Living Donor Kidney Transplant

What is a living donor kidney transplant?

A living donor kidney transplant (LDKT) is an operation where a kidney from a healthy living person (the donor) is removed and placed into someone with end-stage kidney disease (the recipient).

This is usually done without the removal of the recipient's own kidneys.

Why do you need a living donor kidney transplant?

A successful living donor kidney transplant (LDKT) could save your life if you are suffering from end-stage kidney disease. The new kidney can take over the function of the diseased kidneys, and allow your body to self-regulate fluid and electrolyte balance, as well as produce hormones necessary for good bone health and red blood cell production.

The 5 and 10-year survival rates of dialysis vs transplant patients in Singapore are 57.2% vs 93.6%, and 32.7% vs 85.3%, respectively*. This is due to increased cardiovascular complications present in dialysis patients.

(Source: Singapore Renal Registry Annual Report 2019)

Kidney dialysis vs kidney transplant

Compared with dialysis, kidney transplantation offers the following benefits:

  • Better survival outcomes, with at least 90% of transplanted patients doing well after surgery
  • Better quality of life after receiving a new kidney
    • Patients can resume work and normal daily activities
    • Patients are free from the pain and complications related to dialysis
  • Fewer dietary restrictions
  • (For female patients) Higher chances of successfully getting pregnant

Discover the additional benefits of kidney transplantation compared with dialysis, and delve deeper into its viability as a treatment option for end-stage kidney disease.

Deceased donor transplant vs living donor kidney transplant (LDKT)

Compared with a deceased donor transplant, LDKT offers the following advantages:

  • Shorter waiting times, with less time spent undergoing dialysis, and even potential avoidance of dialysis in pre-emptive kidney transplantation
  • Better graft and patient survival rates
  • Ability to schedule your transplant in advance compared to an emergency transplant procedure with a deceased donor kidney
  • Blood group incompatible kidney transplantation can be done for some patients

Who should not undergo a living donor kidney transplant?

An LDKT is not recommended if you have any of the following:

  • An ongoing infection, which must be treated first
  • Severe heart disease
  • Cancer that is not in clinical remission
  • Active AIDS

What are the risks and complications of a living donor kidney transplant?

For the recipient, an LDKT carries the following potential risks:

  • Decreased immunity as a result of the use of immunosuppressants
  • Other side effects of immunosuppressants e.g. new-onset diabetes after transplantation, high blood pressure
  • Acute rejection, where the immune system recognises the transplanted kidney to be foreign, and begins to ‘attack’ it. This is usually treated with stronger immunosuppressant medications.
  • Increased risk of developing cancers, especially certain virus-associated cancers

For the donor, an LDKT carries the following potential risks:

  • Risk of death, which affects around 3 – 5 in 1,000 living donors
  • Chance of premature kidney failure
  • Increased risk of hypertension and/or having protein in the urine later on in life
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