Kidney transplants

• Deceased donor transplant: A deceased donor transplant uses the kidney of a person who is brain dead or deceased by cardiac death.
• Living donor transplant: As the name suggests, a living donor transplant comes from a live person, usually a relative or close friend who donates a kidney to the person in need of the transplant.
• More than 40 percent of all kidney transplant recipients at UCHealth receive their organ from a living donor, eliminating the waiting period for a new kidney, reducing the risk of rejection, and improving overall outcomes.

We do more transplants than any other program in the region, and our transplant volume is higher than national averages. Higher volume translates into more experience with transplant surgery and better outcomes for our patients.

We’ve been performing kidney transplants since the early 1960s, and our program was reinvigorated in the late 1980s by Laurence Chan, MD, PhD and Igal Kam, MD.  Our program is based at University of Colorado Hospital in metro Denver, where we devote an entire floor to transplant patients.

• Our three-year survival rate is nearly 96 percent.
• You’ll receive medical care from a team of experts specifically trained to address the special needs of transplant patients.
• We’re continually conducting research to minimize rejection and improve outcomes.
• We’ve made significant technological advancements that have greatly increased the chances for kidney transplant patients to live normal lives.

Before you receive a kidney transplant, you’ll meet various members of the transplant medical team.  You will then be given a list of tests to complete that will help in determining your current health status and complete your evaluation.   After these tests are completed and
reviewed, your case will be presented to the Kidney Transplant Selection Committee. They determine whether transplant surgery is safe for you. They also will discuss an optimal plan of care for you after transplant.

Your transplant nurse coordinator will inform you of the committee’s decision and plan. Your coordinator will notify you if/when you are placed on the active transplantation waiting list or registry.  Once you are on this list, be prepared to come to the hospital at any time of the day or night.

Kidney Transplant Wait List

The University of Colorado Hospital Transplant Program follows the United Network for Organ Sharing (UNOS) system for prioritizing transplant candidates. UNOS is a nationwide network supervised by the federal government to help ensure that all patients receive healthy organs as soon as they become available. All transplant centers in the United States belong to UNOS.

For this system to work, it relies on organ procurement organizations, called OPOs. OPOs match and distribute donated organs, 24 hours a day, 365 days a year. The OPO in our region is Donor Alliance (DA). DA is responsible for the coordination, retrieval, and distribution of organs in Colorado and Wyoming.

In December 2014, a new Kidney Allocation System (KAS) was put into place.  This goal of this system is to best match donor kidneys with the most appropriate recipients.

Are all kidneys the same?  How are they classified?

• Every kidney offered for a kidney only transplant will have a Kidney Donor Profile Index (KDPI) score.  This is a percentage score that ranges from 0 – 100 percent, and is associated with how long the kidney is likely to function when compared to other kidneys. A KDPI of 20 percent means that the kidney is likely to function longer than 80 percent of other available kidneys.  A KDPI score of 60 percent means that the kidney is likely to function longer than 40 percent of other available kidneys.
• The KDPI score is calculated based on facts about the donor that affect how long the kidney is likely to function.  These factors include:
  • Age
  • Height
  • Weight
  • Ethnicity
  • Whether the donor died due to loss of heart function or loss of brain function
  • Stroke as the cause of death
  • History of high blood pressure
  • History of diabetes
  • Exposure to the hepatitis C virus (these donors are offered only to recipients that are hepatitis C positive)
  • Serum creatinine (a measure of kidney function)

How will this KDPI score be used in allocating kidneys?

• The 20 percent of kidneys expected to last the longest (those with a KDPI score of 20 percent or less) will first be offered to those patients likely to need a transplant the longest.
• The 15 percent of donated kidneys likely to function the shortest time (those with a KDPI greater than 85 percent) will be offered first to a wider area of the country than other kidneys.

Organs donated for transplantation in Colorado and Wyoming are offered first to patients on the UNOS list in these states. If there are no suitable candidates for the organ, then it is offered to patients located outside this area.

The average patient can expect to wait three to five years on the list before an organ becomes available.