A deceased-donor kidney transplant is when a kidney from someone who has recently died is removed with consent of the family or from a donor card and placed in a recipient whose kidneys have failed and no longer function properly and is in need of kidney transplantation.
The donated kidney is either stored on ice or connected to a machine that provides oxygen and nutrients until the kidney is transplanted into the recipient. The donor and recipient are often in the same geographic region as the transplant center to minimize the time the kidney is outside a human body.
Only one donated kidney is needed to sustain the body's needs. For this reason, a living person can donate a kidney, and living-donor kidney transplant is an alternative to deceased-donor kidney transplant.
Overall, about two-thirds of the nearly 18,000 kidney transplants performed each year in the U.S. are deceased-donor kidney transplants, and the remaining are living donor kidney transplants.
The demand for deceased-donor kidneys far exceeds the supply. The waiting list has grown from nearly 58,000 in 2004 to more than 100,000 in 2016.
Why it's done
People with end-stage kidney disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.
For most people with advanced kidney disease or kidney failure, a kidney transplant is the preferred treatment. Compared to a lifetime on dialysis, a kidney transplant offers a lower risk of death, better quality of life and fewer dietary restrictions than dialysis.
The health risks associated with a kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and the side effects of taking immunosuppressant medications needed to prevent your body from rejecting the donated kidney, which include a higher risk of infection and some types of cancer.
What you can expect
If your doctor recommends a kidney transplant, you may be referred to a transplant center or select a transplant center on your own.
You will be evaluated by the transplant center to determine if you are accepted as a kidney transplant candidate. Each transplant center has its own eligibility criteria.
If a compatible living donor isn't available for a kidney transplant, your name will be placed on a kidney transplant waiting list to receive a kidney from a deceased donor.
Everyone waiting for a deceased-donor organ is registered on a national waiting list maintained by the Organ Procurement and Transplantation Network (OPTN). A private nonprofit group, the United Network for Organ Sharing (UNOS), administers OPTN through a contract with the U.S. government.
UNOS categorizes deceased-donor kidneys according to how long they are expected to last. First priority to kidneys expected to last the longest goes to those candidates who are expected to need them the longest.
Additional factors used in matching deceased-donor kidneys include blood and tissue type matching and how long the candidate has spent on the waiting list. The federal government monitors the system to ensure that everyone waiting for an organ has a fair chance.
Some people get a match within several months, and others may wait several years. While on the list, you will have periodic health checkups to ensure that you are still a suitable candidate for transplantation.
When a compatible deceased-donor kidney becomes available, you will be notified by your transplant center. You must be ready to go to the center immediately for final transplant evaluation.
If the results of the final transplant evaluation are satisfactory, the kidney transplant surgery can proceed immediately.