Kidney Transplant: Requirements of a Kidney Donor

The kidneys are responsible for the regulation of electrolytes and maintaining the acid-base balance in the body. The organ also regulates blood pressure and most importantly, ensures the excretion of toxic wastes such as ammonium and urea. The kidneys play a critical role in the re-absorption of amino acids and glucose, and in the production of hormones.

Generation of the required amounts of erythropoietin and vitamin D is another vital kidney function. These paired organs are located behind the abdominal cavity. They are supplied with blood, by the paired renal arteries in the retroperitoneum, and drain into the paired renal veins. 

The urinary system that functions around the kidneys is based around the efficiency of each kidney to excrete urine into a paired ureter, that finally empties the waste into the urinary bladder before excreting it out of the body completely.

Renal physiology or the study of kidney function, observes a number of ailments that affect kidney health and bring on the onslaught of kidney diseases such as:

• Nephritic Syndrome
• Nephrotic Syndrome
• Acute kidney failure
• Urinary tract infection
• Nephrolithiasis
• Urinary tract obstruction

Renal transplant or kidney transplant refers to the transplantation of the organ, from a healthy donor to the body of an ailing counterpart, with a partly functional or completely dysfunctional urinary system. Kidney transplant is usually suggested in case of patients who are battling with some end-stage renal disease.

Kidney transplantation is either performed with an organ donated by a deceased-donor or former cadaveric or a living donor. Most living donors are required to be genetically related to the patient. However, today, the development of technology and a better understanding of organ compatibility, enables doctors to consider non-related transplantation too.

The first ever documented kidney transplant was conducted in the USA, on June 17, 1950 on 44-year-old Ruth Tucker, who was suffering the onslaught of polycystic kidney disease. The world's first successful renal transplant was conducted in 1954, by Dr. Joseph E. Murray and Dr. J. Hartwell Harrison. Dr. Murray received the 1990 Nobel Prize for Medicine.

• The kidney donor has to necessarily be a healthy individual, with suitable cardiac and pulmonary sufficiency. He or she should test negative for any form of hepatic disease.
• Doctors also eliminate kidney donations from those suffering the onslaught of HIV, cardiovascular disease, terminal infectious diseases and any form of cancer.

• The donor undergoes a screening process that involves matching of the blood and tissue type of the donor and receiver. Blood and urine tests are also carried out to ascertain the creatinine levels and electrolyte levels.
• A donor must be above the age of 18 and should have no substance abuse or alcohol problems.

• A donor's urinary tract, blood vessels leading to the kidney and the kidney itself should be normal and fit for transplant.
• A prospective kidney donor should be willing to donate his/her kidney and not be under any mental duress or illness that can make the transplant procedure risky.

• Kidney transplant risks involve the risks faced during the surgical procedure and risks or side effects due to anti-rejection medication. It is not uncommon for the recipient's body to completely 'reject' the transplanted organ even before post-surgery medication is administered.

• The possible complications during or immediately after surgery are the occurrence of blood clots or leakage or bleeding of the tube that connects the kidney and the ureter.
• The medications to be taken after a transplant can give rise to certain side effects like acne, diabetes, high blood pressure, high cholesterol, puffiness and weight gain.

The primary requirement of a kidney donor should be compliance with medical criteria for transplant, i.e., blood and tissue match, and a genuine willingness to donate.

It is understandable for donors to be afraid of donating a kidney and hence are advised to talk to living donor support groups and clinical social workers if they have any doubts or concerns about their decision to donate.