Types of Transplant

Living-Donor Transplantation

Living-donor transplantation can be scheduled more quickly than with deceased-donor transplantation. With living-donor transplantation, the waiting time can be reduced to just a few weeks.

Living-donor kidney transplants also offer additional advantages to both recipients and donors:

For Recipients

• The chance of rejection is less with a living donor.
• Short- and long-term outcomes are superior with a living donor
• Overall cost and length of the hospital stay is less with a living donor.
• The long-term results of living-donor kidney transplants between unrelated donors (spouses, distant relatives and friends) are as good as between related donors (parents, siblings and children).

For Donors

The living donor undergoes extensive medical evaluation prior to transplantation, sometimes revealing previously undetected conditions. In suitable candidates, some organs can be removed laparoscopically, with smaller skin incisions than traditional surgery, less pain after surgery, shorter hospital stays and quicker return to work.

The majority of donors call their experience "exceedingly positive," would donate again if given the choice, and experience "enhanced self-worth and sense of well-being."

Risk of death is generally the same as that associated with any major surgery performed under general anesthesia on a healthy patient. The major complication rate is two per 1000 cases and the minor complication rate is 8 percent.

Deceased-Donor Transplantation

The United Network for Organ Sharing (UNOS) and the Gift of Life–Michigan maintain the transplant waiting list for Michigan residents. UNOS and GOL are committed to the fair and equitable distribution of organs, which is based on a computerized and nationally agreed-upon point system. The DMC Harper University Hospital Transplant Program is a member of both of these organizations.

If it is decided that deceased-donor transplantation is the best option for you, your transplant coordinator will assist you with getting on the waiting list. During the waiting period, our transplant team will periodically update your medical status and share this information with your referring physician. This evaluation includes yearly visits to our Organ Transplant Center. We recognize the complex needs of transplant donors and recipients both before and after surgery, and treat our center as a central resource for all transplant-related issues.

Selection Criteria for Kidney Transplantation

DISCLAIMER:

Age, weight, substance abuse and other medical and surgical risk factors will be evaluated and suitability for kidney transplant will be determined on a case by case basis.

Recipient Inclusion Criteria

• Patients on dialysis (CKD stage V patients) or those with GFR < 20 ml/min

Recipient Absolute Exclusion Criteria

• Disseminated or incurable cancer
• Severe uncorrectable systemic conditions with short expected life expectancy
• Uncontrolled psychiatric disorder
• Proven habitual medical noncompliance or insurmountable psychosocial barriers to post transplant compliance
• Severe heart or lung disease requiring home oxygen use for greater than one year

Live Donor Absolute Exclusion Criteria

• <18 years old
• Hypertension (>140/90)
• Any form of diabetes
• Heart disease including MI, angioplasty, coronary artery bypass grafts, endocarditis
• GFR <80 ml/min
• BMI >36
• Positive hepatitis B surface antigen or Hepatitis C antibody
• Positive HIV status
• Single kidney
• Current pregnancy
• Sickle Cell Anemia
• History of multiple kidney stones
• Hematuria >5 RBC
• Proteinuria >300mg/day
• Active Cancer
• Financial incentive or donation under duress
• Uncontrolled psychiatric disorder
• Active or chronic infection
• Active/untreated substance abuse
• Inability to understand informed consent

Relative Contraindications

• ABO incompatibility with recipient (refer to MOD #200 A2/A2B live donor to O or B/B recipient)
• Cross-match incompatibility with the recipient
• Gestational diabetes history
• Kidney anomalies
• Sickle Cell Trait
• BMI >30
• History of cancer
• Strong family history of polycystic disease