Living Donor Kidney vs Cadaver Kidney?

[TeenHatesDialysis]

My teenage daughter has been on dialysis for 16 months and has been on the "List" for a kidney since May 2007. Unfortunately, I am blood type A and she is blood type B so she needs a kidney from a Blood type O or B donor or a cadaver B kidney. I have been told that a living donor kidney 0 out of 6 antigen match is better than a 6/6 antigen match cadaver kidney? My daughter will take any kidney, but I was wondering what other IHD'ers have heard. Input please. Thank you.

[pelagia]

Here are a couple of sites with useful information:

http://www.livingdonorsonline.org/HLAData.htm

http://emoryhealthcare.org/departments/Transplant/kidney-transplant/Transplant_Evaluation.html

[TeenHatesDialysis]

Thanks for the links. They indicate that a living donor regardless of the match, even 0, is preferred over a cadaveric kidney. 

Since a living donor is preferred over a cadaveric kidney why would anyone reject a 50 year old living kidney donor 1 antigen match for a teenager? Donor Blood type 0, recipient B.  The hospital where I hope to have my daughter's kidney transplant has an age requirement for donors. The donor must be between the ages of 18-50 and several people have asked me why I would consider someone 50 years old as a kidney donor for my teenager daughter.  I feel truly blessed that anyone is willing to donate a kidney to my daughter and I really do not consider 50 old. This person has not been accepted or rejected, but why are so many medical professionals asking why I would consider a 50 yr old's kidney. Am I missing something?? Since I am blood type A and have another daughter that needs my kidney and all potential donors so far have been rejected, I feel truly blessed that someone wants to donate a kidney. Are there more medical complications for the recipient due to the age of the donor? Input please. Thank you.

[Wallyz]

A 50 year old transplanted kidney only has 15-20 years of good funciton left.  They are going to try for a younger kidney.

[BigSky]

This study suggest a CD 6 antigen match is better than a 1 antigen match from a LD in children. 

There are some stats online that list match and survival rates.  However I lost the link with a update from windows a few weeks ago.

Titre du document / Document title
Do six-antigen-matched cadaver donor kidneys provide better graft survival to children compared with one-haploidentical living-related donor transplants ? A report of the North American pediatric renal Transplant Cooperative Study
Auteur(s) / Author(s)
TEJANI A. (1) ; SULLIVAN E. K. (2) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Pediatrics and Surgery, New York Medical College, Valhalla, New York, ETATS-UNIS
(2) The EMMES Corporation, Potomac, Maryland, ETATS-UNIS
Résumé / Abstract
Since 1991, more than 50% of pediatric transplant recipients have received a living donor (LD) kidney, and 85% of these allografts were one-haploidentical parental kidneys. Short-term (1 yr) and long-term (5 yr) graft survival of LD kidneys are 10% and 15% better, respectively, than that of cadaver donor (CD) kidneys. Because of these results, children are frequently not placed on a cadaver waiting list until the possibility of a LD is excluded - a process that may take up to 1 yr. The hypothesis for this study was that the graft outcome of a six-antigen-matched CD kidney is superior to that of a one-haploidentical LD kidney, and that children are at a disadvantage by not being placed on a CD list whilst waiting for a LD. The database of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) for 11 yrs (1987-98), was reviewed to identify children who were recipients of a six-antigen-matched CD kidney (primary and repeat transplants), and those who were recipients of a one-haploidentical LD kidney (primary and repeat transplants). Using standard statistical methods, the morbidity, rejection episodes, post-transplant hospitalizations, renal function, long- and short-term graft survival, and half-life of primary recipients were compared in the two groups. Unlike adult patients, only 2.7% (87/3313) of CD recipients in the pediatric age range received a six-antigen-matched kidney, and the annual accrual rate over 11 yrs was never higher than 4%. Comparison of 57 primary six-antigen-CD kidneys (PCD) with 2472 primary LD (PLD) kidneys revealed that morbidity, rejection rates, and ratios were identical in the two groups. Renal function and subsequent hospitalizations were also identical in the two groups. Five-year graft survival of the PCD group was 90% compared with 80% for the PLD group, and the half-life of the PCD group was 25 ± 12.9 yrs compared with 19.6 ± 1.3 yrs. Our data suggest that the six-antigen-matched CD kidney may have less graft loss as a result of chronic rejection and would therefore confer a better long-term outcome. Based on these findings we recommend that all children, whilst waiting for a LD work-up, be listed with the United Network for Organ Sharing (UNOS) registry for a CD kidney.

http://cat.inist.fr/?aModele=afficheN&cpsidt=1402540

[acspears]

my boyfriend is also on the waiting list, however for his 2nd transplanted kidney
he had his first kidney transplant in 2004 from his father who was a perfect match however, his body just rejected it unfortunately and he's looking to start dialysis in the next few weeks

you might want to check with your hospital on a certain organ donation option.  I don't know the name exactly but here is how the program works:  your daughter needs a type A and you are type O while another family needs a type O and has a type A to give, so basically you swap kidneys.  sometimes the chain is huge and you are giving to someone who will give theirs to someone else and that someone else will pass their kidney onto you etc.

goodluck

[paddbear0000]

The reason you don't want an older kidney is because everyone's kidney's function declines as they age. You want the youngest kidney you can get, especially for someone as young as Jaclyn. Every time you have a kidney transplant, you build up more and more antibodies (PRA, or Protein Reactive Antibodies). The higher your PRA, the fewer kidneys that will be available to you. For example, if your PRA is 88, than 88% of kidneys will react with yours. Besides, the fewer the surgeries over her life the better. No one wants surgery!