What Functions do the
Kidneys Perform?
The
kidneys are a pair of bean shaped organs located behind the abdominal organs,
and on either side of the spine. They perform the following important
functions.
- Filtration of waste products and
toxins in the blood
- Excretion of fluid and maintaining
the correct fluid balance
- Control of blood pressure
- Production of erythropoietin, a
substance that prevents anemia
- Maintenance of the acid base and
electrolyte balance of the body.
Types of Donors
A
person who donates an organ is called a donor and the patient who receives the
organ is the recipient.
The
donor may be a person who has suddenly died and is a registered donor. Such
donors are referred to as
deceased or
cadaver donors. In certain cases, the organ may be donated by a close
relative. Such donors are called
living
donors.
Renal Transplant in
Brief
It
is a surgical procedure carried out
to
place a healthy kidney from a donor who may be either living or dead, into a
patient whose kidneys have failed.
Features
of
kidney failure appear only when more than 90% of the
function is lost. In such patients, a procedure called
dialysis is
done, which is an artificial method of filtering the blood of waste and toxins.
In
patients with
end stage renal
disease, a
renal transplant may help save
their life.
Compared
to dialysis, the quality of life following a renal transplant is better and
most are able to return to their earlier lifestyle.
How the Kidney
Transplant Network Operates
Donor
organs are matched with potential recipients by a registry containing all the
relevant data such as donor list, waiting list of recipients and list of
transplant centers.
If
a registered donor suddenly dies, the registry will be notified and should the
organs prove to be a match for a waitlisted recipient, they will be in turn
notified to get ready for the transplant procedure.
However,
the
list of patients on the waiting list
for a kidney transplant far exceeds the numbers of donor kidneys actually
available, leading to constant discussions on how to overcome the organ
shortage and in some countries this has lead to organ trade and other unfair
practices.
In
the US, the average waiting time is 3 to 5 years, depending on the blood group.
The situation is no different elsewhere in the world too, with prolonged
waiting periods to receive a matching donor organ.
Promise of Preference
for Living Donors - Is it being Implemented?
In
the US,
living donors have been promised
that they will get priority access to organ transplant in the future,
should they fall sick and need one.
Studies
conducted by
Jennifer Wainright, PhD (United Network for Organ Sharing, or UNOS) and
her colleagues determined how promptly living donors received their transplant.
To do this, they
gathered data from the Organ Procurement and Transplantation Network (OPTN),
which contains data on all donors, wait-listed potential recipients, and those
who have already received transplants.
UNOS is a private,
not for profit organization that runs the organ transplant system of the USA,
on contract with the federal government.
What the Studies Revealed?
The highlights of
Dr.Wainwright's studies are as follows -
- 210 prior living donors were added to the OPTN renal transplant waiting list between January 1, 2010 and July 31,
2015.
- Data revealed that until September 2015, 167 of the donors got
deceased donor transplants, 6 obtained living donor transplants, 2 died, 5
were too sick to undergo the transplant, and 29 were still waiting for
their turn.
- The average waiting time
to get a cadaver donor transplant
for prior living donors was 98 days.
- Only 40.7% of the living donors were on
the list before they started
dialysis; 68.3% were in inactive status, meaning they were not eligible
for organs for <90 days, 17.6% for 90-365 days, 8.6% for 1-2 years, and
5.4% for more than 2 years.
- The average waiting time for
prior living donors who were in active status before obtaining priority
was 2 days; 67.4% received priority within 7 days after activation,
while 15.4% waited between 8-30 days, 8.1% for 1-3 months, 4.1% for 3-12
months, and 5.0% waited for more than a year in active status to get
priority.
- After receiving priority, most patients were transplanted quickly,
and the median time in active
status with priority before deceased donor transplant was 23 days.
According to Dr
Wainwright, "
We found
that most prior living kidney donors on the kidney waiting list are
transplanted quickly, but some spend varying periods of time waiting in
inactive status. Others wait weeks or months on the waiting list without
priority access, which must be requested by their transplant hospital," said
Dr. Wainright.
"UNOS has eveloped
procedures and education that aims to reduce these delays in the future."
References :- The Waiting List - (http://www.kidneylink.org/TheWaitingList.aspx)
- UNOS Transplant Waitlist Status - We need your input by February 28, 2014! - (https://www.kidney.org/transplantation/transaction/TC/winter14/UNOS_Committee)
- The State of U.S. Living Kidney Donors - (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974389/)
- Why You May Need a Kidney Transplant - (http://www.emoryhealthcare.org/transplant-kidney/learn-about/why-needed.html)
Source: Medindia
