Brain-dead organ donors
The majority of organs used in transplant programmes throughout the world come from brain-dead organ donors. These are people who have suffered serious injury or other medical conditions that have left them with beating hearts but brains that are already completely dead. Their circulation and ventilation are maintained on life-support machines, but if these were to be switched off they would stop breathing and die.

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There are very strict laws and rules regarding the certification of someone as brain-dead. The diagnosis of the brain-dead state has to be definite. The brain-dead potential organ donor may either be a known card-carrying organ donor, or the family may give consent for the harvesting of organs.

Once the decision to proceed with organ harvest has been made, the donor is taken to the operating theatre where the organs to be used are removed. Occasionally only the kidneys are removed, but sometimes it is possible to use the kidneys, heart, lungs, liver and corneas from the same donor. Thus one organ donor can save or improve the lives of several different people awaiting organ transplantation for a variety of problems.

Once the kidneys are removed, they are placed on ice in sterile bags containing a preserving fluid. Kidneys can be safely preserved for up to 24 hours in this way, and can be transported if necessary. However, prolonged time between harvest and implantation is associated with a worse prognosis. Each of the two kidneys from one donor will be implanted into separate recipients.

Living related and unrelated donors
In the case of a living donor the situation is completely different. The donor is a completely healthy person who will give one of his or her kidneys to the recipient. The donor is usually but not necessarily a relative of the recipient. The procedure is carefully planned beforehand. Obviously, the person donating a kidney needs to have two normal kidneys to start off with.

The decision to donate a kidney is not minor: as with any surgery, there is a small but definite risk involved in the operation to remove the kidney. A person can expect to lead a perfectly normal life with one kidney, provided that nothing happens to that one remaining kidney.

Due to their common genetic makeup, blood relatives will have a much better chance of a close match than unrelated individuals. Identical twins have identical genes (DNA) and will match perfectly. Transplantation between identical twins is the one situation where rejection is not a problem at all. In fact, these are the only transplant patients who do not need any anti-rejection medication.

With living donor transplantation, there is no need to store the transplanted kidney on ice for any significant length of time. The two patients are usually under anaesthetic in adjacent operating theatres and once the kidney has been removed from the donor it is implanted into the recipient straight away.

Read more:
Glass of milk a day may keep kidney stones away
Myths and facts about organ donations

National Kidney Foundation
 

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