Deceased donors are individuals who, while they were living, had requested that their organs be donated for transplantation. Most transplanted organs come from deceased donors. The transplant waiting list is for people waiting for an organ from a deceased donor. These organs are recovered and distributed under supervision of the United Network of Organ Sharing (UNOS). The average wait time on the list is 3-5 years, depending on blood type.
There are several types of deceased donors from whom you may get a kidney. They include:
- Standard Criteria Donor (SCD) is a donor that died from brain death that does not meet the definition of Extend Criteria Donor (ECD) or Donation after Cardiac Death (DCD).
- Extended Criteria Donor (ECD) is a brain death donor who is older than 60 years old, or a donor who is between 50 and 59 years old and had two of the following conditions at the time of death:
a. had a terminal creatinine higher than normal
b. the cause of death was from a Cerebral Vascular Accident (CVA)
c. had a history of hypertension (high blood pressure)
- Donation after Cardiac Death Donor (DCD) is somebody who did not die from brain death. This is someone who suffered a non-survivable illness or injury and was placed on a ventilator to survive. The donor’s family makes a decision to take the person off the ventilator with the expectation that the person’s heart will stop beating within a very short period of time.
- En Bloc Kidney Donor is a pediatric organ donor generally under 5 years old. Both kidneys from this donor come together and are transplanted into one person.
All kidneys are screened by the transplant center before they are accepted. Your transplant team will go over all these options with you and will determine what type of deceased donor organ will work for you. You must agree to accept offers from donors other than Standard Criteria Donors. The Avera McKennan Transplant Institute uses all types of donors. Our outcomes using all types of donors are better than the National Average*. (*See www.ustransplant.org for more of our program’s outcomes.)
Living donors make the decision to give up one of their kidneys. The number of living donors has been steadily increasing. 2001 was the first year that more living donors donated than deceased donors. The recent resurgence of living kidney donation has resulted not only because of the increasing shortage of deceased donor kidneys, but also because of the development of donor procedures that are less stressful for the donor. There are two types of living donors:
- Living Related Donors (LRD) are people who are genetically related like a parent, sibling or other blood relative.
- Living Unrelated Donors (LURD) are people who have an emotional connection to you like a spouse, a friend or a co-worker.
Keep in mind when looking for a living donor, the Avera Transplant Institute follows the guidelines for donation that have been approved by U.N.O.S., The American Society of Transplant Surgeons and The American Society for Transplantation. These guidelines do not permit “solicitation” of donors, either deceased or living. If a person whom you do not know calls to be a donor for you, we will follow our anonymous donor policy.
Anonymous Donors are living donors who do not know the patient, but want to help someone in need of a kidney transplant. Anonymous donors agree to donate a kidney to someone on the center’s waiting list that has been selected by the transplant program. These patients are selected by using similar guidelines that U.N.O.S uses when it selects patients to receive a deceased donor organ.
As you educate your family and friends about the need for a living donor, have anyone who is interested contact the Avera Transplant Institute. Even if your potential living donor does not have the same blood type (ABO incompatible), we do have options for these living donor pairs.
The first option is a desensitization treatment. This is a treatment that decreases the number of antibodies in your blood to keep your body from rejecting or attacking the transplanted kidney. This is not always an option for every living donor pair. The transplant doctors can further discuss this option with you.
The other option for ABO incompatible donors is Paired Donation. Paired donation is like a second list for transplant candidates who have a living donor, but are unable to receive their living donor’s kidney because of ABO incompatibility or positive crossmatch results. The living donor pair is placed on the paired donation list with other incompatible living donor pairs. A computer matching system, similar to those used for the deceased donor list, matches you and your living donor with another living donor pair. You would then trade donors with the other matched pair. The transplant doctors may further discuss this with you.