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Author Topic: Deceased Donor Transplant Planning  (Read 11057 times)
okarol
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« on: June 03, 2007, 09:57:29 AM »

This is a general overview of standard procedure at many of the transplant centers in the United States. Each center may have a slight variation in their process, but this is a good basic explanation:

Cadaver Donor Transplant Planning

Waiting Time

When it has been decided that a living donor transplant is not possible for someone who wishes to have a kidney transplant, then the process of obtaining for a cadaver kidney begins. A cadaver kidney is a kidney that comes from someone who has recently died and whose family has consented to kidney donation.

When a cadaver transplant is planned, the recipient may need dialysis while waiting for the transplant. The waiting time can vary from months to years, depending on blood types. The average waiting time varies depending on blood type and location.

Monthly Antibody Screen

During the waiting time on the transplant list, blood tests are obtained every month. These are checked for antibody levels, which can change from month to month. It is necessary to have the "antibody screen" every month so that when a kidney is available we will have current blood samples needed for the final crossmatch. It is harder to find a kidney for people who have a high antibody level rather than a low antibody level. Therefore, people with a high antibody level (above 30%) will probably wait longer for a kidney. The blood sample is sent monthly from your dialysis center.

Matching Cadaver Kidneys to Recipients

Transplant programs participate in a national computer network which matches recipients and cadaver kidneys. This takes place through their procurement agency. Each time a kidney becomes available, its tissue type and blood type are entered into the computer and matched for the best possible recipient. The goal is to obtain the best possible match between kidneys and recipients regardless of location. As a result, a kidney for a transplant at your center can come from your home state or any other state.

Notifying the Recipient

When it has been found that a donated kidney matches a person on the transplant list, the procurement center is notified. The organ bank is ready to receive calls about kidneys 24 hours a day, 7 days a week. When a call comes in that a kidney is available, the transplant coordinator and the transplant surgeon on call are contacted. The transplant coordinator will then contact the patient. Because the call for a kidney may come at any time of the day or night and because an immediate answer is necessary in order to obtain the kidney, a person on the waiting list must have his mind made up that he is ready for a transplant. Sometimes someone has the flu or some other problem that would make it unwise from a medical standpoint to go ahead with the transplant. Therefore, the kidney is not actually accepted by the transplant team until they have asked the recipient if there have been any recent problems, infections, or blood transfusions.

Telephone Numbers of Recipients

Because the call for a kidney could come at any time of the day or night, it is essential that the transplant coordinator have any and all phone numbers where you might be reached (home, work, relatives, or any other numbers that might be helpful). Also, if you move, change telephone numbers, or will be out of town for prolonged periods, the transplant coordinator must be notified. It is the patient's responsibility to keep these phone numbers current. Sometimes they must accept the kidney within a certain time limit or it will go to someone else. If they cannot locate or talk to you, you could miss the chance for a transplant. They will not leave messages on answering machines because of time constraints.

Coming to the Hospital

When you are called and told that a kidney is available, you should have plans made to leave for the transplant hospital within an hour. You should not eat or drink before you come to the hospital because of the planned surgery. Please bring either a list of all your medicines or your medicine bottles with you to the hospital. Diabetic patients should bring their glucometers.

Final CrossMatch

When you arrive, you will be admitted to the hospital. Blood samples will be drawn. Sometimes a final crossmatch must be done between your blood, which is drawn when you come to the hospital, and a blood sample sent along with the kidney. This final crossmatch, which takes several hours, must show that there is compatibility between your blood cells and the donor's cells. At other times the crossmatch is done using the monthly blood samples that have been kept in the laboratory. In this case, the crossmatch may be completed before you get to the hospital. Either way, if the crossmatch shows incompatibility (positive cross-match), the transplant cannot take place and you will be sent home. The person with a high antibody level is more likely to have a positive crossmatch that shows incompatibility than the person with a low antibody level. If the crossmatch is negative and the patient is found to have no problems on physical exam, the transplant is done as soon as an operating room is available.

Back-Up Status

All transplant hospitals recognize the need to perform a transplant as soon as possible. For this reason, sometimes crossmatches are performed for more than one person at the same time. The people do not need to be in the same transplant center. This approach potentially shortens the time to transplant.

If more than one crossmatch is being performed, you may be called and told that there is a possibility that there is a kidney available on a back-up basis. This means that the kidney is a suitable match for you, but it is also suitable for someone else. Asking you to be a back-up depends on many things. The decision to ask someone to be a back-up is based upon the principles and federal regulations which govern the sharing and matching of kidneys, which gives each waiting recipient and transplant center fair and equal access to donated kidneys. You may be asked to come to the hospital as a back-up. If you do not receive the kidney, you will go home and wait for another call. If everything works out, they will go ahead with the transplant as soon as possible. If you are going to be asked to come to the hospital on a back-up basis, they will tell you this when they call.

