Waiting for Your Transplant

While waiting on the "active list," you are required to send in a blood sample every month. A blood sample kit will be sent through the mail to the Puget Sound Blood Center Lab in Seattle. This lab does the testing for all these blood samples. This kit can be taken to your dialysis unit or to a laboratory near your home to have the blood samples drawn. After receiving the kit, the blood samples should be returned according to the instructions.

These blood samples are used to monitor the immune system for previously formed sensitivities. You may develop antibodies as a result of prior exposure to other human tissues (i.e. blood transfusions, pregnancies and previous organ transplants). Also, illnesses, surgeries, and vaccinations may trigger immunity. If antibody levels are high, waiting time for a transplant will likely be longer compared to someone whose antibody level is lower.

When a deceased donor kidney becomes available, this means that there is a patient in a hospital somewhere with an unsurvivable injury, It is the wish of this person and their family to offer organs to help others live healthier lives. These donors and their families are true heroes. Donors may provide
as many as seven organs and other tissues that help others.

The transplant coordinator needs to be able to reach you 24 hours a day when an organ is available. The transplant office should have telephone numbers of family and friends who will know where to reach you at any time. Often, quick answers are needed when a kidney is available. If you are planning to be out of town or out of your cell phone's range, leave a number with the transplant office of where you can be contacted. Cell phones should be checked regularly to make sure they are functioning properly.

The length of time a person waits for a transplant cannot be determined and is influenced by many factors. These factors include:

• how many donors become available
• number of patients on the waiting list
• the blood type of the recipient
• sensitization
• matching

These factors have no influence on how long people wait for a kidney:

• race
• age
• gender
• financial/social status
• medical condition
• religion
• sexual orientation
• political or celebrity status

It can take anywhere from a few weeks to more than 10 years to receive a transplant. On average, waiting times are one to five years.

Approximately 60,000 people wait for kidney transplants at any given time in the United States. There are 5,000-6,000 deceased donors annually. Therefore, the need for organs exceeds the available number of donors. This shortage of organs can significantly increases the average waiting time for all potential recipients.

Blood type can affect waiting time. On the internet, you can check the average waiting time for a kidney transplant if you know your blood type.²

Some HLA/genetic markers are more rare than others. If a recipient has common HLA markers, they have a better chance that a donor somewhere in the country is an identical match.

Patients with high antibody levels wait longer than patients with low antibody levels. Antibody levels are expressed in percentages (0-100 percent) and roughly predict the chance the recipient will have a positive crossmatch. According to UNOS data, patients with peak panel reactivity PRAs of 20-79 percent waited much longer than those with PRAs below 20 percent. Those with peak PRAs of 80 percent and higher had the longest wait time.

Patients with higher PRA may be called more than once for a transplant until a successful crossmatch is achieved.

² This information is found at the UNOS website and going to the OPTN data on kidneys and selecting waiting time by blood type.