Donation Info

I knew very little about transplants, kidneys, or even my own blood type.  I came to learn ten things that shaped the events and decisions of 2008.  Those things were as follows:

1.    Tissue matching is similar to blood donation when it comes to compatibility.  Type O is a universal donor, and type AB is a universal recipient.  In other words, people with Type O can donate to anybody, and people with type AB can receive from anybody.  People with either Type A or B can receive from their own blood type or Type O and can donate to their own blood type or Type AB.  Karen and I are both AB, which means she could receive from any blood type, and I could only donate to another AB.

2.    In addition to blood type, they match antigens.  Every person has six antigens – three from each parent.  The more antigens that match the better.  That is the reason that siblings are the first ones considered.  Karen and I matched on three.  My older sister matched six for six, but previously passed and currently has a kidney stone.  Her glucose tolerance test also predicted a possibility of diabetes in the future.  While she was more than willing, the risk that she would have future health problems was enough to look past the antigen matching.

3.    Even with matching blood and antigens, there could still be tissue incompatibility.  Specifically, there could be a problem if the recipient already had antibodies against the donor’s tissue.  For example, if a person has had a blood transfusion, they might receive foreign antigens and, as a result, develop antibodies.  Women who have been pregnant may also develop antibodies to the antigens of the fetus.  Karen and I had a slight incompatibility issue.  It did not reach the Mayo Clinic materiality threshold, and the University of Wisconsin at Madison noted it but indicated it would not likely have any impact.

4.    In some cases, antibodies can be removed by a furesis process.  The blood is put in a spinner to remove the liquid and only the plasma is put back.  In theory that process could be used to remove antibodies to viral illnesses such that a person could again become susceptible to chicken pox.

5.    The long-term survival of patients who spend a significant amount of time on dialysis is significantly lower.  Different hospitals have reported no noticeable difference if dialysis lasts less than a year (another reported no difference if it was less than six months), but long-term dialysis takes a toll on the body.

6.    The recipient’s kidneys are ordinarily not removed.  Instead, the donor kidney is grafted to the bladder.  While the kidneys are normally in the back, the donated kidney is generally put in the left front.

7.    If the donated kidney fails, additional transplants may take place.  Ordinarily, the first donated kidney also remains in place.  

8.    The donor’s surgery usually takes longer, but it is done laporscopically.  Four probes are inserted and the abdomen is inflated.  All of the work is done with scopes until the kidney is ready to be removed.  At that point, an incision is made below the stomach and an instrument with a sack on it is inserted in order to “bag” the kidney and remove it.

9.    The donor experiences the risks inherent in any surgery and a small chance of developing high blood pressure, but life expectancy and bodily functions remain the same.  Normally, the remaining kidney will grow in order to offset the loss of the first one.

10.    The median life of a kidney graft from a deceased donor is about ten years.  That means that, after ten years, half have failed and half are still working.  That doesn’t mean that the recipient necessarily dies, but the risk is obviously increased.  The median life of a kidney graft from a living donor is closer to twenty years.  Of the fifty percent that last longer than the median, some may outlive their hosts.

© Bob Gust 2015