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CHAPTER 2









            DECEASED DONOR KIDNEY



                         TRANSPLANTATION





                eceased donor kidneys are donated by          people waiting for a kidney transplant and
                families that have suddenly lost a close      between 140 and 170 deceased donor transplants
        Drelative, mainly from car accidents or a brain       are performed annually.
        haemorrhage. These donors have had a severe and          Deceased donor kidney transplantation has an
        irreversible brain injury that they cannot recover    advantage in that a living donor does not need to
        from and are declared ‘brain dead’ (that is their     undergo a kidney donor operation which has
        heart and body is kept alive by a breathing machine   associated discomforts and risks. The disadvantage,
        but their brain has died). Their families are asked   however, is that there is a world-wide shortage of
        to give consent for their organs to be used for       kidneys to transplant and people have to wait quite
        transplantation.                                      long periods of time for one to become available.
           Unfortunately, at present, the need for kidneys    Currently, the Irish average waiting time for a
        is higher than the number of kidneys available for    deceased donor kidney transplantation is 2 to 3
        transplant. Currently, there are in excess of 500     years.



              IS A TRANSPLANT FOR EVERYONE WITH KIDNEY DISEASE?


        While a kidney transplant can be a very successful operation, it does require a
        major operation lasting up to 3-4 hours. Not all patients with kidney disease will
        be medically fit to cope with this procedure. Patients with severe heart disease,
        history of stroke or peripheral vascular disease are often better served by continuing
        on dialysis rather than having a kidney transplant.
           Patients that have had a history of cancer (except skin cancer)
        generally need to wait five years, after definitive treatment for the
        cancer, before going on the transplant waiting pool.
           There is no upper age limit for kidney transplantation but, as a general rule, patients
        over 70 years of age, who do not have other associated illnesses such as heart disease, history of stroke
        or peripheral vascular disease, will be accepted on the transplant waiting pool.
           In allocating kidneys, there are competing priorities. There is a need to do the best for the individual
        patient but also the best for society in general, by allocating the scarce supply of kidneys to patients who
        will get many years of success.
           Patients who have certain forms of kidney disease, that may recur in the transplanted kidney may be
        better suited to dialysis rather than having to endure repeat transplantation.
           Your nephrologist will discuss with you, your individual case, and will help you make the right decision
        regarding transplantation.





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