If you have advanced kidney disease, you may be eligible for a transplant. You will need to be evaluated by a transplant center, which will do a number of tests to determine whether you are a good candidate for a kidney transplant. In general, qualifications for kidney transplant include having chronic irreversible kidney disease, being on dialysis now or being close to needing dialysis. You may be ineligible for a kidney transplant if you have an additional life-threatening disease, a history of chronic drug or alcohol abuse, or a serious psychiatric disorder.
If you find a donor willing to donate on your behalf, that donor may be able to donate directly to you, but it is often more beneficial for you and the donor to enter the Voucher Program. By entering this program, your donor can donate when it is convenient for them and you can get the best match possible. The Voucher Program also protects the donor because all voucher donors are covered by Donor Shield.
If you need a living kidney donor, you can sometimes find a donor by asking friends and family members. If you are unable to find a donor among people you know, we recommend finding a transplant center that participates in our microsite program, which is a free service that helps kidney patients build a simple website to tell their story and find a donor. The site is sharable via social media and comes with 250 free business cards with the patient’s name and microsite URL that can be given out by the patient. If you need a living kidney donor, visit FindaKidney.org for information and helpful resources.
All donors who donate a kidney through one of the National Kidney Registry’s Kidney for Life “Expert System” centers are evaluated through the KFL Expert System. Not all Kidney for Life centers are utilizing the expert system. During this evaluation, if the transplant center discovers that you have a low eplet mismatch with a potential transplant recipient and they cannot find a better match, you may be able to participate in the Kidney for Life Direct program, which allows you to do a direct donation and be covered by the full range of Donor Shield protections, including kidney prioritization. For more information on the support and protections offered to kidney donors, visit the Donor Shield website.
The NKR protects patients by ensuring they are not disadvantaged for a transplant based on their insurance.
Medicaid does not cover physicians who are not in the same state as the patient. Kidney paired exchange often involves a recipient receiving a kidney that was removed in a state other than where the recipient is. The NKR has set up a program that provides payments to the donor surgeon when the recipient has Medicaid coverage and is out of state.
The 1972 Medicare Act provides Medicare coverage for dialysis and transplant costs and many transplant patients sign up for Medicare coverage when eligible, making Medicare coverage common for patients seeking a kidney transplant. To learn more about Medicare coverage for kidney patients click this link.
Consult your transplant team to determine your coverage as it relates to your kidney transplant and the potential for out-of-pocket expenses including your Rx coverage.
Before the transplant, the patient will be put under general anesthesia—they will be asleep for the entire procedure. The surgeon then makes an incision in the recipient’s abdomen and places the donated kidney inside. The new kidney is then connected to the recipient’s blood vessels and bladder. Once this is done, the surgeon closes the incision. The patient’s original kidneys are usually left in place unless there is a medical reason to remove them. The operation typically takes three to five hours.
Kidney transplantation is a fairly common surgical procedure, with over 20,000 performed in the United States every year. This type of surgery generally has a high success rate and a low rate of complications. Kidney transplants from living donors generally last two to three times as long as those from deceased donors. Furthermore, those facilitated by the National Kidney Registry (NKR) have superior outcomes at three, five and seven years compared to average U.S. living donor transplant outcomes. Having the largest donor pool allows the NKR to find better matches for recipients.
You will generally be in the hospital for two to seven days. Most kidney transplant recipients can return to normal activities within four to eight weeks after surgery.
The National Kidney Registry holds the Guinness World Record for the longest kidney transplant chain in the world. “Chain 357” was facilitated by the NKR from January 6 to March 26, 2015 and included 35 kidney transplants, 70 surgeries, and the combined efforts of 25 transplant centers.