Deceased-donor kidney transplant

A deceased-donor kidney transplant is when a kidney from someone who has recently died is removed with consent of the family or from a donor card and placed in a recipient whose kidneys have failed and no longer function properly and is in need of kidney transplantation.

The donated kidney is either stored on ice or connected to a machine that provides oxygen and nutrients until the kidney is transplanted into the recipient. The donor and recipient are often in the same geographic region as the transplant center to minimize the time the kidney is outside a human body.

Only one donated kidney is needed to sustain the body's needs. For this reason, a living person can donate a kidney, and living-donor kidney transplant is an alternative to deceased-donor kidney transplant.

Overall, about two-thirds of the approximately 20,000 kidney transplants performed each year in the U.S. are deceased-donor kidney transplants, and the remaining are living-donor kidney transplants.

The demand for deceased-donor kidneys far exceeds the supply. The waiting list has grown from nearly 58,000 in 2004 to more than 92,000 in 2017.

Why it's done

People with end-stage kidney disease need to have waste removed from their bloodstream via a machine (dialysis) or a kidney transplant to stay alive.

For most people with advanced kidney disease or kidney failure, a kidney transplant is the preferred treatment. Compared with a lifetime on dialysis, kidney transplant offers a lower risk of death, better quality of life and fewer dietary restrictions than dialysis.

The health risks associated with kidney transplant include those associated directly with the surgery itself, rejection of the donor organ and side effects of taking immunosuppressive medications needed to prevent your body from rejecting the donated kidney. These risks include higher rates of infection and some types of cancer.

What you can expect

If your doctor recommends a kidney transplant, you may be referred to a transplant center or select a transplant center on your own.

You will be evaluated by the transplant center to determine if you are accepted as a kidney transplant candidate. Each transplant center has its own eligibility criteria.

If a compatible living donor isn't available for a kidney transplant, your name will be placed on a kidney transplant waiting list to receive a kidney from a deceased donor.

Everyone waiting for a deceased-donor organ is registered on a national waiting list maintained by the Organ Procurement and Transplantation Network (OPTN). The United Network for Organ Sharing (UNOS), a private nonprofit group, administers OPTN through a contract with the U.S. government.

Additional factors used in matching deceased-donor kidneys include blood and tissue type matching and how long the candidate has spent on the waiting list. The federal government monitors the system in an effort to ensure that everyone waiting for an organ has a similar chance.

Some people get a match within several months, and others may wait several years. While on the list, you will have periodic health checkups to ensure that you are still a suitable candidate for transplantation.

When a compatible deceased-donor kidney becomes available, you will be notified by your transplant center. You must be ready to go to the center immediately for final transplant evaluation.

If the results of the final transplant evaluation are satisfactory, the kidney transplant surgery can proceed immediately.

Feb. 25, 2020
  1. Hart A, et al. OPTN/SRTR 2017 Annual Data Report: Kidney. American Journal of Transplantation. 2019; doi:10.1111/ajt.15274.
  2. Talking about transplantation: What every patient needs to know. United Network for Organ Sharing. https://www.unos.org/wp-content/uploads/unos/WEPNTK.pdf. Accessed Jan. 20, 2020.
  3. Choosing a treatment for kidney failure. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment. Accessed Dec. 16, 2019.
  4. Organ matching. Organ Procurement and Transplantation Network. http://www.organdonor.gov/about/organmatching.html. Accessed Jan. 20, 2020.
  5. Office of Patient Education. Kidney transplant. Mayo Clinic; 2017.
  6. Rossi AP, et al. Evaluation of the potential renal transplant recipient. http://www.uptodate.com/home. Accessed March 11, 2016.
  7. Dingli DD (expert opinion). Mayo Clinic. Jan. 29, 2020.

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