In July 2017, more than 97,000 people were waiting for a kidney transplant in the United States, according to the United Network for Organ Sharing (UNOS).
Because of this staggering number, many people in need of a new kidney wait longer for an available donor—and often get sicker while they wait. One solution? A living donor kidney transplant.
Kidney transplants from living donors generally offer better outcomes for recipients and are key to reducing the time patients spend on organ transplant wait lists. But why are they better? We talked with Transplant Surgeon Ty Dunn, MD, to understand why kidneys from living donors are better for recipients and for public health.
Kidneys from deceased donors may be stressed and usually spend a longer time in a cold preservation solution while they’re being transferred between hospitals, Dunn said. This can temporarily reduce organ function. Roughly one-third of kidneys from deceased donors take days or weeks to become fully functional after the transplant, which prolongs the need for dialysis and makes the recipients more vulnerable to complications after surgery. Kidneys from living donors tend to function immediately, reducing the risk of needing any dialysis after transplant to less than 4 percent, Dunn said.
“Receiving a kidney from a living donor means receiving the healthiest organ possible,” Dunn said. “This sets up the recipient for the best short- and long-term outcomes.”
The ability to schedule a kidney transplant surgery in advance can make a big difference for both the donor and the recipient. Scheduling ensures that the living donor can plan time off work and for family care. For the recipient, scheduling ensures that the transplant takes place at an optimal time—ideally before the recipient needs to begin dialysis. Patients who avoid dialysis altogether—or only receive dialysis for a short period of time—tend to experience better health outcomes.
The same convenience is not possible during deceased donor transplants, which cannot be planned and occur as emergency procedures whenever a donor kidney becomes available. The waiting time for a deceased donor kidney is typically 4-6 years.
“If you’re waiting for a long time to receive a deceased donor kidney, you’re at higher risk of other health complications that could affect the success of your transplant—or your ability to even get a transplant,” Dunn said.
Also, living donor kidneys tend to have greater longevity than those transplanted from a deceased donor. A living donor kidney functions on average for roughly 14 years, compared to 10 years for a kidney from a deceased donor.
However, if a recipient makes it through their first year following a living donor kidney transplant without any major complications, doctors expect the kidney to last for about 20 years on average, Dunn said.
“The better people do with their first transplant, the less likely they are to need another transplant,” Dunn said. “That, in turn, makes more kidneys available to more people. Living kidney donors are life savers—not only for the recipient, but for others on the wait list.”