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A kidney transplant diary (includes tests, procedures, recipiant and donor points of view):Pineda family:"We met with the Transplant Coordinator at ADMC in early August of 1997 and started getting familiar with what lay ahead if we indeed decided to go ahead with a transplant. Five persons volunteered to be tested for possible donors: A friend, Evie's sister, Evie's 2 nieces and myself. One person was immediately eliminated, without testing, because of incompatible blood type. Evie is O+ so only type O is compatible. Three of us were tested in September. Results were: one incompatible blood type, one we never heard from again, and I was a blood match (O+) and a 0 antigen match. The last person was tested in early January 1998: blood match and a 2 antigen match. After discussing it with the doctor, he was of the opinion that a 2 antigen match would not be significantly better than a 0 match. Also, because of work commitments, that person would not be able to undergo further testing until the summer of '98. The doctor felt I would be an acceptable donor. I did not want to wait until summer and neither did Evie. Neither of us wanted to take a chance waiting for a cadaveric kidney. The average wait here is about 2 years."
http://www.pinedafamily.net/enio/transplant.html

Indications for transplantation and more:Mayo Clinic:"Any chronic kidney disease leading to kidney failure may be an indication for transplant, including the following conditions: Type I (insulin-dependent) diabetes Glomerulonephritis Chronic pyelonephritis Interstitial nephritis Polycystic renal disease Congenital diseases of kidney Dysplasia Hypertensive nephropathy Types of Kidney Transplants There are two types of kidney donors: Living (related or unrelated) donors. Living unrelated donors are usually emotionally related to the recipient. Mayo Clinic Scottsdale offers the latest technology for live-donor transplantation with laparoscopic donor surgery in select cases. Cadaver donors. If there are no compatible living related or living unrelated kidney donors, transplant patients are placed on a waiting list to receive a cadaver kidney."
http://www.mayo.edu/mcs/Medical_Specialties/Transplantation_Medicine/Kidney_Transplantation/#IndicationsforTransplantation

Study challenges conventional theories on racial differences in kidny transplant outcomes:Uva health system:"An analysis of national transplant data conducted by researchers at the University of Virginia Health System may have important implications for the level of drug therapy given to African-Americans undergoing kidney transplants. Because African-Americans experience more episodes of rejection than Caucasians, many physicians give them higher levels of immunosuppressant drugs to prevent rejection. Unfortunately, these drugs can have potential side effects. But the findings, presented in May at the American Society of Transplant Physicians annual meeting in Chicago, challenge the conventional theory that increased episodes of rejection are responsible for the significantly higher rate of kidney failure in African-Americans who have undergone kidney transplant"
http://www.med.virginia.edu/newstips/Archives98/kidney_transplant.html

How do we find a kidney that "matches" mine?:inforenal.com:"The best match for a kidney transplant is an identical twin because identical twins have perfectly matching kidneys. Brothers and sisters (by birth), or your mother or father, may also have a kidney that is compatible. The relative who wishes to donate must talk with the doctor about additional tests, the surgery, and possible risks. Tests include a complete medical evaluation, blood and urine tests, an EKG (electrocardiogram) and x-rays. To determine a good, healthy match, the following steps are done: The donor's blood is tested to rule out hepatitis or AIDS The blood type and tissue type are tested to see if they match (Tissue typing is done on a sample of blood and does not require taking any tissue from your skin or body.)"
http://www.inforenal.com/us/patients/choices/transplt/

Taking Control of Your Treatment:diabetes.about.com:"Grafting a healthy kidney from a cadaver or living donor is a complex process. The donor kidney and the transplant candidate must be tissue matched for antigen compatibility. The kidney has six antigens (which stimulate the production of antibodies), and compatibility is based on how many of the antigens match up from donor to candidate. Once a kidney is found and grafted, a life-long regimen of immunosuppressive medication must start, leaving the patient at increased risk for infections due to the weakened immune system. And transplanted kidneys do not last forever; the average life of a cadaver graft is less than 15 years and rejection of the kidney by the patient can occur at any time. However, the life span of transplanted kidneys has increased dramatically over the past decade, and there are transplant recipients who have had functioning grafts for over 35 years"
http://diabetes.about.com/library/weekly/aa030501c.htm

What are the advantages of kidney transplantation?:transplant.med.va.gov:"Transplantation offers several advantages over dialysis: no rigid schedules or large time commitments required each week for treatments. Hemodialysis takes four to five hours three times per week, not including time spent commuting to and from the dialysis center or waiting for an available machine. dialysis patients require regular injections of Epogen. The transplanted kidneys produce this substance naturally. no dependency upon a machine or equipment. a more normal, active lifestyle than with dialysis"
http://www.transplant.med.va.gov/transplant-information.asp

