Kidney transplant: urgent & life-giving

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Kidney Transplant: Donations are urgently needed.

(08/24/2010) The decision of Frank Walter Steinmeier (SPD) to donate a kidney to his wife is widely recognized throughout Germany and puts the topic of kidney transplantation in the focus of public debate. Around 12,000 people are currently waiting for a donor kidney in Germany, but just under 2,500 kidneys are transplanted every year.

The two kidneys serve the human body to regulate the water and electrolyte balance and take on important functions in hormone and blood formation. If both organs fail, this situation is life-threatening. So the body is z. B. no longer able to release potassium, which can lead to ventricular fibrillation with fatal outcome. About every thousandth German citizen suffers from kidney failure today, says the medical director of the Berlin Charité, Ulrich Frei, although a transplant is not always necessary. According to the Charité transplant coordinator, Thomas Mehlitz, the cause of kidney failure can be: Vascular or autoimmune diseases, as well as diabetes mellitus or cysts.

Of the almost 2,500 kidney transplants performed annually, however, only a very small proportion is attributable to living donations. A healthy person can easily do without one of his two kidneys. In most cases, the remaining kidney takes over the functions of the removed organ without any problems, without affecting the daily life of the donor; only about one percent of the donors become ill as a result of the operation. At the Berlin Charité, only one in five transplanted kidneys has been a living donation since 1998, the rest of the organs came from the deceased. For comparison: in the UK about 25 percent were living donations, in the USA about 35 percent and in Scandinavia even more than 50 percent ..

An unpleasant statistic for the affected patients, because they wait "on average two to seven years for a new kidney," says kidney specialist Frei, and this time span could be shortened considerably if more people could decide to donate their kidneys during their lifetime. A donor kidney would spare the patient the ongoing dialysis (mechanical blood purification) and "the patients (received) more quality of life and a longer chance of survival," explained Thomas Mehlitz.

The donation of organs is clearly regulated in the Transplantation Act, whereby primarily first and second degree relatives and life partners are possible donors. Through the personal relationship between donor and recipient, the legislator wants to ensure transparency and prevent people from being forced to donate or that lively organ trade develops due to financial incentives. A discussion with the living donation commission is mandatory before the living donation, because the voluntary nature of the donation should be checked again here. In principle, anyone who is healthy and has two fully functional kidneys is suitable as a living donor. According to the experts, matching tissue and blood groups are advantageous, but not absolutely necessary. Incompatible organs have already been transplanted, but the risk of the body rejecting them is considerably higher. In Germany, according to the Munich Clinic Großhadern, the majority of living donations come from parents (35 percent) and spouses (33 percent). Around 18 percent of living donations come from siblings, nine percent from close friends and five percent from distant relatives.

According to Thomas Mehlitz, a living donation has other significant advantages, since the quality of the organs is usually better than that of the deceased. In addition, the transplantation takes place under planned conditions so that the organ can be implanted again immediately after removal, the specialist explained further. Accordingly, the shelf life of living donations to the organs of the deceased is significantly increased. Living donations from kidneys last on average about 15 to 20 years, whereas the kidneys of a deceased person only work for ten to twelve years.

Kidney transplantation is one of the longest researched organ transplants to date. As early as 1902, a Viennese doctor performed the first kidney transplant on a dog, and in 1966 the first kidney was transplanted in Germany. During the transplant, the kidney is removed in a one-and-a-half hour operation, rinsed in a preservation solution at four degrees and then stored refrigerated until the implantation. In the following operation, the donor organ is implanted directly into the abdominal cavity of the needy, the sick kidney also remaining in the body. (fp)

Also read:
Kidney tumor
Kidney abscess
Renal infarction

Author and source information

Video: Kidney Transplantation: Living Kidney Donation - Anjay Rastogi, MD, PhD. UCLAMDCHAT

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