Dialogue between doctor and patient regarding kidney donation
Answers
Answer:
Dr. Barry: Good morning. Your Nephrologist has referred you to our center for evaluation of your kidney transplant surgical candidacy. I understand that the cause of your end stage renal disease is Diabetes Mellitus Type II and that you are not yet on dialysis.
Pt: yes, that’s correct.
Dr. Barry: Do you have any friends or family members that are interested in donating a kidney to you?
Pt: I’m not sure. How does one become a donor?
Dr. Barry: Living donor kidney donation involves identifying a family member or an emotionally related donor (e.g., spouse or good friend) who has a compatible blood type with the recipient, is in good health and has no risk of kidney problems in the future such as diabetes or high blood pressure. If a donor is identified who meets these initial criteria, he or she will then undergo an extensive psychosocial evaluation, physical exam, laboratory tests including more detailed screens for immunologic compatibility and imaging tests (X rays and MRI scan) to assure normal anatomy and absence of intrinsic kidney disease.
Pt: What is the risk to the donor?
Dr. Barry: If the donor passes our rigorous screening procedures, then we will arrange for a simultaneous surgical procedure in which the donor’s kidney is removed and immediately transplanted into the recipient. We almost always perform the donor surgery laparoscopically (see video of left kidney removal or right kidney removal), using small incisions, and the patient stays in the hospital for two to three days. The risks include adverse reactions to general anesthesia, bleeding, infection and possible conversion from a laparoscopic to open procedure. These risks are minimal and the chances of having to perform an open procedure are less than 1%.
Pt: What are the advantages of living donor kidney transplant?
Dr. Barry: The main benefit is that we can perform the transplant within months of identifying a suitable donor. The waiting time for a deceased donor transplant (formerly called cadaveric transplant) is 4 to 5 years here in our region. Also, living donor kidneys are more likely to function immediately, lessening the likelihood of the recipient needing temporary dialysis after the transplant. Finally, living donor kidney transplant recipients enjoy better long term graft survival.