Kidney transplant (comprehensive information):Institute of child health:"Blood groups and tissue types Everyone has a blood group which remains the same throughout life. It is based on which of two types of protein (antigens) are present in your body. The main blood groups are A, B, AB and O. People with blood group A have only antigen A in their body, people with blood group B have antigen B, people with blood group AB have both antigens, and people with blood group O have neither. The most common type is O, followed by A. Everyone also has a tissue type which does not change. It is based on the antigens present on the surface of most cells. You have only one tissue type but it is made up of six different parts. The three main sorts of tissue type are A, B and DR. There are about 20 different versions of the three tissue types. The more tissue types you match with the donor the less likely the body is to reject the kidney"
http://www.ich.ucl.ac.uk/patients_fam/ppweb/html/pig_lfts.html/kidney/transplant.html

PRETRANSPLANT EVALUATION (a patients guide to kidney transplant surgery):kidneytransplant.org:"Pretransplant tests, as well as giving a clear picture of the patient's overall health status, help in identifying potential problems before they occur. They also help in determining whether transplantation is truly the best option. This increases the likelihood of success. The following procedures help in evaluating a patient's health status: Physical exam - Gives the doctor an overall picture of the patient's conditions. Chest x-ray - Determines the health of the patient's lungs and lower respiratory tract. Complete medical and surgical history - Determines what additional tests may need to be done. Electrocardiogram (EKG or ECG) - Determines how well the patient's heart is working and may reveal heart damage that was previously unsuspected. Ultrasound with Doppler examination - Determines the quality of the iliac vessels. Blood tests - The patient's blood count, blood and tissue type, blood chemistries, and immune system function will all be checked. In addition, blood tests for certain infectious diseases will be performed"
http://www.kidneytransplant.org/patientguide/pretransplantevaluation.html

Kidney transplant-information about kidney transplant:Northwestern memorial hospitol:"Most patients with irreversible kidney failure are potential candidates for kidney transplant. In general, patients who are less than 65 years of age are eligible for transplant. However, overall health and well-being are also important. For example, you must have stable heart and lung function in order to safely withstand the surgical procedure. Your medical history, including previous transplants, any drug abuse, and difficulty in following medical advice, will also affect your possibility for transplant. All of these issues are considered with each patient to insure that the best decision is made."
http://www.nmh.org/services/transplant/kidney_transplant_info.html

How donors and recipients are matched:University of south Florida college of public health:"Donors and recipients can be matched several ways. Kidneys can be harvested from both living and those who have just died if all the medical data and proper matches are present. Now, procedures donating parts of livers from a living donor are also possible given the right circumstances. Most donations come from cadavers, however. When a patient's name is added to the allocation list, his or her profile is entered and stored in the OPTN computer. This pool of patients is crossed matched by the computer with all available donors. This list in based on medical and scientific criteria. Where possible, organs are allocated to those on in the local area of the transplant team. If no match is made locally, a regional search is done. If no match is made regionally, the organs are offered to the highest-ranking person in need in the US "
http://www.med.usf.edu/~kmbrown/organ.htm

The kidney transplant/dialysis association, Inc"The KIDNEY TRANSPLANT/DIALYSIS ASSOCIATION, INC. (KT/DA), is an organization made up of artificial kidney and kidney transplant patients, their families and friends, and health professionals. Our officers are themselves kidney patients or spouses of kidney patients. Now with over 2,200 members across New England, as well as throughout the country and abroad, the KT/DA is dedicated to providing financial aid, information, and emotional support to chronic renal disease patients and their families."
P.O. Box 51362 GMF
Boston, MA 02205-1362
(781) 641-4000
ktda1@rcn.com
http://users.rcn.com/ktda1/

Financial Resources:

Pharmaceutical Indigent Programs:Unknown author:"This is something I found a few months back I don't know if these Companies are still around or not but thought I would pass this info on. (thanks to the unknown author of this information The research-based pharmaceutical industry has had a long standing tradition of providing prescription medications free of charge to physicians whose patients might not otherwise have access to necessary medications. The list below contains the name and telephone numbers of companies that have indigent programs in place"
http://www.geocities.com/HotSprings/8374/Indigent.htm

NeedyMeds.com:NeedyMeds.com:"There is help available for the many millions of people who have no insurance and can't afford to purchase their medicines. NeedyMeds is the place to learn about patient assistance programs and other programs designed to help those who can't afford their medicines. NeedyMeds is not a program. It's an information source The first step in learning about what's available is to explore our website. It's designed to be easy to navigate. We stay away from fancy graphics, multiple layers, etc. Read our introduction to learn more about this problem and how NeedyMeds can help."
http://www.needymeds.com/

National transplant assistance fund"National Transplant Assistance Fund (NTAF) is a not-for-profit resource serving all organ and tissue transplant patients, their families and the professional community who treats them. NTAF also provides services for patients with catastrophic injury. We provide fund-raising expertise for patients raising money for uninsured medically related expenses, $1,000 challenge grants for eligible patients and educational information regarding organ/tissue donatio"
NTAF
Suite 230
3475 West Chester Pike
Newtown Square, PA 19073
Telephone 610-353-9684
Toll Free 800-642-8399
Fax # 610-353-1616
http://www.transplantfund.org/homepage2.html



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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