having a kidney transplant - ministry of health · 0800 kidney / 0800 543 639 having a kidney...
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0800 KIDNEY / 0800 543 639 www.kidneys.co.nz
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A kidney transplant is the best treatment for most people with complete kidney failure. A kidney transplant is an operation to give a healthy kidney from one person to another person who has kidney failure.
There are two types of kidney transplants:
• Atransplantfromalivingdonor.Anyfamilymemberorfriendwhoishealthyandwillingtodonateakidneycanbeconsideredasapossibledonor.Itisalsosometimespossibleforapersontoreceiveakidneyfromsomeonethattheydonotknow,non-directed(oraltruistic)donation.Anybodythinkingofbeingakidneydonorshouldcontactthetransplantcoordinatoratthekidneyunitclosesttothem.
• Atransplantfromapersonwhohasdiedsuddenly-usuallycalledadeceaseddonor.Inthiscasefamilyofthedonorhaveagreedforthekidneytobedonated.
Asuccessfulkidneytransplantmeansthatyounolongerneeddialysis.Likedialysisthough,akidneytransplantisnotacompletecure.Complications,suchasrejection,canleadtolossofthetransplantandareturntodialysis.
Can anyone receive a kidney transplant?
Everyonewhosekidneyshavefailedisentitledtobeassessedtoseewhethertheyaresuitableforakidneytransplant.Ifyouhavekidneyfailure,itisimportantthatyoutalktoyourkidneyteamaboutwhetherornotyouareabletohaveakidneytransplant.
Anyonethinkingabouthavingakidneytransplantneedstobeingoodgeneralhealth.Ifyourhealthisnotgood,havingakidneytransplantmaynotbethebestoptionforyou.
Allpeopleconsideringhavingakidneytransplantwillneedageneralmedicalcheck-up.Somepeoplewillrequireadditionaltestswhichmayincludechecksoftheirheartfunction,acervicalsmear,aprostatecancercheck.Insomecaseswheretheurinedrainagesystemhasbeendamagedareviewbyaurologysurgeonwillberequired.
Akidneytransplantisnotrecommendedforpeoplewhohaveahighriskofhavingaheartattackduringorsoonaftersurgery.Peoplewhohaveanactivecancerorinfectioncannothaveatransplant.
Peoplewhoareoverweightmayneedtoloseweightbeforetheycanreceiveakidneytransplant,asthiscanincreasetheriskofslowwoundhealingandbloodclotsorchestinfectionsaftertheoperation.
Thekidneytransplantsurgeonwillreviewallpatientsbeforetheyareacceptedforakidneytransplant.Thesurgeonwillexplaintheoperationandwhatisinvolvedandwillexaminethepatientforanyproblemsthatmightmakesurgerydifficult.
Other specialists may need to be consulted depending on the patient’s medical history.
Having a Kidney Transplant
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www.nzkidneyfoundation.co.nz
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0800 KIDNEY / 0800 543 639 www.kidneys.co.nz
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Advantages of the a Kidney Transplant
Asuccessfultransplant:
• meansnomoredialysis
• formostpeopleitmeansalongerlifeandimprovedqualityoflife
• allowsfreedomofchoiceoffoodandliquid
• enablesamorenormallifestyle,includingfreedomtotravel
• canimprovefertilityandmanypeoplehavesuccessfulpregnanciesandhealthy childrenafteratransplant.
Disadvantages of a Kidney Transplant
Somepossibleproblemsfromtransplantare:
• itinvolveshavinganoperation
• medicationstopreventlossofthekidneyneedtobetakendailyfortherestofyourlife,orforas longasthekidneyworks
• thesemedicationscanhavephysicalsideeffectssuchasanincreaseinweight,increasedhairiness, and acne
• thereisuncertaintyaboutthekidneytransplantworking.Thereisnoguaranteethatthekidneywillworkafterthetransplant.Evenifitworksthereisalwaysapossibilityofthekidneystoppingworking(called‘rejection’)atanytime,butthisdoesbecomemuchlesslikelyafterthefirstyear
• theanti-rejectionmedicinescancausecomplications.Themostseriousisanincreasedriskofgettinginfections.Transplantpatientsalsohaveanincreasedriskofgettingcertaincancers,especiallyskincancer
• somepeoplemayhavetorelocateforatimewhentheyhavethetransplant.
www.nzkidneyfoundation.co.nz
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0800 KIDNEY / 0800 543 639 www.kidneys.co.nz
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Getting on the waiting list
Thekidneytransplantteammeetsregularlytodiscussandreviewallpatientswhowanttogoonthetransplantwaitinglist.Yourkidneyteamwilldiscussyoursuitabilityforatransplantagainstasetofnationalrules.Youwillneedtohavevarioustests,dependingonyourmedicalsituation.If,afterreviewingthem,thekidneyteamdecidesthatyouaresuitable;arrangementswillbemadeforyoutogoonthekidneytransplantwaitinglist.
