Transplant Waiting List

What does it mean to be on the waiting list for a kidney?

The waiting list refers to individuals who are waiting for a non-living donor kidney transplant at a transplant center. The median waiting time nationwide was more than three years for those listed in 1999. Individual transplant centres maintain waiting lists of candidates.

What determines who gets a kidney when one becomes available?

Many factors are considered each time a kidney becomes available. Candidates are matched to kidneys based on such factors as blood group (A, B, 0, AB), tissue type (approximately 150 different kinds), length of time on the waiting list and medical condition.

When a kidney becomes available, transplant centres first try to find a match locally. If no match is found, a suitable recipient will be sought regionally, and then nationally.

Who makes the final decision about the transplant?

Once the list is generated, other factors become important such as medical suitability. The final decision to offer the kidney to you is made by the transplant surgeon and your nephrologist. You, of course, have the final say in whether or not you consent to the transplant operation.

Can you be on more than one list?

Yes, but transplant centres have different rules about how transplant candidates on multiple lists are treated. If you go on another list, you need to be able to get to that center in a reasonable time (6 to 10 hours). Being on more than one list may increase your chance of getting a kidney somewhat. But, if you get your transplant at a center far from where you live, it usually makes your follow-up management more difficult. Hospitals may have different rules about patients listed at other hospitals.

What does it mean to be on the "national list"?

Each person listed for a non-living donor kidney transplant in the UK is required to be on the national list. This list is kept by UK Transplant on a computer in Bristol. When a kidney becomes available in an area, information is sent to the computer center and a list of people for that kidney is generated. If the kidney is a perfect match with a person on the national list, it will be offered to that person no matter where he or she is located.

How could I get a perfect match kidney?

You could get a "perfect match" kidney either from a brother or sister (living-related) or through the national computer match system. The chances of getting a perfect match kidney from a natural brother or sister is about 25 percent, while from a non-living donor, the chance is about 6.5 percent.

My doctor told me that I have a lot of antibody. What does that mean?

Antibody refers to proteins the body usually makes in response to other proteins that are not familiar to your body such as infections, blood transfusions, pregnancy and transplants. The job of antibody is to protect the body from whatever might harm it such as infection. In the case of a transplant, antibody can cause you to reject the new kidney because your body "sees" or senses that the new tissue is different. Therefore, your body will try to destroy this new tissue like an infection. A person who has a lot of antibody generally will have to wait longer for a kidney than one who does not have much antibody.

What is a crossmatch?

A crossmatch is a final test performed before you would be transplanted to determine if you are at risk for rejection. It can be thought of as a "test tube transplant" because a part of your blood is mixed with a part of the kidney donor's blood in a test tube. If your cells kill the donor's blood cells, you will most likely reject the new kidney and you will not be transplanted with that organ.

See also in this A-Z guide:

• Kidney Transplant
• Nutrition and Transplantation
• Getting Ready for a Transplant