Kidney Transplantation
Kidney Transplantation
Living kidney donation is when a healthy living individual donates one of his/her kidneys to a person with end-stage renal disease. In the Philippines, this can be classified further based on the Department of Health Administrative Order 2010-0018:
Living Related Donors (LRD)
Donors who are related to the recipient by blood within the fourth degree of consanguinity
(e.g. parents, children, siblings, nephews/nieces, first cousins)
Living Non-Related Donors (LNRD)
Donors that are not related to the recipient by blood but have the willingness and intention to donate a kidney based on certain reasons.
LRNDs can further be categorized into:
a. Voluntary Donors – Those who are not related by blood to the recipient but bear close emotional ties with him/her.
(e.g., spouses, relatives by affinity, friends, employers/employees of long standing, colleagues, fiancé/fiancée and adoptive parents or children).
b. Commercial Donors – Also known as kidney/organ vendors who offer their kidneys and other organs for sale. They usually engage the services of a broker or agent. Payment or a promise of payment is a precondition and pre-requisite to the organ donation. These type of donation is strictly prohibited.
In deceased donor kidney transplantation, the kidneys for transplant comes from someone who has died. In the Philippines, the recipients who desires to undergo kidney transplantation but do not have a living donor can enrol to the deceased donor waiting list which is managed by the Philippine Network for Organ Sharing (PhilNOS).
Deceased donation is the process of giving an organ or a part of an organ for the purpose of transplantation to another person when a person has died.
In deceased organ donation, death can be classified further into:
1) Donation after circulatory determination of death (DCDD)
a) Controlled donation after circulatory death (cDCDD) which refers to organ donation from a patient who has died after the withdrawal of life-sustaining treatment (WLST)
b) Uncontrolled donation after circulatory determination of death (uDCDD) which is the organ donation after failed efforts to resuscitate an individual who experienced an out-of-hospital or unexpected in-hospital cardiopulmonary arrest.
2) Donation after neurological determination of death (DNDD) or more commonly known as brain death. This type of donation refers to organ donation from an individual who has permanent cessation of brain function including brainstem reflexes. It is considered globally as a legal form of death.
In the Philippines, the deceased organ donation program follows donation after brain death.
This program is mandated by the Department of Health Philippines through DOH Administrative Order No. 2010-0019 Establishment of a National Program for Sharing of Organs from Deceased Donors