There are two types of kidney transplants. One type comes from living donors, and the other type comes from an unrelated donor
who has died (cadaveric donor). If an organ from a living donor (usually a relative) is not available, the patient will be
placed on a waiting list for a cadaveric kidney.
In the United States, more than 50,000 patients are currently waiting for kidney transplants, but only about 14,000 will receive
transplants this year because of a shortage of suitable organ donors. Of the single kidney transplants performed in the U.S.
in 2002, 6,554 were from living donors and 6,185 were from non-living donors.
With a living donor, the donor and the patient are operated on at the same time, with one surgical team removing the donor
kidney and another preparing the recipient for the new kidney. Patients on the waiting list for a cadaveric kidney must be
ready to come to the hospital as soon as a kidney becomes available.
Cadaveric Transplantation
Living Donor Transplantation
Cadaveric Transplantation
Organs from cadavers are acquired based on criteria established by UNOS (United Network for Organ Sharing). Working with the
Gift of Life Donor Program, the non-profit organization that procures organs in the Philadelphia region, the Einstein Transplant
Team is able to implant allocated organs within 24 hours.
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Living Donor Transplantation
Due to the shortage of cadaveric organs and the success of living donor transplantation, this procedure has become increasingly
common, even among people who are unrelated (link to the altruistic donor story – Jude Schwegel). There are many benefits
to having a living donation, including avoiding a lengthy waiting time for a cadaveric donation, and decreased risk of rejection.
Einstein’s Kidney Transplant Program offers a minimally invasive procedure for living donor nephrectomy. (See laparoscopic
kidney removal LINK).
If a patient has a living donor – a relative or close friend who is donating a kidney – then a medical evaluation is scheduled
for both recipient and living donor. They are both tested for compatibility. If they are found to be compatible, then the
donor gives one of their healthy kidneys to the person in need of a transplant. Living donation offer many advantages over
cadaveric donation:
- The kidney, when obtained from a relative, is usually a better match, which reduces the risk of rejection (more than a 90
percent success rate for the first year)
- Kidneys from living donors last longer than cadaveric organs
- The patient does not have to wait months or years for an organ
- The transplant can be scheduled when both patient and donor are ready
- Patients do not have to take as much anti-rejection medication
- Living donated kidneys begin to function immediately; cadaveric donors may take several days or weeks to begin working
People with working kidneys need only one to keep their bodies healthy, and living donation does not shorten life expectancy.
After surgery, living donors can lead completely normal lives. Most donors return to their normal activities within two to
six weeks after donation.
Just because a patient has a child or sibling who is willing to donate a kidney, doesn’t mean that they will be compatible.
There’s a 25 percent chance that siblings will have identical genetic make-up. Siblings can have an exact match in their genetic
make-up (HLA), but their blood type can be different and they may have antibodies against each other.
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