Rejection & going back on dialysis

[MelissaJean]

It seems many people on this site go back to dialysis when their transplanted kidney has rejection.  When I asked my dialysis nurse if I could go back on dialysis if my transplanted kidneys reject she told me no.  Are there certain reasons why someone couldn't go back on dialysis after their kidneys reject?
Also, if your body is fighting your foreign kidney, how does dialysis help you live?

[Zach]

Everyone's situation is different.

But in general, if the transplant fails, you go back on dialysis.
That is unless you receive a new transplant right away.   

[Sara]

It seems many people on this site go back to dialysis when their transplanted kidney has rejection.  When I asked my dialysis nurse if I could go back on dialysis if my transplanted kidneys reject she told me no.  Are there certain reasons why someone couldn't go back on dialysis after their kidneys reject?
Also, if your body is fighting your foreign kidney, how does dialysis help you live?

What did the nurse expect one to do?  Die? 

[livecam]

It does seem like alot of people have had to return to dialysis after a transplant.  The whole thing is making me paranoid!  Anyway if the kidney rejects or just wears out over time you still have to replace it's function.  So its back to hemo, pd, or if really really lucky another transplant.  I think we're going to see transplants continue to function better and last longer.  Newer drugs and using minimal quantities of those drugs all bode well for long lasting transplants.  Right after my transplant I used to say it would have been worth it if it only lasted a week.  One thing for sure, if I had continued on dialysis much longer I wouldn't be here today.  The side effects such as out of control blood pressure during treatment were killing me. It is worth it.

[coravh]

It seems many people on this site go back to dialysis when their transplanted kidney has rejection.  When I asked my dialysis nurse if I could go back on dialysis if my transplanted kidneys reject she told me no.  Are there certain reasons why someone couldn't go back on dialysis after their kidneys reject?
Also, if your body is fighting your foreign kidney, how does dialysis help you live?

It seems to me that your nurse didn't really know what she was talking about. Almost everyone who loses their kidney goes back on dialysis unless they choose to die. Dialysis works the same way if you are in rejection or not. It takes excess substances (potassium etc) and fluid out of your system to keep you alive.

Cora

[Zach]

I mentioned this in a different post:

A nephrologist at my center once explained what he called, The Cycle of Treatment for the Chronic Kidney Patient.  In that presentation he said, in many cases, a kidney patient should expect to go from dialysis to transplant to dialysis to transplant during their lifetime.

It was one of the most intellectually honest transplant presentations I have ever seen.     

[MelissaJean]

Thanks for your responses.  I thought such was the case, but just wanted to check!

[angieskidney]

It seems many people on this site go back to dialysis when their transplanted kidney has rejection.  When I asked my dialysis nurse if I could go back on dialysis if my transplanted kidneys reject she told me no.  Are there certain reasons why someone couldn't go back on dialysis after their kidneys reject?
Also, if your body is fighting your foreign kidney, how does dialysis help you live?

It seems to me that your nurse didn't really know what she was talking about. Almost everyone who loses their kidney goes back on dialysis unless they choose to die. Dialysis works the same way if you are in rejection or not. It takes excess substances (potassium etc) and fluid out of your system to keep you alive.

Cora

Ya I agree! I am surprised that nurse had said what she did and must not know what she is talking about because I was on dialysis, had a transplant, and am now back on dialysis and am in fact on the transplant list for another transplant. That is what is expected for my life! I am too young to die (even though it is possible .. I accept that) but if I could not go back to dialysis ... I would have been dead 5 years ago

[Panda_9]

Im in the same boat angie, dialysis, transplant, dialysis, waiting for weight loss for transplant. Im really only just realising the reality of it now, and that this thing is going to be with me for the rest of my life.When I had the transplant I felt so good I didnt really think about it failing. It was a huge shock when it happened.

[GuyIncognito]

WOW, That nurse may be working in the wrong dept.
I had a preemptive transplant that was lost to a baterial infection and from there I went onto Hemo... and now I'm attempting to get back on the waiting list.
Always working towards a transplant... thats the focus

[stauffenberg]

The projected half-life (i.e., the time at which 50% of the transplanted organs shall have failed) of a transplanted kidney is 10.9 years if it comes from a cadaver and 17.7 years if it comes from a living donor, so if patients are young enough when they get a transplant, they can more or less expect some day to return to dialysis.  Although rejection is the cause of many graft failures, the new concept, chronic allograph nephropathy, has been developed to describe the gradual decline in function of a transplanted kidney from many causes, including the toxic effects of the immunosuppressive drugs themselves, the continuing effects of damage to the organ during transplant surgery, high blood pressure, itself often caused by the immunosuppressives, and the continuing, low level attack by the immune system.

[Zach]

I never have been quite sure as to how the "half-life" numbers are extrapolated.  What logarithm is used?

I thought these numbers might be helpful since they come from the U.S. transplant program itself:

                                                 3 Months
Deceased Donor Graft Survival           93.9%   
Living Donor Graft Survival                 97.1%
   
                                                  1 Year
Deceased Donor Graft Survival            89.0%
Living Donor Graft Survival                  95.1%

                                                  3 Years
Deceased Donor Graft Survival           77.9%
Living Donor Graft Survival                 87.9%

                                                  5 Years
Deceased Donor Graft Survival            66.7%
Living Donor Graft Survival                  80.2%

                                                  10 Years
Deceased Donor Graft Survival            40.5%
Living Donor Graft Survival                  56.4%
   
   

3 Years = 2000-2003
10 Years = 1993-2003 --Yes, a lot has changed in the anti-rejection medications since 1993.  But there is still no magic bullet ... yet.   

Source: OPTN/SRTR Data as of May 2, 2005.
http://www.optn.org/AR2005/default.htm

[BigSky]

I never have been quite sure as to how the "half-life" numbers are extrapolated.  What logarithm is used?

I thought these numbers might be helpful since they come from the U.S. transplant program itself.

As to the US transplant figures and to those of half life it may be that they are excluding patients who have passed in unrelated ways to the transplant.


I did see they say at 10 years that 60.7% of the patients were alive while 40.5% of the transplants were still going.  If I read that right then most of the surviving patients transplants would be working.  Only roughly a difference of 20% failure of transplants  vs surviving patients.    So roughly 67% of those still alive still have a transplant if I am reading that right. (deceased donor numbers)