Kidney Transplant Explained: Living Donor vs Deceased Donor - Which Is Better?

Kidney transplants are amazing medical procedures that give people with end-stage kidney failure a chance to get their lives back to normal. It lets them go back to work, travel, eat what they want, and

spend time with loved ones without having to worry about dialysis. But not all kidney transplants are the same, and it's important to know how they work.

What are the two pathways to a new kidney?

“A donated kidney can originate from two distinct sources: a living donor or a deceased (cadaveric) donor. While both routes are life-restoring, each comes with its own unique characteristics and processes,” said Dr Harsha R, Associate Consultant - Urology and Renal Transplant Surgery, Manipal Hospital.

Living donor transplants

According to Dr Harsha, a living donor transplant occurs when a healthy individual chooses to donate one of their kidneys. Humans are capable of functioning perfectly well with just a single healthy kidney. Typically, living donors are:

• Parents and siblings
• Spouses or other close family members

What are the advantages of living donation?

Living donor transplants offer several significant benefits:

Shorter waiting time

Recipients receive a kidney much faster than waiting on a national list.

Planned surgery

The transplant can be scheduled at a time that is optimal for both the donor and the recipient.

Immediate kidney function

Kidneys from living donors usually start working immediately after the transplant.

Better long term survival

These transplants are associated with better long-term success rates for the recipient.

Fewer complications

There is a lower risk of complications like infections and rejection.

“A potential donor goes through a strict evaluation process to make sure they are healthy enough to give. The surgery itself is usually not too invasive, and it usually doesn't take long to heal,” he said. Most donors are back to their normal, busy lives within a few weeks. Living donors are real-life superheroes because they save two lives: the person who gets their kidney and the person who moves up the waiting list for the deceased donor.Also read: Blood Pressure May Raise Kidney Cancer Risk, Doctors Warn

Deceased, or cadaveric transplants

In a deceased, or cadaveric, transplant, the kidneys are donated after a person has passed away. This is done with the prior consent of the deceased person, through organ donor registration, or with permission from their family. Dr Harsha explained that recipients are mostly placed on a waiting list and matched with a suitable kidney based on several factors, including:

• Blood group compatibility
• The patient's health priority
• The amount of time they have been on the waiting list

The role of deceased kidney donation

It is a vital form of donation for various reasons, which include:

• It provides a lifeline for patients who do not have a willing or medically suitable living donor.
• It significantly expands access to transplantation for a larger number of people.
• It helps ensure an equitable and fair distribution of available organs.

“Deceased donor transplants come with certain challenges like a longer wait time, which can sometimes extend for years. Also, the donated kidney may take some time to "wake up" and start functioning fully. There is also a higher risk of the body rejecting the new kidney,” Dr Harsha added. Despite these challenges, deceased donation remains the backbone of national transplant programs around the world.

Why are both essential?

Even if every possible living donor came forward, there would still be a lot more demand for kidneys than there are available ones. This is why it's so important for countries to improve both systems at the same time. This means getting families to talk openly about organ donation and teaching people about the safety and importance of both living and deceased donation.