Who is eligible for a transplant?

 

Because many more people need transplants than there are kidneys available, a patient must meet standardized criteria in order to be eligible for a transplant. Criteria are based on lab tests that measure the amount of a waste product, called creatinine, in a person's blood. The results of this test, along with age, race, and gender variables, are calculated using a mathematical formula. The formula yields what is known as the "glomerular filtration rate" (GFR). GFR is roughly equal to the amount (in percentage) of an individual's working kidney function. In other words, a person with a GFR of 92 has roughly 92% kidney functioning. GFR is expressed as ml/min. 

 

Chronic kidney disease doesn’t usually cause the kidneys to fail all at once. Instead, the disease progresses over a period of years (as mine has). Doctors estimate disease progression by using a standard guideline that divides the course of disease into 5 stages. The stage that a person is in is determined by his or her GFR. Factors such as diet, hydration, and medications can affect test results, so one’s GFR can vary slightly from time to time. GFR also varies by age, race, and gender. On average, though, a normal person’s GFR is usually in the range of 90-120.

 

Stages of Chronic Kidney DiseaseT

 

 

Stage

 

Description

 

GFR 

   1

Very mild:  No symptoms.iDamage is usually discovered only because a person is being treated for some other condition. Not considered kidney disease but renal insufficiency.

90 ml/min. or more

   

   2

   

Mild:  Usually no symptoms. Kidneys do a good job even when they’re not functioning at 100%. As with Stage 1, most people don’t know they have Stage 2 kidney disease. Still considered renal sufficiency.

 60-89 ml/min.

    3

Moderate:  Waste products begin to build up in the bloodstream. Symptoms and complications begin to appear. A GFR below 60 for 3 or more months indicates chronic kidney disease.

 30-59 ml/min.

     4T

Severe:  Toxins continuexbuilding up, causing additional symptoms and more serious complications.

 15-29 ml/min.

    5

End-Stage Renal Disease (ESRD):  TheT kidneys have lost nearly all their ability to function, and dialysis or a kidney transplant is necessary to survive.

 less than 15 ml/min.  

  

When a person's GFR equals 20, he or she becomes elibible for a transplant. For survival, dialysis is usually necessary once a patient's GFR reaches 15. Since dialysis compromises a patient's chances for the best possible outcome, (see Dialysis: A Poor Option), it is always best if a donor is found before dialysis is necessary. 

During the latter stages of kidney disease, functioning declines much more rapidly than in earlier stages. A person may be able to function well enough to get by, then quickly lapse into complete renal failure. At that point, the person will die without dialysis or a transplant. Obviously, this tailspin scenario is one that every patient hopes to avoid. Whether a particular recipient is able to do so depends on finding a compatible living donor as soon as possible.

NEXT

 

Tougher than "Marry Me"  "It was a huge request--the biggest I've ever made. It was easier asking my wife to marry me!" says Barry Hammond (l) of asking his brother, Brian (r), to donate a kidney to him. Click here to read the story.

 

 

True Teamwork: In 2007, Dallas Cowboys legend Everson Walls donated a kidney to his friend and former teammate Ron Springs. Although Springs had two relatives who were perfect matches, those plans fell through. "I said, 'Well, look, I know my blood type is the same as his. Why not give it a shot and see what happens?'" Walls said of volunteering to be tested. He has since written a book, A Gift for Ron: A story of Friendship & Sacrifice On and Off the Gridiron. Click here to read the story.