Matching for Transplant

Related donor kidneys survive better than cadaveric kidneys. Why? Because they are better matched and "fresher" - taken straight from a heart beating body in a few minutes. The latter reason will make living unrelated donor kidneys work better and longer as well. Now if your hopes are limited to a cadaveric kidney it depends what you want. Long survival with a well functioning kidney? You better opt for a good match in a kidney not sitting around for hours. If it is just to get off dialysis as quickly as possible you may be willing to undergo the "battery exchange" or a new kidney every few years. The problem with the "battery exchange" is that there are not enough kidneys available. Potent immunosuppressives used today can overcome antigen mismatching but may not give longer kidney survival and if used excessively pose the risk for later development of malignancy. You need to be good consumers in getting a kidney transplant and can be if you can make dialysis work for you in the interim while awaiting your kidney which hopefully will work for a lifetime. You may want to be careful of a transplant program where the doctors see you as just another potential statistic and do not seen interested in meaningful communication. On the other hand, you may not care, just want a kidney, and that is your choice.

Peter Lundin

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