Receiving a kidney from a deceased donor

Even though it is called a waiting list, a kidney is not always given to the person who has been waiting the longest. The list is like a pool of people who might be offered a kidney from a deceased donor.

Kidneys from non-directed donors are also allocated through the deceased donor list — often through the kidney exchange.

Non-directed donors are people who are alive and decide to donate one of their kidneys to someone they do not know.

Once you get to the stage when your kidneys are only just working, the team looking after you will talk to you about dialysis and transplant.

Many people who have end stage kidney disease can go on the list for a kidney transplant from a deceased donor.

However, not everyone is suitable for a kidney transplant from a deceased donor. Some people may be told that they can have a kidney transplant from a live donor but not from a deceased donor because of:

• previous transplants
• other health conditions
• the person’s overall health
• how their kidney disease has affected the rest of their body
• other surgery the person may need at the time of transplant
• lower than 80% chance of living more than 5 years after a deceased donor transplant.

Usually there are more than 400 people on the active waiting list. In Aotearoa New Zealand about 100 kidneys are donated each year from deceased donors. This means only people with a good chance of doing well after a transplant are able to go on the list.

Your kidney doctor and the team at your transplant centre will discuss:

• your health
• your test results
• how your kidney disease has affected your heart and the rest of your body.

This checks you are fit enough to have a transplant at any time. This is called your Comorbidity Score.

Looking at all these things helps doctors to make the same decisions across Aotearoa. This means deciding who gets a kidney from a deceased donor is as fair as possible.

If you are assessed as having a lower than 80% chance and your doctor does not think that is correct, they can ask for the decision to be reviewed.

Everyone on the waiting list is reviewed every 1 to 2 years to make sure they are still well enough to stay on the list.

You may be lucky and get a kidney quickly. However most people will wait for several years. Sometimes this is because of your blood group or antibodies. Some people on the waiting list may never be offered a kidney from a deceased donor.

When a family offers a kidney for transplant, the New Zealand Blood Service uses the information from your monthly blood tests as well as how long people have been waiting to decide who gets offered the kidney.

Kidneys are offered to people based on 2 things. First who has been waiting the longest time on dialysis and secondly the best match.

There is no way of guessing the blood group of the next donor and what antibodies a person needing a transplant might have against that kidney.

If your health is not good enough to be on the deceased donor list, you could still be well enough for a transplant from a live donor.

These sorts of transplants are more likely to happen, happen more quickly and you do not always need to have the same blood group.

Talk to your family and friends about them donating a kidney to you.

Live organ donation