The Donation Process:
Where Kidneys Come From
Kidneys for transplantation can come either from living donors or from the generous donation of organs by the families of brain or cardiac death victims (deceased donor kidneys). Living donors are frequently close relatives (living-related donor) or friends or spouses (living unrelated donor) of transplant candidates. Acceptable living donors can donate one of their two kidneys and lead a normal and healthy life with the remaining kidney.
There are several major benefits of living donor transplantation. First, the waiting time before transplantation is usually very short. Second, the results are significantly better than those with cadaver transplants. Third, the operation can be timed to suit the patient's needs and, occassionally, the patient may avoid chronic dialysis altogether. Timing transplant surgery also gives patients a better opportunity to prepare both physically and mentally.
There is little risk to the donor outside of the usual risks associated with anesthesia and surgery. The recipient's insurance plan usually covers the costs of the donor surgery and medical care. Ideally, living donors should be between 18 and 55 years of age and in excellent health. Prospective donors must pass a comprehensive examination before they are accepted.
California Pacific Medical Center has been performing an increasing number of living-unrelated donor transplants -- usually from a spouse or a friend emotionally related to the recipient. National results of living-related and living-unrelated transplants show similar success rates three years after the operation. These results are also superior to those from deceased donors.
Laparoscopic Nephrectomy for Living Donors
California Pacific's Kidney Transplant Program has been a pioneer in the use of laparoscopic nephrectomy, an advanced minimally invasive surgical procedure that makes living donation easier. This procedure benefits living donors by reducing incision size, recovery time and hospitalization.
Typically, laparoscopic nephrectomy donors are hospitalized for three days, compared to an average of five days with the typical open donor kidney transplant surgery.
California Pacific medical Center was the first transplant center in the San Francisco Bay Area to perform a laparoscopic nephrectomy in 1998.
The Organ Donor Network
With living kidney donation, surgery takes place when the donor and recipient have been medically cleared. If, instead, you choose kidney transplantation from a deceased donor, we place your name on the California Pacific Medical Center kidney transplant waiting list and the search for a compatible deceased donor kidney begins.
The California Transplant Donor Network (CTDN) is an independent organization that administers organ procurement in the Northern California region. CTDN is part of a larger nationwide registry called the United Network for Organ Sharing (UNOS).
These two agencies match waiting recipients with available donor kidneys based upon the length of time your name has been on the waiting list. They also consider severity of illness and medical factors such as size of donor and recipient, and the compatibility of blood and tissue types.
California Transplant Donor Network
1611 Telegraph Ave., Ste. 600
Oakland, CA 94612-2149
(888) 570 - 9400
United Network for Organ Sharing (UNOS)
1100 Boulders Parkway, Suite 500
P.O. Box 13770
Richmond, VA 23225
(804) 330 - 8500
Rarely, a deceased donor kidney that exactly matches your tissue type becomes available in a distant part of the country. Because the results of an perfectly-matched transplant may be superior, your name will automatically move ahead of others on the list.
Unfortunately, the number of patients on the waiting list continues to rise faster than the availability of cadaveric donors. As a result, the waiting time for deceased donor kidney transplantation has been increasing every year. We cannot predict exactly how long you will have to remain on the waiting list for a cadaveric kidney donor, but an average wait is between four to six years.
The Call You've Been Waiting For
Once your name has been activated on the waiting list for a cadaveric kidney, you will need to be prepared and ready to respond should a suitable donor kidney be found. We must move quickly to minimize the time between the removal of a donor kidney and the transplantation itself. We frequently ask that you carry a pager while waiting for an available organ or, if you live far away, you may be asked to move closer to California Pacific when you are near the top of the waiting list.
If you are paged, you should call our Medical Center immediately. More commonly, you or your contact person will receive a telephone call directly from our transplant nurse coordinator. We will give you specific instructions on when and where to arrive, what to bring and what to do concerning transportation to the hospital. Your special needs during this hectic time should be addressed well ahead with your friends and family.