Treatment Options for Kidney Failure (ESRD)
Once kidney function diminishes to less than 10 to 15% and end-stage renal disease (ESRD) occurs, dialysis or transplant are the only treatment options.
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 candidatethe more the better. After transplant, a life-long regimen of immunosuppressive medication is required, leaving the patient at increased risk for infections due to the weakened immune system.
Although the majority of transplants come from cadaver organ donors, living kidney donations are becoming much more commonplace. Living donor kidneys have a significantly higher survival rate than cadaver kidneys (at five years, living donor kidney transplants have a 78.4% graft survival rate compared to 64.7% for cadaver kidney transplants).
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.
Reviewed by Francine Kaufman, MD. 4/08
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