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On the waiting list for a kidney transplant
If the kidneys no longer work or hardly work, dialysis is often used. This partly absorbs the kidney function, but it remains a major burden. Many kidney patients cannot wait to receive a kidney transplant. But that requires patience, because the average waiting time is currently 4 years with peaks to 6 years.
At a kidney transplant someone gets a new kidney. If it functions properly, this basically means that the patient has sufficient kidney function again. That’s a huge difference with dialysis, which partly takes over the kidney function, but where someone still has significant health problems due to the reduced kidney function and the dialysis itself.
Not every kidney patient is a candidate for a transplant. Due to various impeding factors, only one in five dialysis patients is on the waiting list for a donor kidney. Because, for example, a suitable kidney must be available, but other factors also play a role, such as a limited general condition due to having several diseases at the same time.
To transplant or not?
Although age is not a criterion for a kidney transplant, it is true that the general condition of a person deteriorates with age and the chance of a successful kidney transplant is therefore smaller. Illness can also be a reason to forgo a transplant. Bee diabetes does it happen, for example, that heart and vessels are also affected. Recurrent and chronic urinary tract infections are another reason to forgo transplantation. It is also possible that someone has had a kidney disease, which will return with certainty with a new donor kidney. Patients who cancer have had a kidney transplant for the first few years after treatment. For them, transplantation increases the chance of the disease returning. Nevertheless, it sometimes happens that patients with an increased risk of surgery are still put on the waiting list for a new kidney.
Waiting list
Anyone who qualifies for a new kidney will be placed on the waiting list. Research is carried out beforehand into, among other things, the blood type and tissue characteristics. We call this tissue typing. In order to minimize the chance of rejection, the tissue characteristics of the recipient and donor must be as similar as possible. Such an examination also examines whether someone has certain antibodies in the blood, which can influence the success rate of a transplant. This is taken into account when looking for a new kidney.
Tissue typing
As soon as a donor kidney becomes available, a tissue typing is also done, after which a search is made for the most suitable recipient of this kidney. This involves looking at the waiting time of the candidates and the most suitable tissue match.
Types of Kidney Transplants
We distinguish two types of kidney transplants. The best known is the transplant that uses a kidney from a deceased donor. In addition, there are transplants with living donorse.g. a family member, friend or partner. A relatively new form of transplantation is the so-called crossover transplant. If someone wants to donate a kidney to a loved one (pair A), but the kidney does not suit that kidney patient, a pair (pair B) is sought with which to exchange. The kidney of donor A then matches recipient B and vice versa. In order to use as many available donor kidneys as possible, an exchange between three or more pairs sometimes takes place.
Old kidney stays put
Technically, a kidney transplant is not a difficult operation. Contrary to popular belief, the old kidney is not simply replaced with a new one. In general, the old kidney is left in place, and the new kidney is placed in the lower abdomen and connected to the bladder. Only when your own kidneys are very large, cause bleeding or are infected, will they be removed.
Hospital stay
The patient is back on their feet about two to four days after the operation. The hospital stay lasts two to three weeks. The new kidney will start working in about two to three days for most people. If this takes longer, temporary dialysis is needed. Incidentally, that says nothing about the functioning of the kidney; it is becoming increasingly rare for a donor kidney to fail.
Rejection
Despite all precautions and medications, there is always a chance that the body will reject the donor kidney. About a quarter of patients experience this one or more times. Fortunately, it is often possible to counteract the rejection with medication. One year after transplantation, about 80 percent of the kidneys are functioning properly. After five years, that’s about 50 percent.
How long does a donor kidney last?
A donor kidney lasts for years, but usually not for a lifetime. People who become kidney patients at a young age often undergo several transplants in their lifetime. If the donor kidney no longer works, a kidney patient reverts to dialysis and will have to be placed on the waiting list again. The chances of success of a second, third or even fourth transplant are just as great as with the first transplant. The chances of success of a living donor kidney are many times greater than a donor kidney after death.
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