Two kidney transplant questions

  1. If someone (in the U.S.) needs a kidney, and there’s none available from the family, what is the average time he’d have to wait for a new kidney?

  2. If the original kidneys failed due to complications from diabetes, would that disqualify the person from receiving a new one (because the new one will eventually fail as well).

I haven’t gone through the site, but I suspect many of your answers may be here:

Here’s the answer to one of the questions:

From here:

No sources, but I think that recipient candidates are prioritized based on the likelihood of long term success. Diabetes can usually be controlled through medication, so it isn’t necessarily a show stopper in the way that, say, heavy drinking is to liver candidates.

I don’t think they have literal show-stoppers for transplants that mean life or death. I have a suspicion that people who would pretty much be a ‘waste of a transplant’ just never get them and are pretty much prioritized at the bottom, but are not actually declared “Sorry, you are too fucked up for a transplant”. They might still wind up on transplant lists, just not really move up on them. My stepfather has cirrhosis due to some combination of drinking, hepatitis C he acquired about 30 years ago and some sort of hereditary haemochromatosis (apparently genetic and unrelated to hepC). He is also a heavy smoker, 60 years old and a diabetic. Medically speaking he probably should’ve been dead a long time ago. His doctor is still talking about putting him on a transplant list… :dubious:

  1. Wait time varies depending upon where you are, and what your OPO (Organ Procurement Organization) you have. Some people can get dual listings. OPOs are regional, and some have slightly overlapping regions (Dallas and Fort Worth have two separate OPOs so people can get listed on both).

  2. No

I work in the Transplant Department.

I can’t give you answers on average wait times, but kidney transplants aren’t limited to family members now. A friend of mine needed one about a year ago. No family members were available. We found 6 potential donors among friends. It took a blood type match, and then the best candidate (health, medical coverage, availability of time off, etc) had some extra blood work done, to check into minimizing rejections.

It seems that current meds can greatly expand the pool of potential donors.

Kidney transplant patient speaking here.

The time to wait for an organ in the U.S. depends on the region, and whether the region follows any protocol or rules of triage governing who’s first in line for the organ.

Some regions, for instance, want the organ to go to the best patient: that is, between two otherwise identical candidates, they might give the organ to the married man with kids over the single man with none, as the married man has dependents who rely upon his health and income. Smoking, alcohol and drug use, and the patient’s likelihood of compliance are taken into account, among other factors. (This is a good reason to listen to your doctor!) Such a place is New Jersey (last I heard, anyway).

Other regions may choose to do the transplant for whoever’s got the cash, irrespective of long-term prognosis. Such a place is New York State.

The waiting list for an organ also depends on your blood type, as some types are more common than others — more patient waiting in line, yes, but also more potential donors.

The last I heard, about 5 years ago, was that the waiting list for a liver in New Jersey was 9 months. In New York, it was 18 months. I couldn’t say for sure on kidneys, though the difference is probably comparable.

Diabetic patients get kidney transplants — but more often, they get kidney-pancreas.

The only really big medical do-not-transplant indicators would most likely be a patient who could not survive the operation itself, due to pre-existing heart conditions or poor lungs, or age, or similar. Transplant patients are also screened for AIDS and various cancers. As noted above, some regions choose not to perform a lung transplant for a 3-pack-a-day smoker unless he gets his habit under control.

Kidneys are tissue-typed in addition to matching compatible blood types. There are 6 potential antigen matches. You could do a transplant with an organ that had 0 of 6 matches; the medications today could work, in theory. However, the closer the match, the fewer immunosuppressant drugs you need to take — and bear in mind that the immunosuppressants are very hard on the kidneys themselves, so loading up on drugs isn’t the best answer.

Tissue match is another part of the organ selection process, at least for the catch-as-catch-can cadaveric organs. If a rare 6-of-6 match comes up for someone way down the list, it’s possible that they get that kidney — even though that guy’s not at the top of the list, you don’t wanna waste a perfect match.

All of this post is courtesy of the transplant clinic at the University of Washington, as best as I can remember. If accuracy is called into question I will look up cites, but I went through a whole clinic on this stuff prior to transplant so I’m pretty darn sure on most of it.

Is the lifestyle of the donor impacted in any way by donating a kidney? Are there certain activities they can’t participate in as often or at all?

Kidney donor here.

In concept there is a risk of damage to the remaining kidney (due to injury, cancer or whatnot) and not having a backup. In the real world though there really isn’t any risk. I am aware of only one study of long term effects of donor nephrectomy, which showed the risk of kidney disease was equivalent to that of the general population. There were a couple of people who developed kidney damage due to high blood pressure and/or diabetes, and one guy had kidney damage when he was hit by a softball.

Also, a study was made of World War II veterans who had lost a kidney in combat which also showed no effect on long term health or quality of life.

I have had zero problems since donating. I even nagged the urologist and was able to return to work a week early. I will say that I was incredibly nervous when helping coach my son’s little league team that spring, though I wouldn’t give it a second thought if he were playing today.

My first operating urologist lectured me (preached, actually) about lowering the amount of protein that I ate, but he seemed a little out of touch. In any case, he was dismissed from the hospital early in the qualification process and I haven’t heard anything that backs him up.

Not really answering the question, but… There is a woman I work with whose daughter needed a kidney transplant. Something happened last summer (05’)and they needed to be removed. She was only 10 years old. I am happy to report that the woman called us about 2 months ago to let us know that the daughter was getting the transplant that night. So in her case the wait was about a year.

Yes: they can’t donate a kidney. :slight_smile:

You can get a kidney transplant in China. Wait time is very short, a matter of days while they get a match. Of course, there are other “issues” involved.

I know this is going to make me sound like a dummy, but I don’t want to trust my assumptions as to what you’re alluding to without knowing for sure. Can you elaborate?

One of my friends at work is going through the process of being approved to donate a kidney to her mother. It is a lot of work and she’s gone to the doctor for just about every test known to mankind. During one of the tests, they thought she had liver cancer.

She didn’t.

She’s much happier now.

I think the whole process may take her close to a year of being approved to donate.

This is really shallow but… I once saw a photo of the torso of a kidney donor, and he had a scar shaped sort of like an upside down ‘7’ that stretched almost from hip to well up on the rib cage. :eek:

Do they really have to slice you open THAT much? I’d find the idea of that big a cut much more off-putting than the absence of a kidney.

I once had a girlfriend with that scar. It’s just a scar. Yeah, it’s big, but it’s just not a big deal. Liver transplant scar: Also large. Bypass surgery scar: May also be large.

I think you misunderstand. It’s not the scar, but what the scar shows. That is, that someone took a knife and sliced you open most of the length of your body! :eek: :eek: :eek:
Sorry, the thought just scares me.

There are different ways that they can do the kidney excision procedure.

What you may have seen is a standard nephrectomy, which is a highly invasive procedure. I believe that kind of donation sometimes means they have to remove part of a rib in order to get the kidney out, but I haven’t found a site to back that up.

The other way to perform the nephrectomy is laporoscopically — also called keyhole surgery. They stick a scope through a small slit in your abdomen and perform the surgery … well, in the dark, basically, with remote control instruments. The slit need only be as wide as the instrument going in, the organ coming out, and the surgeon’s hands.

More here from a website by the Mayo Clinic.