Types of donor

Where do donor kidneys come from?

Donor kidneys can come from two sources:

• A living donor (someone you know who gives you a kidney – friend or family). 
• A deceased donor (someone who has died and donated their kidneys).

Are all deceased donors the same?

No. Just like everything in life, donors can vary in age, size, gender, medical problems and how the kidney was retrieved. The doctors should be able to tell you some information about your donor and whether there are any potential issues with the kidney you are being offered.

What are the differences in retrieval?

There are two main types of deceased donors – Donors after Brain Death (DBD) and Donors after Cardiac Death (DCD). Up to one third of transplants at the Royal Free are from DCD. DBD are patients who have had a massive injury to their brain (usually due to a stroke) and tests have shown that their brain is dead. The patient cannot survive without a machine to help them breathe and they have lost all sensation. The organs are retrieved while the heart is still beating (which is why they were previously known as heart beating donors) and the organs are well flushed through with storage solution during the surgery. DCD are patients who have either had a massive injury to their brain, from which they cannot survive, and their heart stops beating after the machine to help them breathe has been stopped or their heart has stopped and they have died. The organs are retrieved after the heart has stopped beating (which is why they were previously known as non-heart beating donors) and the organs are flushed through with storage solution after the heart has stopped.

Are there any differences in outcome between DBD and DCD?

In the long term, there is no difference in the function or survival of the kidneys from DBD or DCD but the kidneys from DCD often take longer to start working (which means you may be in hospital longer) and there may be a slightly higher complication rate after the transplant. All types of donor may be variable in their suitability to you and the doctors should be able to discuss any issues about the donor. Access to DCD may increase the chances of you having a transplant and your doctor should be able to discuss the potential benefits with you. We may ask you whether you wish to be considered for kidneys from DCD.

Why might I be offered two kidneys?

There is a limited supply of kidneys for transplantation and there are not enough kidneys for everyone on the waiting list. We try to utilise all offers of kidneys, even from donors who may have had medical problems themselves, to maximise the number of patients who can have a transplant. Occasionally, we are offered kidneys from a patient where one kidney would not provide enough kidney function for a patient. In this case, we may offer the kidneys to you as a “dual transplant” and both kidneys would be transplanted to you. This would mean a bigger operation but may provide you with a transplant that you might not otherwise receive.

Can I get cancer or infection from my donor?

All donors are thoroughly screened for cancer and infection (particularly hepatitis and HIV) to reduce any risk to you following transplantation. Although we cannot guarantee the screening 100%, it is very rare for the screening to miss any potential problems. If there are any potential risks to you from the donor, the doctors will discuss this with you and ask whether you want to receive the kidney. Only patients with hepatitis will be offered kidneys from donors with active hepatitis. If you would like to know more about donors, speak to the pre-transplant nurse on 0207 794 0500 x 34084.