Kidney transplant

The Iowa Methodist Transplant Center has one of the shortest waiting times for a deceased donor kidney transplant in America and regularly receives referrals from all over the country. Many of these patients have been waiting years at their local transplant center. Fortunately, search sites like txmultilisting.com  have empowered them to take control of their own health care and seek out centers with shorter waiting times. To potentially benefit from a transplant a patient should have: • Progressive, irreversible renal disease • No active malignancy or infection • Absence of systemic disease which would severely limit rehabilitation • Life expectancy greater than 5 years with a successful transplant • Effective family or social support systems • Willingness to comply with treatment and follow-up requirements Absolute contraindications to transplant include: • Active malignancy • Severe respiratory conditions • Severe Ischemic heart disease • Severe peripheral vascular...

The new kidney allocation system was implemented in December 2014 after more than a decade of careful consideration. It was designed to maximize the years of life gained through transplantation and to reduce the discard rate for marginal kidneys. There is more sharing of kidneys outside of the local area due to regional and national priority for very highly sensitized patients, as well as the use of a combined local/regional list for more marginal kidneys. However, substantial geographic disparities continue to exist as this was not the primary goal of the new system. The new system does use dialysis start time to calculate waiting time but early referral and listing are still very important. Patients that never go on dialysis and those with shorter duration on dialysis prior to transplant have better outcomes. I am fortunate to work in the Midwest where the waiting time for organs is very short. Iowa is a flyover state but because of the very long waiting times for organs on the eas...

The incidence of end-stage organ failure is growing exponentially; fueled by an aging population and the burden of metabolic diseases, the gap between the supply and demand of organs continues to widen. Unfortunately many patients die on the waiting list and many more are taken off the list because of worsening health. Despite extensive campaigns to increase donation from deceased donors, the figure has remained around 6000 donors per year. For organs such as the kidney and liver, living donation is an excellent alternative. Living donor transplants result in outcomes that are substantially better than for deceased donors. In fact, the half life of a deceased donor kidney transplant is 8-10 years compared to the 16-20 years for a living donor. The patients live longer and have a far better quality of life compared with remaining on dialysis. The median survival on dialysis is 2 years, the 5 year survival is 40% and the 10 year survival is 10%. Kidney transplantation is n...