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Life After Kidney Donation: What if I Need a Future Transplant?

Eusebio (EJ) Tamez - Director, Patient Coaching

One question we sometimes hear from potential kidney donors is: “What if I donate a kidney now, then at some point in the future my remaining kidney fails and I need a transplant?”

In fact, living kidney donors may be less likely to be diagnosed with kidney disease than the general public. All potential living donors undergo an extensive medical evaluation before being approved as donors, and assessing kidney function is a large part of that evaluation. If your kidneys are healthy enough to get you approved as a kidney donor, chances are they will continue normal, healthy functioning for many years to come.

In one study, which tracked 133,494 living kidney donors from 1987 to 2015, just 331 (about 0.25%) were diagnosed with kidney failure later in life. The National Kidney Registry has facilitated more than 6,400 living donor kidney transplants since 2008, and to date not a single donor has needed a kidney transplant.

In the unlikely event you do need a kidney transplant in the future, if you donated through the NKR you will be prioritized for a living donor transplant.

Living Donor Kidney Prioritization: What it Means & Why It’s Important

The mission of the National Kidney Registry is to protect all living donors, and one important way we fulfill that goal is to ensure all donors who donate through the NKR receive the best possible donor kidney in the unlikely event they ever need a transplant in the future.

To ensure this safeguard, the NKR offers prioritization for a living donor kidney transplant as part of Donor Shield, a comprehensive suite of protections offered to living kidney donors. Kidney prioritization is available through the NKR’s Voucher Program, NKR paired exchange donations including loops and chains, and Kidney for Life direct transplants.

If you donated under one of the above scenarios and you are told you need a kidney transplant, activating your priority status is fast and easy. Simply contact the transplant center where you donated and let them know that you are in need of a transplant and that you qualify for living donor kidney prioritization under Donor Shield.

The transplant center will do a medical evaluation and contact the NKR to activate your case. Once you are active in the NKR’s kidney-matching system, your priority status goes into effect immediately. That means the NKR will immediately begin trying to find you a matching living donor kidney from among its pool of living donors. If a match is found for you, you are first in line for transplant, even if that kidney matches other kidney patients in the NKR system.

While the NKR does not guarantee that a match will be found within a set period of time, as of July 2022 the median wait time from activation in the NKR system to transplant is 1.8 months.

Kidney Prioritization: Deceased Donor vs Living Donor Kidneys

Since 1996, living kidney donors who need a kidney transplant later in life have received priority status on the deceased organ waitlist managed by the Organ Procurement and Transplantation Network (OPTN). However, many people with this “priority status” still have to wait as long as two years for a transplant.

A 2016 study found that between January 2010 and July 2015, about 60% of prioritized prior living donors had already begun dialysis by the time they were added to the deceased donor waiting list. Of the prior donors seeking priority status for a transplant, 26% had to wait 90 days to one year to achieve active status on the waiting list, and 5% waited two years or longer for active status. Once attaining active status, the median time before receiving a transplant was 23 days, although 5% waited an additional year or more before receiving priority status.

For the National Kidney Registry, that situation is unacceptable for two reasons. First, people who have generously given the gift of life by donating a kidney should not be subjected to lengthy wait times for a kidney should they need a transplant in the future. Second, prior donors should have access to be best possible donor kidney, and that means a kidney from a living donor.

Kidneys from living donors are typically healthier that those from deceased donors, since the donor is living and in good health, having gone through extensive health testing before being approved as a donor. In addition, living donor kidneys typically have better outcomes, lower patient mortality rates and last twice as long as deceased donor kidneys.

Kidney transplants facilitated by the NKR have even better outcomes. According to the latest NKR Outcomes Report, NKR kidney transplants are 13% less likely to fail after one year compared to all living donor kidney transplants in the United States, and the patient mortality rate is 31% lower with NKR transplants.

By donating a kidney through the NKR, you can rest assured that should you ever need it, we will make it a priority to ensure you receive a healthy, well-matched living donor kidney as quickly as possible.

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