Getting schooled

   A short history:
The science behind organ transplants has advanced enormously over the last fifty years. In 1954 the first successful kidney transplant was performed from a living donor to his identical twin. Since then doctors have been working tirelessly to find new and less invasive ways to transplant kidneys and other organs. Researchers have also been inventing countless new immunosuppressive medications. The advancements that have been made with these medications in the last 25 years has had a tremendous impact on the outcome for transplant recipients. As a result transplantation has proven to be a viable option for people suffering from end-stage organ failure.

  The Kidneys:
The kidneys are located on both sides of your spine, behind the liver and the stomach. Only one healthy kidney is needed to live a normal healthy life. Most people are born with two kidneys, however some people are born with only one and some people have three. Kidney disease will rarely affect only one kidney, so end-stage kidney failure affects both kidneys equally.

The Kidneys play a very important role in our body. They:
 -clean and filter waste products from your blood
-regulate minerals such as potassium, sodium, calcium, phosphorus and other chemicals in the blood that regulate the blood ph(acid/base balance). This is why watching your diet can play an important roll in helping to lighten the load on your kidneys.
-control water/fluid balance
-regulate red blood cell production, and blood pressure control
The kidneys also filter waste material and excess fluid from the body, making urine.When kidneys work properly they keep waste products in the blood at a healthy level. When the kidneys do not work properly they lose their ability to filter waste products from the blood. Excess waste and chemicals start to build up in the body. This is kidney failure. There are many causes of kidney failure, the most common are: diabetes mellitus, hypertension(high blood pressure), glomerulonephritis, and polycystic kidney disease. There are only two forms of treatment, dialysis and transplantation.

 Dialysis is where a machine is used to filter your blood for you. This can be done in a hospital or at home. Its very time consuming, needing to be performed 3-4 days a week for 4 hours each time.
  Kidney transplantation:
There are two types of transplants: living donors and deceased donors(only available for dialysis patients with few exceptions).
The one-year success rate for recipients of living transplant is 95%. The success rate for recipients of deceased donor transplants is about 85-90% at the end of the first year after transplant. Because of the  better outcome with living donor transplants, the transplant program strongly encourages living donation. The functioning transplanted kidney is about five times more effective in replacing kidney function as compared to dialysis.

  Advantages of living donation:
-With a living donor there is more time to find the best possible match among donors.
-Kidneys that come from living donors are usually in better condition and begin to function immediately after transplantation.
-Transplant surgery can be scheduled at a convenient time for both donor and recipient rather than an emergency operation.
-The recipient is able to start taking immunosuppressant drugs three days before the operation which decreases the risk of rejection.
-The recipient will not have to take as much anti-rejection medication after the transplant as they would with a diseased donor. Therefore likely experiencing fewer side effects due to medication.

  Steps for receiving a living donor:
Before donors are evaluated, the recipient needs to be evaluated to be sure they are healthy enough to except a kidney.
-They will likely receive a physical exam, discuss meds, take a blood test, get an ekg and chest x-ray. The doctor may also have a tissue typing done. Counseling may also be recommended by the doctor before they go any further.
-More tests will then be done, such as: hepatitis vaccine, mammogram and pap smear (for women), gallbladder ultrasound, bladder ultrasound, heart echo, heart stress treadmill, cardiac catheterization, blood vessel ultrasound, dental exam, and more.

  I'll stop right there for now. Quite a bit to digest I know, but I have been receiving lots of questions from people interested in the process. Next time I hope to cover a little bit of the donor side. This is not a step by step but just an overview for those who are curious about both kidney disease and donation.