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

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

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

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

0800 KIDNEY / 0800 543 639 www.kidneys.co.nz

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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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