Chronic kidney disease is a progressive disease that requires dialysis or kidney transplant treatment after entering the end-stage phase. Kidney transplantation is the best method of renal replacement. After a kidney transplant, patients live twice as long as patients treated with peritoneal dialysis or haemodialysis. It is possible to return to full professional activity and the quality of life is improving very much.
Patients with chronic renal failure in a nephrology clinic with a glomerular filtration index (GFR*) of approximately 15 ml/min/1. 73 m² and patients with chronically dialysed should receive as much information about kidney transplantation as possible. In patients with kidney failure in diabetes, conversation and preparation for kidney or pancreatic kidney transplantation begins with GFR 20 ml/min/1. 73 m². Kidney and pancreatic transplantation is performed for type 1 diabetes, avoiding dialysis and insulin injections.
* GFR – is the abbreviation for the first letters of the termglomerular filtration rate. This is a parameter calculated by a doctor with special formulas, which is used to evaluate kidney function. The higher the creatinine value, the lower the GFR value. The correct GFR is above 90 ml/min/1. 73 m².
Talk to your family about your illness and the various options for renal replacement therapy. Remember that the best choice for people with end-stage renal disease is a preemptive transplantation of a kidney from a living donor before starting dialysis. Invite your family to an educational interview with your nephrologist.
In order to become a kidney recipient, you must be registered with the National Waiting List (KLO – Krajowa Lista Oczekujących) for a kidney transplant. In the first place, various examinations and consultations are carried out, which exclude diseases that are contraindications to kidney transplantation.
After these examinations, the doctor conducting the examination (in a dialysis station or in a nephrological clinic) sends a notification to the Head of the Regional Team of the Qualification Centre (Regionalny Ośrodek Kwalifikacyjny). If the application is accepted, it will be given the status of “active” on the National Waiting List (KLO). From now on, the patient can be summoned at any time for a kidney transplant by any transplantation centre in Poland that has donated a kidney from a deceased donor. The selection of the recipient for the kidney is made by a special computer program in the tissue compatibility laboratory, which takes into account the compliance of the main blood groups, tissue compatibility and several other parameters. The average waiting time for a kidney transplant in our country is about 12 months.
If you have a potential living donor, tell your doctor. They will report your “couple” to the Transplantation Centre that prepares and performs kidney transplants from living donors. Remember that a kidney donor does not have to be a relative in Poland.
Be prepared that your doctor can call you at any time for a kidney transplant. You must then come to the hospital/dialysis station for an examination to determine whether you currently do not have absolute contraindications to the procedure, such as an infection. Take your current test results (ECG, chest X-ray) and the original of blood group with you. Then you will be transported to a Transplantation Centre in Poland, which has taken a kidney that matches your needs and will perform a transplant. Before the operation, it may be necessary to perform an additional dialysis procedure and additional tests. All information about the procedure will be given to you by a team of doctors at the Transplantation Centre.
If you have a potential living donor, the attending doctor will report your couple to the transplant centre that prepares and performs kidney transplants from living donors. If a person close to you may be a kidney donor for you during qualifying tests at the centre, the procedure will be scheduled at a convenient time. You will be informed of everything by the doctor who will be leading and preparing you and the Donor for your kidney transplant. You will receive a phone call from the Transplant Coordinator, who will plan appointments. You will receive support from a psychologist working with the team.
Remember that a kidney donor doesn’t have to be a relative. Altruistic and commercial donors are not accepted in Poland. If the donor and recipient have a mismatch between the main blood groups, the couple can be reported to the kidney pair replacement program.
- Blood type
- Tissue compatibility antigen assay (blood testing)
- Determination of the degree of allergy to foreign antigens – the so-called PRA (blood test)
- Laboratory blood testing
- If you pass urine, a general urine test and urine culture
- Faeces for occult blood
- Heart echo – very often coronarography is also required
- Women: cytology, breast ultrasound or mammography
- Men: Urological assessment of the prostate
- Abdominal ultrasound
- Doppler-Ultrasound of hip/neck vessels
- Sometimes also computer tomography or magnetic resonance imaging
- Chest X-ray
- Voiding cystourethrogram
- Colonoscopy (for persons over 50 years of age)
- Dental, ophthalmic (bottom of eye assessment), laryngological and cardiological consultation,
- Surgical consultation
- Sometimes it will be necessary to perform surgery before a kidney transplant, e.g. removal of one kidney, removal of a gallbladder with deposits, replacement of a diseased heart valve.
- If you are a National Waiting List member and you are “active” your serum is collected and sent to all Transplant Centres in Poland every 6 weeks. The test for foreign antigen allergy (PRA) is repeated every 12 weeks.
- If your kidney failure is caused by diabetes, your qualification for a kidney transplant should start earlier, i.e. when your creatinine clearance (GFR) is about 20 ml/minute.
- Kidney transplantation in obese people is of higher risk. Ideally your BMI should not exceed 30 kg/m²
- Active infectious diseases until they are cured
- Generic cancer
- Severe and irreversible diseases of other organs and systems, e. g. generic atherosclerosis
- Persistent addiction
- Active psychosis
- No cooperation with the doctor
If you are a patient with a diagnosed chronic kidney disease, who has not started dialysis treatment yet or you are already a patient on dialyse, you can make an appointment for a video interview with one of our specialists, Marta Serwańska-Swietek PhD or Michał Wszoła MD, PhD. You will receive information about further treatment options. This form of contact helps to save time spent on travel. Before the video interview, you will be given a form to fill out, which will help the doctor to conduct the interview properly. You will be asked to send us your hospital discharge and your current (last year’s) laboratory and imaging results. Proper assessment of your health condition will allow the doctor to select and plan the examinations and consultations necessary to prepare a KLO report for your doctor.
MediSpace deals with the professional performance of tests preparing the patient for kidney transplantation.
In order to become a kidney recipient, you must be registered on a National Waiting List (KLO) for kidney transplantation. This requires up-to-date tests and consultation, which excludes contraindications of kidney transplantation. At MediSpace it is possible to perform appropriate examinations and consultations in a relatively short period of time.
Then the doctor in the dialysis station sends the patient’s results in a report to the Regional Qualification Centre (ROK). If the report is accepted, the patient will receive the status of “active” in the KLO. From now on, a patient can be called in at any time for a kidney transplant from a deceased donor.
NOTE – the performance of tests at the MediSpace in no way affects the time of waiting for a transplant.
More information can be read in the material on kidney transplantation, which has been developed by the specialists cooperating with us – Marta Serwańska-Swietek PhD and Michał Wszoła MD, PhD.