Starting The Transplantation Process
This is the third session of the Columbia and Lyfebulb patient information and education session series. It is sponsored by Veloxis Pharmaceuticals.
Panelists and moderators include Mark Hardy, professor of surgery at Columbia university, Dr. Karin Hehenberger, CEO of Lyfebulb and visiting associate researcher at Columbia, Dr. Lloyd Ratner professor and chief of the renal pancreas transplantation service, Mr. Brian Runge, chief coordinator of donors at Columbia University transplant program, Dr. Geoffery Dube, assistant professor of medicine and senior nephrologist on transplant service, and Gretchen Boyd chief coordinator of renal and pancreas transplant program at Columbia.
This session discusses the preparation after dialysis and starting the transplant process to get listed as well as recruiting a potential living donor.
To begin conversations with a transplant center as a potential kidney transplant recipient, a patient usually gets referred from a dialysis program, nephrologist, or the patient is able to do research on their own regarding transplant centers, they contact them directly. A few things to keep in mind when choosing a transplant center is the proximity of the center to the recipient’s residence, and the ease of traveling for follow up care consistently. Logistics play a role in the optimal choice. Choosing a transplant center that the patient has good communications and report with is very important as a patient will spend a lot of time with their transplant center through the process of transplant. It’s important to evaluate how responsive and helpful a particular transplant center is. And it’s important to know that a potential recipient can change transplant centers at any time if they chose to do so. There is also a public database called SRTR where anyone can log on and see the clinical outcomes of various transplant centers. This also could be an important factor when choosing a center to go to.
When it comes to evaluating whether someone is a good candidate to receive a transplant, a potential recipient undergoes a daylong evaluation that consists of various tests and meeting with the transplant coordinator, the surgeon, physician, social worker and others. There will be a lot of information to absorb so it is important for candidates to bring a support person with them to help remember the process and details and also to provide care if needed to the potential recipient.
During evaluation day as well as subsequently, there will be an abundance of educational materials and discussions with the coordinator, physician, social worker about what to expect after transplant. After evaluation, the team meets to discuss candidacy for the patient and if they are ready for the patient to be listed, then there are additional education classes. For any patient process, the first source of information is the transplant coordinator.
After someone is deemed eligible for transplant, they are placed on the wait list. The list is the United network of organ sharing (UNOS) waiting list.
If someone has an unusual or difficult problem, not all transplant center will tackle it, but even if someone is turned down by one transplant center, they can be accepted for a different one. And, someone can be on more than one transplant centers list at one time.
Someone can get taken off the list if their condition worsens and the risk of doing the transplant outweigh the benefits. Additionally, if a patient is abusive to the staff or if they are noncompliant in their care and refuse to take care of themselves this could also lead to removal. Other underlying conditions could be a reason someone gets taken off the list for example due to a cancer diagnosis. This person would have to wait a certain time before getting back on, but it depends on the type of cancer, size, and malignancy.
Individuals can be on the transplant list waiting for a deceased donor and still also be looking for a living donor. Live donor kidneys work better over the long term, they last about twice as long – 15 to 20 years. This option should be considered as the optimal treatment. If a patient hasn’t had time to find a living donor, they can get listed on deceased donor list and begin searching for a living donor. Donor age limit does matter when it comes to how much longevity the donated kidney has. if its from an old donor the lifetime of that donated kidney won’t be as long. The oldest donor recorded was 83 years old. With that, donor safety is paramount and extensive evaluation will be undergone to ensure the surgery is safe and the donor will be ok with one kidney and both are normally functioning.
Listen to the webinar and learn more about these conversations and other kinds of support and educational resources for potential kidney transplant recipients. This, and future webinars can be found on transplantLyfe.com.