Donor Transplant
There are over 100 million people in the United States who are registered as anatomical donors. These are individuals who agree, upon death, to donate their organs, corneas, and/or tissues for transplant or research purposes.
Organs that are transplanted include the heart, liver, pancreas, intestine, kidneys, and lungs. Tissues include bones, tendons, veins, skin, and heart valves. In 2014, there were more than 1 million tissue transplants and just under 30,000 organ transplants performed in the United States. While these numbers are nothing short of miraculous for the recipients of these transplants, the number of annual deceased donor transplants isn’t increasing nearly fast enough to keep up with demand.
Organ transplant is less common because of the complexity involved. The criteria for using deceased donor organs are very strict – so much so that less than 1% of all registered donors are able to donate an organ at the time of death. These circumstances result in a severe shortage of transplantable organs. This shortage is especially pronounced in patients with kidney failure, who make up about 80% of the total number of people on the national waitlist. Wait times for a deceased donor kidney average 4.5 years with waits as long as 7 years in highly populated areas of the United States. For more information about transplantation, steps in the matching process, and the process for joining the waitlist, visit unos.org.
Living Donor Transplant
Living kidney donation involves a family member, friend, co-worker, or anonymous “Good Samaritan” who donates one of their kidneys to a person in need. This “ultimate act of generosity” is a commonly accepted and safe medical practice. Living donors maintain normal lives with the remaining kidney doing the work previously performed by two.
A transplant candidate with an eligible living donor can significantly reduce or altogether eliminate the wait time experienced by those planning for a deceased donor transplant. Click here to read a full list of benefits from living donor transplantation.