Tell me about... the different types of kidney transplants

Many patients with end-stage kidney failure have to go on dialysis, as seen in this filepic, while waiting for a donor kidney and many often die without getting a new kidney.

I was told that there are different types of kidney transplants. What types are there?

There’s one where the kidney comes from a donor who is already deceased. Usually, it is someone who has just recently died and has signed up for an organ donation programme. If this person has signed up, he or she will usually have an organ donor card. Alternatively, the family can also consent to it.

But the kidney is dead? What use is it to me then?

Actually, the kidney is not dead yet – even if the donor is medically dead. It still can be used and harvested. It is then stored on ice or connected to a machine that provides it oxygen and nutrition until it can be transplanted to a recipient. It is preferable that the donor and recipient be in the same area to ensure that the kidney does not spend too much time outside a living human body.

Is this type of transplant common?

Kidneys from deceased donors account for about two-thirds of kidney transplants. There is a very long waiting list for donor kidneys worldwide. Many patients with end-stage kidney failure have been on dialysis, waiting for a donor kidney. Many have died after a futile wait. And you can’t just accept any kidney from any deceased donor. It is like receiving donated blood. You have to have compatible blood types between the donor and the recipient.

Selena Gomez, kidney transplant, organ donation,
Gomez had a kidney transplant donated from her friend. The important thing is not being related, but having compatible blood and tissue typing. — AFP

Selena Gomez received a kidney from her best friend. I assume this is a living donor kidney transplant?

Yes. You only need one kidney to survive. The body has two because the other one is a backup. Based on this concept, a healthy person with two kidneys can donate a kidney to someone else. One-third of all kidney transplants are living donor transplants.

Is this a better option than a deceased donor transplant?

There are certain things that make live donor kidneys better. For example, you don’t have to wait months, or even years, waiting for a donor to die before you get your kidney. That way, your kidney function does not have to deteriorate further. You can then save a lot of money on months or years of dialysis fees. Living donor kidney transplants offer better survival rates. And living donor kidneys start working immediately in the recipient’s body after transplantation compared to deceased donor kidneys, which sometimes can have delayed function because they have been put on ice for a while.

Does the living donor have to be a sibling or a relative? Gomez got one from her friend, and they are not related, right?

Just as a deceased donor does not have to be related to you, a living donor does not have to be related to you either. The living donor can be your friend, neighbour, colleague or anyone you know from your circle of acquantainces. However, if you are genetically related – such as family members are – there is a higher chance of success. The important thing once again, is that you share compatible blood and tissue typing.

Dialysis, kidney transplant, organ donation,
Many patients with end-stage kidney failure have to go on dialysis, as seen in this filepic, while waiting for a donor kidney and many often die without getting a new kidney.

My sister wants to undergo a kidney transplant, and I am willing to donate. However, my blood type is not compatible with hers. She can’t find anyone else to donate, and she was told that the waiting list for deceased donors is several years. What can I do?

Even if the donor is not a complete match, there are ways to ensure success with additional medical suppression of the recipient’s immune system before and after the transplant surgery. This is to reduce the risk of rejection. There is such a thing as a paired donor programme. If your living donor is not compatible with you, your transplant centre can alert your donor to give to someone else compatible to his kidney, and you in turn will receive a compatible kidney from that recipient’s donor. It should be noted that a kidney transplant is not a cure to whatever disease you are having.

Is a kidney transplant a dangerous and very complicated procedure?

It is considered a major surgery, and like all surgeries, it has risks. But the benefits may far outweigh the risks, and that is the way you have to look at all surgeries and procedures. For example, during the surgery itself, you can get blood clots like deep vein thrombosis, bleeding, infections, leakages from tubes and rejection of the donated kidney. You can also get infections, or even cancer, from your new donated kidney if it has not been screened properly. In very rare cases, surgeries can be fatal. But like I said, all these are risks with any surgery. Later on, you have to go on lifelong immunosuppressive drugs to prevent your body from rejecting the new kidney. These come with a variety of side effects as well.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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