Kidney Transplant: How does it Work?

Kidneys are vital – if they no longer work properly, a replacement is needed. In addition to blood washing, a donor kidney offers this possibility. About 2,600 people in Germany receive a new kidney each year – after an average of 5 to 6 years of waiting. Another 8,000 patients hope that a suitable organ will be found. Regardless of which disease originally destroys the kidney tissue – a resulting loss of function of both kidneys (kidney failure) ends fatally if no countermeasures are taken.

Such kidney replacement procedures include lifelong blood washing (dialysis) on the one hand, and transplantation of a foreign kidney on the other. If a suitable organ is found and the kidney transplantation is successful, it allows, in contrast to dialysis, an almost normal life – with one (instead of two) functioning kidneys, life can be lived almost without restriction.

What are the requirements?

In Germany, four out of five organs transferred come from brain-dead patients who gave their consent to organ donation during their lifetime or whose relatives consented to organ removal. Such kidneys are arranged through transplant centers and ultimately through the central organ procurement agency Eurotransplant.

Living donations are also possible, usually from parents or siblings or from life partners. The prerequisite is a high tissue compatibility between donor and recipient so that the foreign organ is not rejected by the body.

Criteria for the allocation of donor kidneys

Because the need for donor organs is far greater than their number, other criteria besides tissue characteristics determine which patient receives a new kidney. These include waiting time, urgency, likelihood of success, and distance between the organ retrieval site and the transplant site.

Once a suitable organ has been found, the recipient is notified immediately. Therefore, the recipient must be available around the clock. In order to be included in the waiting list, the person concerned must undergo numerous examinations. These serve to determine the type of tissue, the general surgical risk and to exclude sources of infection.

Transplants are not performed for cancers that have not yet been cured, chronic or severe acute infections, alcohol and drug addiction, and severe illnesses that make surgery impossible.