To help you better understand the process of organ donation and transplantation, we have compiled the following list of common terms and procedures.
A
ABO incompatible transplant— In some cases, it is possible to transplant a kidney from a blood-type incompatible donor into a patient who needs a kidney. In these cases, extra therapy is required before the transplant in order to overcome the incompatibility. These therapies include rituximab, intravenous immune globulin, and plasmapheresis, a procedure that removes antibodies from the blood.
Access— Patients with kidney failure require an access site to receive dialysis through since the volume of blood that needs to be cleaned is high. Types of dialysis access include catheters, fistulas, and grafts.
Adherence- Also called "compliance", this is the act of following instructions, such as attending dialysis sessions and taking medications as prescribed. Adherence is a very important component of transplantation since loss of the transplant may occur when patients are not adherent to their medication and follow-up schedules.
Allocation— This is the process used by the United Network for Organ Sharing to distribute organs for transplant to the most suitable recipient, based on waiting time and matching of the donor and recipient.
Allograft— Another term for a transplanted organ. Sometimes referred to as "graft". For example, a kidney transplant may be called a kidney allograft or kidney graft.
Altruistic donor— A person who wishes to be a living kidney donor although they do not have a specific person in mind to donate to. Altruistic donors are key to the success of donor chain transplants since their participation enables many transplants to occur. Altruistic donors are also known as "non-directed" or "Good Samaritan" donors. View the video for "" on YouTube.
Anti-rejection medication— Also known as immunosuppressants, these are the medications that transplant patients must take for as long as their transplant continues to function in order to lower the risk that the immune system will try to reject the transplanted organ.
Antibody— An antibody is made by the immune system in response to a foreign intruder such as an infection or a transplanted organ. The antibody locks onto the cells of the invader, which signals the immune system to destroy the cell.
Antigen— These are proteins present on the surface of cells that enable the immune system to tell that the cell is an invader. In response to the foreign antigens, the immune system then creates antibodies which then latch on to the antigen proteins and signal the immune system to destroy that cell.
B
Biopsy— A biopsy is a procedure performed so that the transplanted organ can be examined under a microscope. Currently, biopsies are the gold standard for diagnosing rejection of the transplant organ. In addition, biopsies can provide other important information about the function of the transplant, such as infection or recurrence of kidney disease. During a biopsy, a needle is introduced into the transplanted organ under local anesthesia.
Bladder— The bladder holds urine made by the kidneys until it is ready to be released from the body. During a kidney transplant, the new kidney is attached to the bladder using the ureter (tube that carries urine from the kidney to the bladder) of the donor. In order for the bladder to heal from the surgery, a Foley catheter is placed in the bladder so that the urine produced by the new kidney can be continuously drained from the body while the bladder heals.
Blood pressure— High blood pressure is a leading cause of kidney disease since the increased pressure can damage the kidney over time. After transplant, it is important that the blood pressure is neither too high nor too low in order to ensure the best outcomes. Control of blood pressure after transplant is also very important to prevent damage to the transplanted kidney.
Blood Type— Each person has a specific blood type, A, B, AB, or O. Blood type is very important for both blood transfusions and transplantation because incompatibility can cause a reaction that could lead to loss of the transplant. The table below shows transplant blood type compatibility.
Brain death— The majority of deceased organ donors are declared brain dead. Although their heart and lungs may be temporarily functioning due to artificial support systems (such as a ventilator), the person has no brain activity and therefore no possibility of recovery.
C
Cadaveric donor— An older term for a person who has donated their organs upon death. The term now used is “deceased donor”.
Chronic kidney disease (CKD)— All patients who need a kidney transplant have chronic kidney disease which has progressed to the point of needing dialysis and/or a kidney transplant.
Coercion— Coercion is when a donor feels compelled to donate out of fear, guilt, pressure or other emotion. Other words for coercion include "arm-twisting", force, compulsion, constraint, duress, and pressure.
Potential donors should realize that their health information is protected by the living donor team and is not shared with the potential recipient or the healthcare professionals caring for your potential recipient. If a potential donor feels coerced into donating, the living donor team will be able to provide that potential donor with a "way out" based on medical reasons that will not be disclosed to the potential recipient.
Cold ischemia time— This is the amount of time that an organ is out of the body, in between being removed from the donor, and being placed into the transplant recipient. For deceased donor kidney transplantation, the cold ischemia time often exceeds 24 hours; in general, kidneys can be out of the body for up to 48 hours. The longer the cold ischemia time, the longer the kidney may take to "wake-up" and begin to function after being transplanted.
Compliance— Also called "adherence", this is the act of following instructions, such as attending dialysis sessions and taking medications as prescribed. Compliance is a very important component of transplantation since loss of the transplant may occur when patients are not compliant with their medication and follow-up schedules.
Crossmatch— A crossmatch is a test performed to see if a donor and recipient are compatible. The blood of the donor and recipient are mixed, and if there is a reaction, it is called a positive crossmatch. This reaction is caused by antibodies that the recipient