Kidney transplant, living donation

Carrying out the kidney transplant

Corpse donation:

First, the attending physician with the support of a coordinator DSO (D.German S.foundation Organtransplantation) if there is an indication, the possibility of a Kidney transplant considered. The patient is then anonymously registered with the Eurotransplant agency in the Netherlands, placing them on a waiting list in order to be able to find a donor organ over time. A recipient is determined by Eurotransplant, who takes care of organ removal and transport DSO.

The waiting time for a corpse donation for a kidney transplant is on average five to six years and depends on various criteria. The organs are allocated on the basis of a point system (ETKAS = Eurotranplant Kidney Allocation System), which shows tissue matching of donor and recipient (HLA compatibility), blood group compatibility, medical urgency, waiting time, the existence of certain antibodies in the blood (PRA = panel reactive antibody) and distance between the donor region and the recipient center.
There is one in Germany Organ donation cardthrough which people can decide before their death whether they want to be considered as donors or not.

Before kidney transplantation, both in the case of the corpse donation and the living donation, the patient must have sufficient Vaccination protection received that polio, diphtheria, tetanus, Hepatitis B., Pneumococci such as Influenza includes. These vaccinations are necessary before a kidney transplant, as the patient receives medication to suppress the organ donation Immune system (Immunosuppressants) gets. This also increases the risk of contracting bacterial or viral infections, which means that vaccination can be prevented.

Living donation:

Persons close to the recipient (e.g. relatives) can choose one of your Kidneys donate (living donation). The personal relationship is a prerequisite for approval of living donation by one Ethics Councilto exclude financial reasons as the cause of the donation. In the case of living donations, too, the donor must meet certain health criteria and blood group compatibility and tissue compatibility (HLACompatibility) between donor and recipient in order to enable kidney transplantation.

If a patient receives an organ - corpse or living donation - this is surgically carried out together with the ureter (Ureter) usually to a specific region in the pelvis that Iliac fossa (fossa = Pit), transferred. Then the kidney blood vessels are sutured together and the (new) ureter to the bladder connected. The recipient's own kidneys are left in the body during a kidney transplant, except in special cases. The transplanted organ usually begins to function during the operation.

After the operation, preventive drugs against certain pathogens (Pneumocystis jiroveci, cytomegaly virus) and started lifelong immunosuppression therapy (suppressing the immune system). The latter includes the administration of steroids, calcineurin inhibitors, purine synthesis inhibitors and proliferation inhibitors, all of which are immunosuppressive drugs with different modes of action.