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Living Donor Kidney Transplant

Improving the quality of life and health outcomes for patients with advanced kidney disease through increased access to living donor transplants.

Transplantation is the best therapy for most patients with end stage kidney disease because it provides the best quality of life and helps people live longer compared to dialysis. A successful kidney transplant can as much as triple a patient's life expectancy.

Transplant First

Transplant First - a joint initiative between the BC Renal's Kidney Care Centre (KCC) Committee and BC Transplant - is to promote pre-emptive transplants (transplants provided to patients before they start dialysis) through living donation.

The first goal of this initiative was focused on working with staff and patients at the 14 Kidney Care Clinics (KCCs) across BC to inform them of the advantages and safety of living donation and give tools to assist in finding willing donors.

In the second phase of this initiative, the focus has been more about implementing and sustaining enhanced pre-transplant clinical processes to ensure every KCC patient who is a potential kidney transplant candidate is identified, assessed and supported along the path toward transplantation as the treatment of choice, including assistance in finding a living donor.
People Considering a Kidney Transplant
A kidney transplant from a living donor is the preferred treatment for many people suffering from kidney disease. There are several advantages to a living donor kidney transplant over a deceased donor kidney transplant:
  • Improved success rates
  • Shorter waiting times
  • Surgical date is known in advance (helps with planning)
  • May avoid the need for dialysis (pre-emptive transplant)

As the patient’s kidney function declines, the kidney care team will monitor blood work and assess whether the patient is a candidate for transplant education. If there are not any significant health reasons for the patient to not proceed with transplant, the kidney care team will offer the option to start transplant education.
 
Patient Resource:

Transplant education is provided early and over time starting in the Kidney Care Clinic to ensure your patient has a clear understanding of the benefits associated with living donor kidney transplant (LDKT) and to help them decide if this is the best treatment option for your patient in collaboration with the kidney care team.


Transplant Education Resources:

The kidney care team will start to talk to the patient about living donor outreach and the best ways to communicate their story to friends, family, and community. The team will provide the patient with the support and resources needed along the way to help overcome any challenges and answer any questions about how to reach out to potential donors. The kidney care team will help develop a living donor outreach program, but it is the patient's responsibility to develop the plan and do the outreach to potential living donors. Potential donors need to come forward voluntarily without feeling pressure or coercion especially from anyone involved in the patient's kidney care.


Living Donor Resources:


Once the patient has received education, the patient is referred to the local transplant clinic or kidney care clinic. Screening is done as part of the referral process to the provincial transplant centre (Vancouver General Hospital and St. Paul's Hospital). Some of this screening includes information about previous blood transfusions, prior pregnancies, prior transplants, and kidney biopsies


Patient Resources:


Testing includes blood tests such as those that are standard during regular health checks and more specifically those to rule out sexually transmitted infections (STIs), diagnostic tests such as chest x-ray, cardiac testing and various other tests such as tuberculosis, fecal test for colon cancer screening, etc. Some tests will take more time than others, but it is an important step towards ensuring your patient is suitable to receive a living donor kidney transplant.


The local transplant clinic and kidney care clinic work together to ensure that all the testing required is completed and sent to Vancouver General Hospital or St. Paul's Hospital.  The patient's family doctor may be contacted to provide important health information as well.


Once testing is complete and the referral is sent to Vancouver General Hospital or St. Paul's Hospital, the priority in which the patient will be seen and assessed depends on different factors. For example, your patient will be assessed more quickly if they have identified a living donor and the living donor has registered as a possible donor. People with registered living donors are prioritized over those who do not have a living donor registered.  People with lower GFR may get prioritized to be seen sooner as well.


It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.


Living Donor Resources:

Vancouver General Hospital or St. Paul's Hospital will review testing results that were completed at the local clinic.  The results will help them decide whether your patient is suitable to proceed with the next step on the journey towards living donor kidney transplant. 

  • If the transplant team decides your patient is suitable to proceed, they will start the assessment process. This may include more testing and a visit will be scheduled with the transplant team
  • If they decide your patient cannot proceed, they will be contacted by their nephrologist or kidney care team. The team will explain to the patient the reasons why and discuss other treatment options

Vancouver General Hospital or St. Paul's Hospital will schedule an assessment visit with your patient to help determine whether they are suitable for transplant based on all of the testing that was completed. The initial assessment is done by the transplant surgeon (urologist), transplant physician (nephrologist) and transplant nurse and/or social worker. More tests may be requested based on the assessment with the transplant team.


It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.


Patient Resources:

Living Donor Resources:

The transplant team will determine if your patient is suitable for a living donor kidney transplant once you have been assessed.  To help determine whether they are suitable, there may be some more testing that is required depending on your patient's individual circumstances. 

  • If your patient is not suitable, the transplant team will contact them and provide the reasons why they are not able to proceed. 
  • If your patient is suitable, the next step is to start preparing them for the transplant procedure.

The provincial transplant donor team will communicate with the recipient's transplant team to determine the timing of the transplant procedure based on their level of kidney function and whether a donor will be ready.


It is important to continue to have living donor outreach discussions with your patient and addressing any challenges that may come up along the way.


Patient Resources:

Living Donor Resources:


People Considering Becoming a Living Donor
Living Donation
Living organ donation is an act of altruism that reduces the wait time for patients in need of a life-saving kidney or liver.
 
Living Donor Kidney Program
There are many reasons why a transplant from a living donor may be the best option for a patient. Transplant outcomes are generally better with kidneys from living donors than for kidneys from deceased donors. With careful planning, a patient can avoid the need for dialysis and go straight to transplant from a living donor. 
 
Living donors are often related to the recipient, but they don’t have to be. Living donors can be siblings, parents, children, or relatives. A donor can also be a friend, relative through marriage, co-worker or a member of the recipient’s community.
 
Adults in BC, may choose to donate a kidney to someone they know, on behalf of someone they know, or can donate anonymously.

All living donation is managed through Vancouver General Hospital (VGH) and St. Paul’s Hospital (SPH) Pre-Assessment Transplant Clinics. The process includes the following steps:

If you are considering becoming a kidney donor, you can begin the process by calling Pre-Transplant Services at Vancouver General Hospital or St. Paul’s Hospital. You will be asked to complete a medical and social history questionnaire. If there are no immediate concerns, a blood test will be arranged to check for compatibility between you and the recipient.


Contact either program directly at:

Vancouver General Hospital Living Donor Program -  Kidney 

Gordon and Leslie Diamond Health Care Centre
Level 5, 2775 Laurel Street
Vancouver, BC V5Z 1M9

604.875.5182 or 1.855.875.5182

St. Paul’s Hospital Living Donor Program - Kidney

Unit 6A, 6th Floor, Providence Building
1081 Burrard St.
Vancouver, BC V6Z 1Y6

604.806.9027 or 1.877.922.9822


You will need to do several tests to ensure it is safe for you to donate. Some tests may be done through your family doctor, and most can be done close to your home or workplace, even if you live outside of the province.

 

If all your test results are normal and you decide you want to proceed, the next step is to meet the transplant team in Vancouver. This is usually a two-day visit, so that you can meet with various members of the transplant team and complete any required testing.  Once the evaluations and tests are done, the transplant team will determine if you are a suitable donor.‎

 

Choosing a surgical date usually requires discussions between the various members of the transplant team.  As the surgical date approaches, you may be asked to repeat certain blood tests.  Following surgery and throughout your life, you will require routine monitoring to make sure you stay healthy living with one kidney.‎

 


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SOURCE: Living Donor Kidney Transplant ( )
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