Ifyouarenotacceptedforanyreason,youcantalktoyourkidneyteamaboutthedecision.
Peopleonthewaitinglistarereviewedeveryonetotwoyearstomakesuretheyarestillwellenoughtoreceiveatransplant.
How does the kidney transplant waiting list work?
NewZealandhasonenationalwaitinglistforkidneytransplantsmanagedbyOrganDonationNewZealand(www.donor.co.nz).Onceyouhavesimplebloodtestsdonetodetermineblood group and tissue typing informationyouwillbeacceptedontothewaitinglist.ThisinformationisstoredonaNewZealandBloodServicecomputeralongwiththedateyouwentonthewaitinglist.
Onceyouareonthewaitinglistafreshbloodsampleisneededeachmonth.Ifyoudonothaveyourmonthlytestyouwillnothaveachanceofbeingofferedakidneyduringthenextmonth.
Kidneysareallocatedtopeopleonthewaitinglistbyanumberofrules.Patientswhohaveaveryclosetissuematchtothedonoraregivenfirstpriorityforthekidneynomatterhowlongtheyhavebeenonthewaitinglist.
Abouthalfofthekidneysareallocatedtopatientsthisway.Theotherhalfwillnotbesuchaclosetissuematchtoanyonewaitingonthelist.Inthesecasesthetimeonthewaitinglistplaysabiggerrole.
Ifacloselymatcheddonordoesnotbecomeavailable,youwillbeofferedakidneywhenyouhavereachedthetopofthelistintermsofthetimeyouhavebeenwaiting.
Itispossibletogoonthewaitinglistbeforeyoustartdialysis.Butwaitingtimewillnotbecounteduntilyouhavestarteddialysis.Acloselymatchedkidneycouldbecomeavailableforyoubeforeyoustartdialysis,butmostpeoplestartdialysisbeforetheyreceiveakidneytransplant.
Itisalmostimpossibletopredicthowlongapersonwillwaitforakidneytransplant.Somepeoplewillgetatransplantveryquickly,whileotherscanwaitforyears.Ingeneralthough,mostpeopleareonthewaitinglistfor3-5yearsbeforetheyreceiveakidneytransplant.
www.nzkidneyfoundation.co.nzwww.donor.co.nz
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0800 KIDNEY / 0800 543 639 www.kidneys.co.nz
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What to expect after the operation
Whenyoureturnfromtheoperationyouwillhaveathintubeinaveininyourneck,acatheterinyourbladderandanIVline(adrip)inyourarm.
Afterthetransplantyouoftenneedtodrinkseverallitresoffluideachday,whichcanbedifficulttoadjust towhenyouhavebeencarefullycontrollingyourdailydrinkingasadialysispatient.
Sometimesthetransplantedkidneydoesnotworkstraightawayandyoumayneeddialysisforawhileuntilitisworkingproperly.
Youwillneedtocometothetransplantclinicanumberoftimeseachweekafteryouleavehospital,foranumberofweeks.Lateryouwillonlyneedtocometothecliniceveryfewmonths.
Thestaffwillgiveyouinformationaboutexercise,dietanddrinking,andyourmedications.
What if the transplant fails
Unfortunately,somekidneysarelostthroughrejection,infection,orproblemswithbloodsupplytothekidney.
Althoughweknowthatayearafteratransplantoperationabout9outof10kidneystransplantedfromalivingdonorwillbeworkingwell.Abouthalfofthesekidneyswillstillbeworkingwell15yearslater.Somepeoplehaveatransplantthatisstillworkingwellafter20years.
Ifatransplantdoesfail,thenthepersonwillneedtogobackontodialysis.
Click on the picture if you would you like to hear what Kaela has to say about having a kidney transplant?
www.nzkidneyfoundation.co.nz
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0800 KIDNEY / 0800 543 639 www.kidneys.co.nz
Havin
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BLOOD GROUPPeoplehaveoneoffourmajorbloodgroups–O,A,BorAB.Apotentialdonorandrecipientaresaidtohavecompatiblebloodgroupswhentherecipientdoesnothaveantibodiesagainstthepotentialdonor’sbloodgroup.ForexampleapersonwithanObloodgroupwouldhaveantibodiesagainstdonorswithbloodgroupsA,BandABbutiscompatiblewithanotherpersonwithbloodgroupO.
OrecipientscanonlyhaveanOkidneyBrecipientscanreceiveaBorOkidneyArecipientscanreceiveanAorOkidneyABrecipientscanhaveanA,B,O,orABkidney
TISSUE TYPINGAspecialpatternofantigens(calledtissuetype)ispresentoneveryone’scellsandtissues.Tissuetypingisatestdoneinthelaboratoryinwhichthetissuesofaprospectivedonorandrecipientaretestedforcompatibilitypriortotransplantation.
www.nzkidneyfoundation.co.nz
Advantages of the a Kidney Transplant Disadvantages of a Kidney Transplant Getting on the waiting list How does the kidney transplant waiting list work? What to expect after the operation What if the transplant fails
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