Kidney Transplant

Types

Mayo Clinic's transplant program emphasizes living donor kidney transplant, transplantation prior to initiation of dialysis, blood group (ABO) incompatible kidney transplants and positive crossmatch kidney transplants. The program has special interest in transplantation in people who have polycystic kidney disease (PKD) and in treating people whose kidney disease is likely to recur after transplantation.

Living donor kidney transplant

Living donor kidney transplant may be the most appropriate option for you if a matching donor can be found. Living donor organs offer the following advantages:

• A living donor kidney can be transplanted immediately, while the wait for a cadaver kidney may be three to five years.
• Due to the lack of waiting period, many people can receive a living donor transplant prior to initiation of dialysis.
• A living donor kidney's quality can be tested thoroughly before your transplant.
• Living donor kidneys function longer than kidneys from deceased people (cadaver kidneys).
• Most living donor kidneys function immediately after transplant, while many cadaver kidneys don't function well initially.
• Mayo Clinic doctors will perform surgical kidney removal (nephrectomy). In this procedure, your surgeon removes the donor kidney through a small incision (laparoscopy). This approach is safer for the donor, involves less pain and allows quicker recovery when compared to traditional open surgery.

Living kidney donor transplant involves medical evaluation of the donor, as well.

• Donating a kidney. You and your loved ones must consider carefully the decision to donate a kidney. The process begins with a brief phone interview with members of the Mayo Clinic team. You'll then receive a blood sampling kit with instructions in the mail. If your blood sample results are suitable, doctors will evaluate your general health and kidney function.
• Meeting with specialists. The donor also meets with a kidney specialist (nephrologist) and a surgeon for an evaluation to be sure that the donor is in excellent health and meets donation criteria.
• Donation surgery. A surgeon will remove the healthy donor kidney (nephrectomy) through a laparoscopic donor nephrectomy or traditional donor nephrectomy.

Transplantation between incompatible donors and recipients

In some cases you may have found a living donor, but you have incompatible blood groups or you may have antibodies against the donor. Antibodies can severely harm your new kidney after transplantation. Most transplant centers don't perform transplants under these conditions. However, Mayo Clinic has developed techniques that allow for transplantation under these conditions.

How paired kidney donation works

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• Paired kidney donation. Paired kidney donation may be an option if you've found someone willing to donate a kidney but the donor kidney is incompatible with your blood or you're sensitized to his or her antibodies. Rather than donating a kidney directly to you, your donor may give a kidney to a person whose blood and tissue is compatible with the donor's kidney, and you receive a kidney from the other transplantee's donor. Mayo Clinic doctors in Minnesota and Arizona evaluate each person to confirm compatibility and transplant readiness. When both individuals are ready for surgery, the transplants will be scheduled for the same day.
• ABO incompatible kidney transplant. ABO incompatible transplant permits transplant across blood types. About 30 percent of people who need a kidney are limited to a donor with an incompatible blood type.
• Positive crossmatch kidney transplant. Positive crossmatch kidney transplant makes transplant possible for people who have developed antibodies against their kidney donor (positive crossmatch). These antibodies usually develop after pregnancy, blood transfusion or a previous kidney transplant. The Mayo Clinic transplant teams in Minnesota and Arizona perform these kidney transplants with a success rate similar to that seen in cadaver kidney transplants. Mayo Clinic in Florida offers transplantation for some positive crossmatch patients if their levels of antibodies are low (known as "flow positive" crossmatch).

Polycystic kidney disease (PKD) kidney transplant

Up to 50 percent of people who have polycystic kidney disease (PKD) eventually experience kidney failure. Fortunately, most people who have PKD remain relatively healthy, making them good candidates for a kidney transplant. Mayo Clinic doctors have researched and published extensively on the genetics and clinical care of people who have PKD. In many people, doctors can use a kidney from a living donor without the recipient's having to undergo dialysis.