Deceased Donor Transplant
The deceased donor kidney transplantation procedure is governed by the Human Organ Transplant Act (HOTA) and The Medical (Therapy, Education and Research) Act (MTERA), and it is applicable to Singapore Citizens and Permanent Residents. The majority of patients receive kidneys from deceased donors. Sometimes two kidneys, instead of one from a deceased donor will be placed if the kidneys are assessed that one kidney is not enough to provide sufficient function for the patient.
Living Donor Transplant
Whenever possible, a living kidney donor is preferred because the success rates are generally better. In order to receive a kidney from a living donor, there must be a living donor who is willing, able to give informed consent and is otherwise medically and psychologically suitable to donate one of his or her own kidneys. The living donor does not need to be genetically related to the potential recipient. However, if there are no living kidney donors, then the only option is to receive a transplant with kidney (s) from a deceased donor. In Singapore, there are strict regulations about living kidney donation which must be followed in order for the transplant to be approved and to proceed.
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Kidney transplantation involves the transfer of a kidney from one person (the donor) into another person with end-stage kidney failure (the recipient).
During transplant surgical procedure, a donor's kidney or kidneys is/are transferred into the lower pelvis of the recipient. In most cases, the recipient's own kidneys are left in place. In order to receive a kidney transplant, there must be a kidney donor who could be either a deceased or living person.
Transplant patients need to be on close follow-up and take anti-rejection drugs as long as the kidney is functioning. Patients will also need to adopt a healthy lifestyle by adopting a healthy diet and doing regular exercise.
Short-term results of modern kidney transplantation have improved significantly with at least 95% of kidney transplant functioning after 1 year.
Long-term survival, however, has improved by a lesser extent. This is because rejection, drug toxicity, infections, heart disease and cancer continue to be major problems years after transplantation. Every transplant patient plays a critical role in preventing these problems and maximising the lifespan of his/her kidney transplant.
1. What is incompatible living donor transplant?
-Incompatible living donor kidney transplantation refers to kidney transplants that are performed between donors and recipients who do not share similar blood groups or tissue typing.
2. What are the benefits of a living donor versus a deceased donor kidney transplant?
- The potential lifespan of a living donor living donor kidney transplant is longer than that of a deceased donor kidney transplant- If there are several potential living kidney donors, the best kidney donor can be selected- Waiting time for transplantation is shorter than waiting for a deceased donor kidney transplant- Living donor kidney transplant is an elective procedure and thence can be done at the convenience of both the donor and - recipient If the living kidney donor is incompatible to the recipient, the recipient can undergo medical procedures which will enable him/her to receive the incompatible kidney- In a incompatible pair situation, there may be opportunities to do kidney paired exchange where two pair-exchange donors who are more compatible to the other recipient
3. Who can be a living kidney donor?
- At least 21 years of age- Able to remain healthy with one kidney- No conditions that can be potentially transmitted to the potential recipient, for example cancer and infection- No recent history of drug abuse or sexual promiscuity- No active mental disorder or intellectual impairment- Needs to be fully informed of the risks and benefits of transplantation- Should not be under coercion to donate- Should not be involved in a financial transaction that will directly lead to donation
4. What is the process of evaluation for living kidney donation?
- A potential living kidney donor must be as healthy as possible so that the surgery to remove the kidney (called a nephrectomy) can be done safely.
The risks of donating a kidney are risks of major surgery and the risks of living with one kidney for the rest of the donor's life. However, death resulting from kidney donation is extremely rare. Current research indicates that donation does not shorten one's life, impair the ability to have children or cause other health problems. However, there is a risk of end-stage kidney failure which the donor needs to be carefully counseled by the transplant team.
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