Why is living donor kidney transplant better?

Categories: Nephrology

Why is living donor kidney transplant better?

Everyone has a pair of kidneys located on the posterior abdominal wall below ribs. The normal function of the kidney includes filtering the nutrients out of human blood and excreting urine. Sometimes kidney loses its ability to function normally. When the extent of its function is lost by 90%, it is known as end-stage kidney failure. Such patients need dialysis to remove waste and stay alive. Kidney Transplant is a restorative treatment that reinstates normal body functions by placing a functional kidney in the patient.

Kidney Transplant can happen in three ways:

Living Donor Transplant – Living-kidney donation is the commonest type of transplant. Anyone kidney of a healthy individual is donated and the other kidney can make the required functions.
Paired Kidney exchange – When you have a living donor available but, the issue concerned is incompatibility, another similar pair is found and exchange is made.
Deceased donor transplant– When a person dies, due to any cause and the guardian decides to donate their organs. This also happens in brain death cases. The likely life span of a deceased kidney donor transplant is considered less than the living donor kidney transplant. It may be affected by many factors including donor characteristics.

The bigger question: Why is living donor kidney transplant better than a deceased donor kidney transplant?

Sr. No.	Factors	Living donor	Deceased Donor
1	Rejection after Surgery	Minimal risk	Can happen
2	Waiting Time for Transplant	Immediately	According to the nationalized list of candidates waiting for a transplant. Around 20 people die every day waiting for an organ transplant.
3	Longevity (How long the kidney lasts)	Greater than 10 years for a majority of patients*	Less than living donor kidney transplant*
4	Kidney Health before surgery	Better	Kept in cold preservation; Travel time affects its functionality leading to complications.
5	Post-Surgical functional achievement	Reported to functioning soon after anastomosis	Takes days to fully function
6	The post-surgical requirement of dialysis	Not required (less than 4-5% cases)	The patient may require dialysis until full functionality is achieved.
7	Complications to the donor	Minimal complications with laparoscopic donor surgery. In rare cases: Pain Infection Hernia Bleeding Blood clot (DVT) Infected wound.	Donor is Deceased
8	Complications to the recipient	Risk of infections due to medications given for preventing rejection of the transplanted kidney. Possible surgical complications.	Same
9	Social and Financial Impact	Planned therefore very less One less person from the list to receive a transplant Surgical cost for otherwise healthy donor Cost of hospital stay post-surgery	Emergency procedures involving huge manpower and money

*impacted by various donor & recipient factors

Well, after going through all the aspects of living and deceased kidney donation you can decide which one is better and healthier. The most emerging fact is that kidney transplants are much needed. Various studies suggest that life expectancy for a living donor is the same as for similar people who haven’t donated. Some studies suggest living kidney donors may have a somewhat higher risk of kidney failure in the future. But this risk is still lesser than the average risk of kidney failure in the general population. I understand that it is a difficult decision to donate an organ even to a loved one. A person should consider kidney donation after making an informed decision and are mentally prepared.

Prof, Dr. Suman Lata Nayak, Senior Consultant – Nephrology, Kidney Transplant – Adult, Dharamshila Narayana Superspeciality Hospital, Delhi & Narayana Superspeciality Hospital, Gurugram