There are three treatment options for an individual with kidney failure which are peritoneal dialysis, hemodialysis and kidney transplantation. Improving the quality and length of life and allowing a greater freedom to the patients, successful kidney transplantation is preferred both by doctors and patients for many patients with end-stage renal disease.

What is kidney transplantation?

Kidney transplantation is the transfer of a healthy kidney to a person whose own kidneys have no activity.
The kidneys have a vital importance for our lives. They are two bean-shaped organs located on each side of our body. The main role of the kidneys is to clean our blood. 
If the kidneys lose the ability of cleaning our blood, waste products can accumulate in our body. This is a life threatening medical condition which is known as kidney (renal) failure or end stage chronic kidney disease (ESRD), and is the indication for dialysis or kidney transplant treatments.

Preliminary analyses required for diagnosis of ESRD:

  • Urine Analysis, Full
  • Albumine
  • Calcium
  • Creatinine
  • Creatinine Clearance
  • Phosphor, Inorganic
  • Potassium
  • Protein, Urine (24-hour)
  • Creatinine clearence, Urine (24-hour)
  • Sodium (Na)
  • Aspartate Aminotransferase
  • Alanine Aminotransferase
  • Urea Nitrogen (BUN)
  • Blood Count, Automatic Hemogram (Wide Panel)
  • Parathormone (PTH), Intact
  • US, Urinary System

Due to various reasons the majority of the patients are on dialysis. Being on dialysis is not a restriction for kidney transplantation and if the dialysis patient has a suitable donor, he/she is suggested to undergo a kidney transplant surgery. However, -end-stage renal disease (function of kidneys less than %15) patients with potential living donors may also undergo pre-emptive transplantation before dialysis is initiated.  The results for pre-emptive transplantation are reported to be more successful in the long term.

What are the types of Kidney Transplantation?

There are two types of kidney transplantation regarding the donor types: from living donors and from deceased donors (patients in intensive care units with brain death).

Being a living donor

Donating an organ may be a traumatic process for an individual. However, since one kidney is sufficient to survive, a living person can donate a kidney. This type of donation is known as a living donation. Blood-type matching between donor and recipient is a must in kidney transplantation, however HLA (tissue-typing)-match is not essential. Depending on the developments regarding immuno-suppresive therapies in recent years, it has become possible to make successful kidney transplantations from donor with no tissue compatibility.

Kidney donations are also possible from deceased donors. This type of donation is known as cadaveric transplant. However, cadaveric transplant has a slightly lower chance of long-term success. Most importantly, only Turkish citizens have a privilege to be on waiting-list for receiving kidneys from deceased donors.

Requirements for being living donor;

  • Blood groups of the recipient and donor should be compatible. Blood group compatibility requirements are as follows:

RECIPIENT DONOR
A                                  A or 0
B                                   B or 0
AB                                 A, B, AB, 0 (all blood groups may donate)
0                                   0 (only group 0 may donate)
         RH factor does not matter. (-) and (+) may donate to each other.

  • The candidate kidney donor must be relative of the patient or his/her spouse up to the fourth degree. Accordingly;

Spouse is accepted and not qualified as 1st/2nd/3rd/4th.
First Degree Relatives: Mother-father-child
Second Degree Relatives: Sibling, grandfather, grandmother, grandchild
Third Degree Relatives: Paternal/maternal uncle, paternal/maternal aunt, cousin (child of sibling)
Fourth Degree Relatives: Children of third degree relatives.
Relatives of the spouse of the person are ranked in the same way.

  • The candidate kidney donor must have turned the age of 25, and must be mentally balanced.
  • If the candidate donor has a known health problem or is overweight, he/she must contact the facility by phone before arriving to our center.

For living donors, first choice is always immediate family members such as brother, sister, parents or children as the likelihood of blood and tissue match is higher.

International patients can receive kidney from living donors. In order to be considered for living donation transplant, individuals should apply to the legal authorities of their countries and provide official documentation that the intended donor and recipient are related at least to the 4th degree. (I.e. parents and children are first-degree relatives; siblings, grand-children and grand-parents are second-degree relatives; uncles, aunts and cousins are third-degree relatives; and children of third-degree relatives are considered fourth-degree relatives. These relations can be established either through blood or marriage). The aforementioned documents should be submitted to the Organ Coordinator for evaluation and submitted to the Local Ethics Committee, if need be. Further information about the process can be obtained from our Organ Transplant Coordinators.

 


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Friday, June 22, 2018 2:02:22 PM