2.13 - Kidney Failure

Kidney transplants and dialysis vs transplant

• Kidney failure can be treated with dialysis or cured with a kidney transplant.
• A transplant is currently the only cure - a healthy kidney from a donor replaces the failed kidneys.

Where donor kidneys come from

• From people who have died suddenly and were on the organ donor register or carried a donor card - provided their relatives agree.
• From a living donor, because a person has two kidneys and can survive with one. Donating carries a small risk to the donor.

The problem of rejection

• The main problem with a transplant is rejection: the patient's immune system can treat the donor kidney as a foreign body and attack it with antibodies, just as it would a pathogen.
• Two precautions reduce this risk:
  1. A donor whose tissue type closely matches the patient's is chosen.
  2. The patient is given drugs that suppress the immune system so it doesn't attack the transplant.
• Even with these precautions, rejection can still happen.

Dialysis vs transplant

Dialysis keeps a patient alive and buys valuable time until a donor kidney is found, but it does not cure the condition. A transplant is a cure, but a well-matched kidney must be found first.

The two treatments have different advantages and disadvantages.

• A well-matched kidney is less likely to be rejected, so donors are matched by blood type and tissue type.
• This improves the outcome but lengthens the wait for a suitable kidney.