TRANSPLANTATION

Kidney transplantation is a procedure where the kidney of another individual is transplanted to a dialysis patient or a patient with decreased kidney function (<GFR 20 ml/dk). Generally there are two ways of doing it: The procedure of transplantation from a deceased individual is called “kidney transplantation from a cadaver”. Another method is the transplantation of a kidney from a living donor. Kidney transplantation is possible for a dialysis patient if there is no medical obstacle. However the applicants that are 70 years or older should be evaluated in more detail.

CONDITIONS THAT POSE A CERTAIN OBSTACLE FOR KIDNEY TRANSPLANTATION:

•Cancer
•Active AIDS
•Active Tuberculosis
•Active Hepatitis or cirrhosis
•Severe vascular disease
•Intravenous drug abuse
•Less than 5 years of life expectancy
•Recent myocardial infarction
•Final stage heart, lung or liver failure

Besides these, there are some relative impedi
ments to kidney transplantation: Being too slim or fat, and cigarette-smoking can cause problems. Some transplantation centers do not perform trnsplants for smokers.

Kidney transplantation from a cadaver co
nstitutes much of the kidney transplantation in the world. Contrary to this, in our country transplantation from a cadaver constitutes 20-30% of total transplantations.

Transplantation from a living donor:
Everyone who is elder than 18 years old is a candidate for being a kidney donor. Which people cannot be a kidney donor?

•Cancer patients
•HIV carriers
•Hypertensive patients
•Diabetics
•Renal patients
•Pregnant women
•People with another organ failure
•People with cardiac disease

Despite the accepted age range of the donors is between 18 to 65 years, the upper limit could be higher according to the persons health condition and renal functions. In order to be successful at cadaver transplantations, blood compatibility along with tissue compatibility is required. For living donor transplantations, tissue compatibility has lost its’ earlier significance. However, blood compatibility is important. Tissue antigens are present on the surface of all cells and are inherited. There are three basic tissue antigens: A,B and DR. Each individual has six different antigens in total; particularly 2A, 2B and 2DR as one comes from the mother and one from father. In cadaver transplantation, the higher the concordance between these six antigens, the higher the chance of success. A DR compatibility is definitely required. After several examinations, a person is accepted as a transplantation candidate as long as there is no obstacle for transplantation.