Organ transplantation is one of the triumphs of modern medicine, so much so that the number of potential organ recipients now exceeds the quantity of available organs. According to the United Network for Organ Sharing, more than 77,000 people in the United States were actively awaiting transplant as of October 2013. Each day, on average, 77 of those people receive an organ, but 18 people die because a suitable organ could not be found in time. One reason for that shortage is that potential donors and their organs must meet strict criteria to be deemed acceptable.
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Living Kidney Donor Requirements
In general, kidney recipients live longer when they receive an organ from a live rather than a dead donor. Live donors can range in age from 18 to 70 years and must be in good general health. They do not have to be related to the recipient, but they should have the same blood type. Potential donors should not have diabetes, high blood pressure, cancer, HIV, heart disease, liver disease or sickle-cell anemia, but under special circumstances some centers will consider donors who have some of these conditions. Potential donors also are evaluated psychologically. Some people have a specific recipient in mind, while others simply have an altruistic desire to help another person. Either way, the gift of an organ must be the donor’s own choice, with no undue pressure from family members or anyone else. The donor should be able to understand the consequences of organ donation, including the need for regular medical checkups for the rest of his life.
Along with the medical and psychological requirements, adequate financial support is an important consideration for any potential donor. The organ recipient’s insurance should cover the donor’s medical costs directly associated with organ donation, but it may not cover related costs such as travel expenses, time lost from work or school, child care or unanticipated medical problems. These possibilities should be accounted for before going ahead with the donation. Most transplant centers have staff members who can assist donors in evaluating these issues and making an informed decision.
Deceased Kidney Donor Requirements
The standard deceased donor is younger than 60 years of age and has been in good health, with no conditions such as cancer or serious infections that might be transmitted to a potential recipient and with a blood type that matches the recipient’s. Most deceased donors are people who have died in accidents such as falls or car crashes or from a sudden noncontagious illness such as a stroke. A standard deceased-donor requirement is brain death, which refers to the irreversible loss of brain function while the heart is still beating. The beating heart ensures a steady blood supply to the kidneys and any other organ that might be transplanted, which helps keep those organs in optimal condition.
Given the serious shortage of kidneys and other organs, some doctors and transplant centers are now experimenting with kidneys from donors who do not meet the standard requirements. For example, kidneys from deceased donors who are older than 60 -- or who have conditions such as high blood pressure or even certain forms of kidney disease -- are now being used with good results when the recipients have been properly chosen. In some cases, organs have been taken from a patient whose heart has stopped beating on its own, even if she has not met all the technical criteria for brain death. Kidneys from live donors who fall outside the standard age limits or who do not have the same blood type as the recipient also have been transplanted successfully in a few cases.