Pre-Operative Preparation

When you get to the hospital, you will have a physical examination, electrocardiogram, chest x-ray, blood studies, and dialysis if needed. The examination, x-ray, and electrocardiogram are to determine that you are medically fit for the transplant surgery. Dialysis may be carried out so that your body chemistries are in good balance. A physician will visit you and will ask you to sign consent forms for the operation, the anesthesia, and for blood transfusions which may be needed during surgery.

While you are in the hospital, the transplant surgeons and nephrologist will both be taking care of you.

The transplant team may be conducting some research studies. You may be contacted by them in order to explain the study and to ask if you would be willing to participate. The willingness to participate in any study is a matter of personal choice, and you are free to say yes or no. When the operating room is available, you will be taken there and the transplant will be done.

You will not know the name of the donor of a cadaver kidney. The family of the donor will not be told your name by anyone in the transplant program. These rules are strictly enforced to maintain the privacy of both the donor family and the transplant recipient.
« Last Edit: March 15, 2011, 02:28:32 PM by okarol » Logged


Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
okarol
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« Reply #1 on: March 02, 2010, 11:46:16 AM »

 :bump;

The term "cadaver donor" is now often replaced with "deceased donor." This is still a pretty good overview.
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Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
Rerun
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Going through life tied to a chair!

« Reply #2 on: March 15, 2011, 05:57:52 AM »

Did they have to dummy down the word?   :rofl;
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Sugarlump
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10 years on and off dialysis

« Reply #3 on: March 15, 2011, 08:40:11 AM »

What is the difference between a beating-heart donor and a non-beating-heart donor.
In terms of technicality and in success rates for transplant?
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10 years of half a life
3 years HD 1st transplant Feb 08 failed after 3 months
Back to HD 2nd transplant Dec 10 failed after 11 months
Difficult times with a femoral line and catching MSSA (Thank you Plymouth Hospital)
Back on HD (not easy to do that third time around)
Fighting hard (two years on) to do home HD ... watch this space!
Oh and I am am getting married 1/08/15 to my wonderful partner Drew!!!
The power of optimism over common sense :)
okarol
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« Reply #4 on: March 15, 2011, 02:26:50 PM »

Deceased donors may be either beating heart or non beating heart donors.
Beating heart donors have suffered brain stem death and are maintained on a ventilator in an intensive care setting.
Non beating heart donors are used rarely as death has been determined by the heart stopping and cessation of their respiratory function and are therefore associated with increased warm ischemic time which can damage the donor organs. However, the increased use of such donors is one way to help try and meet the current demand for organs for transplantation.
« Last Edit: March 15, 2011, 02:28:05 PM by okarol » Logged


Admin for IHateDialysis 2008 - 2014, retired.
Jenna is our daughter, bad bladder damaged her kidneys.
Was on in-center hemodialysis 2003-2007.
7 yr transplant lost due to rejection.
She did PD Sept. 2013 - July 2017
Found a swap living donor using social media, friends, family.
New kidney in a paired donation swap July 26, 2017.
Her story ---> https://www.facebook.com/WantedKidneyDonor
Please watch her video: http://youtu.be/D9ZuVJ_s80Y
Living Donors Rock! http://www.livingdonorsonline.org -
News video: http://www.youtube.com/watch?v=J-7KvgQDWpU
MooseMom
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« Reply #5 on: October 11, 2011, 04:44:38 PM »

You know, even though I've been listed for a bit over a year, this is the first time I dared read this thread.
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
sullidog
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« Reply #6 on: October 11, 2011, 06:30:27 PM »

It would be nice if my transplant unit would get it together and transfer info to my new clinic
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
MooseMom
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« Reply #7 on: October 11, 2011, 08:33:02 PM »

It would be nice if my transplant unit would get it together and transfer info to my new clinic

You stay on their case about that!
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"Eggs are so inadequate, don't you think?  I mean, they ought to be able to become anything, but instead you always get a chicken.  Or a duck.  Or whatever they're programmed to be.  You never get anything interesting, like regret, or the middle of last week."
Emerson Burick
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« Reply #8 on: August 09, 2012, 07:48:33 PM »

Did they have to dummy down the word?   :rofl;

"Deceased donor" has better alliteration than "Motorcycle Rider."
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jbeany
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Cattitude

« Reply #9 on: August 09, 2012, 07:51:39 PM »

Around here, that's Donorcycle Rider, especially now that we've got a no-helmet law in Michigan!
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"Asbestos Gelos"  (As-bes-tos yay-lohs) Greek. Literally, "fireproof laughter".  A term used by Homer for invincible laughter in the face of death and mortality.

bleija
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« Reply #10 on: August 09, 2012, 08:33:34 PM »

Did they have to dummy down the word?   :rofl;

"Deceased donor" has better alliteration than "Motorcycle Rider."


lol :clap; very nice first time ive genuenly laughed today, thank you i needed that
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Clara
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« Reply #11 on: August 11, 2012, 11:30:29 PM »

I just started the process for pre-transplant and my neph seems to think a transplant can happen before dialysis.  I am a type O.  I suspect that means a longer waiting list from what I have been reading.  I am applying for Kidney and Pancreas so anybody know the waiting times for these?  Is my Doctor be too optimistic?  I just need to prepare myself.
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