New Horizons
                                         Kidney



A patient’s guide to pre-transplantation




      Genente...
You Are Considering a Kidney Transplant…

What Happens Next?
Because your kidneys aren’t working properly, you are faced w...
Important Facts About the
Kidneys and Their Functions
What do your kidneys do?                • Filtering and removing was...
Vein            Artery



  Old kidney




New kidney



                      Ureter



         Bladder




            ...
What happens when the                    When the kidneys are not working
kidneys are not working                  correct...
7
When is a kidney                         • Cancer
transplant a consideration?
                                         • I...
Types of kidney                           Whichever option is right for you,
transplant surgery                        it ...
Live donor kidney transplant            who are at least 18 years old and
                                        cousins....
• Over 18 years of age and in good       Deceased donor kidney
  physical condition (some centers       transplant
  requi...
“The list”—waiting for a deceased         Antibodies—These help your body
donor kidney. There is a designation      fight ...
You are only on “the list” when              As you never know when a donor will
your transplant nurse coordinator        ...
What are the possible                       • Bleeding
complications of surgery?                   • Delayed or no functio...
Pre-transplant screenings                • Kidney and liver function
There are a number of tests that         • The presen...
Other Common Pre-transplant Tests (Kidney)
 Test type                   What it measures
 Blood urea nitrogen (BUN)   Kidn...
An increase may mean                               A decrease may mean
• The kidneys are not functioning properly         ...
Chest x-ray will help determine the    heart or vascular disease, or have
health of your lungs.                  significa...
19
Keep a record of all the tests you may need
You and your transplant team may use the following table to keep track of
the ...
Test                              Required Date Scheduled Completed
Cancer Screening

Colonoscopy

Mammogram

Pap smear

U...
What does all this                                           Is everyone a candidate
testing mean?                        ...
Who are the members of                    The transplant surgeon evaluates
your transplant team and                  wheth...
The consultant physicians may           laboratory results, educating you
include cardiologists, infectious       post-ope...
The dietitian/nutritionist is a         The pharmacist can help
licensed professional trained in the    oversee and coordi...
Stay healthy prior to                     • Do not drink alcohol or use illicit
transplantation                           ...
Emotionally                               • Join a support group through your
                                           t...
Be prepared                               Surgery and recovery
                                          timeline
Be prepa...
the intensive care unit for 1 to 2 days   After everything you will go through
and in the transplant unit for about 7    t...
30
Keeping your kidney                     schedule may be changed, and
healthy                                 sometimes oth...
Kidney Dictionary
The following is a list of terms you          Coagulation (coe-ag-u-LAY-shon).
may hear your healthcare ...
Diuresis (die-yur-EE-sis). An            Immune system. The body’s natural
increased production of urine.           defens...
Noncompliance (non-com-                Tissue typing. A blood test to identify
PLY-ants). Failure of the patient to   how ...
Important Resources
The following is a partial list of where you can turn for support, information
and education.

America...
The Transplant Patient Partnering Program™
                    consists of educational materials provided by
             ...
Kidney
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Kidney

  1. 1. New Horizons Kidney A patient’s guide to pre-transplantation Genentech Transplantation, your partner in patient education
  2. 2. You Are Considering a Kidney Transplant… What Happens Next? Because your kidneys aren’t working properly, you are faced with an important decision: whether to start dialysis, possibly for life, or to have a kidney transplant. Many people prefer a kidney transplant because it gives them a lifestyle free from dialysis and allows them to enjoy a less restricted diet. In order to do what’s right for you, learn as much as you can before you make a decision. It can be helpful to talk to other patients who’ve already had a kidney transplant. Also, don’t hesitate to talk to your transplant team about any issues or concerns you may have. If you are thinking about a kidney transplant, you should ask yourself the following questions: • Am I willing to go through all the tests and doctor’s visits to get ready for the transplant? • Am I willing to wait months or maybe years to get a kidney? • Am I willing to follow all my doctor’s instructions after the transplant? • Am I willing to possibly take medications for the rest of my life? If you have answered “Yes” to these questions, you’re ready for the next step. Individuals shown are not real transplant patients or organ donors. 3
  3. 3. Important Facts About the Kidneys and Their Functions What do your kidneys do? • Filtering and removing waste by producing urine Your kidneys are 2 bean-shaped organs located behind your stomach • Helping to regulate blood pressure in the middle of your back, on either • Cleaning and controlling the side of your spine. Each kidney amount of blood in your body is about the size of your fist and, although they may be small, kidneys • Keeping the body’s balance of perform some of the most important water, salt and acid constant jobs in your body. • Making hormones that help bone marrow produce red blood cells 4
  4. 4. Vein Artery Old kidney New kidney Ureter Bladder 5
  5. 5. What happens when the When the kidneys are not working kidneys are not working correctly, the body’s waste and the way they should? excess fluids build up, causing harm to the body. Some signs of kidney If something happens to abnormally disease are: change the way the kidneys function, it is usually because of a condition • Fluid retention—puffiness in the that has been attacking the kidneys face, swelling of hands and feet for some time. This leads to chronic • A change in urination (frequent, kidney disease which generally affects painful or difficult) both kidneys. The kind of condition you have might be something you • Shortness of breath were born with; it could run in your • Mental confusion family or it could be a problem that developed over time (such as a • Abnormal blood or urine problem due to long-term use of over- test results the-counter pain relievers). There may • Tiredness be no symptoms of kidney disease until you have had it for a while. 6
  6. 6. 7
  7. 7. When is a kidney • Cancer transplant a consideration? • Infection Some of the conditions that can injure • Injury or trauma the kidney and lead to chronic kidney disease are: If kidney disease has not been diagnosed or treated early enough, • Diabetes or if the patient has not responded to • High blood pressure treatment, the disease may progress to kidney failure. At this point, the • Glomerulonephritis (inflammation kidneys have usually stopped working, of the kidneys’ filtering units) requiring dialysis (for life) or kidney • Polycystic kidneys transplantation. A transplant has (cysts that enlarge over time) high success rates and offers the opportunity to live dialysis free. • Kidney stones 8
  8. 8. Types of kidney Whichever option is right for you, transplant surgery it is important to know that there may be some concerns if you In order for transplant surgery to have a history of alcohol or illicit take place, you will need a donated substance abuse. If this pertains kidney, either from someone who has to you, you can still be a candidate died or from a living donor. Currently, for transplantation. However, you the national 1-year survival rate for may need to show that you have kidney transplant patients is as high participated in a rehabilitation as 95% for patients receiving a kidney program for 6 months and are from a deceased donor, and 98% for successfully avoiding the use of those receiving an organ from a living either alcohol or illicit substances, donor. or both. You may be required Research has found that, on to take screening tests to prove average, a patient on dialysis has your abstinence. more medical complications and does not live as long as a patient who has had a successful kidney transplant. So, as you can see, kidney transplantation can be a successful treatment for kidney disease. There are 2 possible kidney transplant procedures that you may want to discuss with your transplant team to determine which option is right for you: • Live donor kidney transplant • Deceased donor kidney transplant 9
  9. 9. Live donor kidney transplant who are at least 18 years old and cousins. There is also a possibility A living donation is provided when a that an altruistic (“Good Samaritan”) person (while alive) gives one of his nonrelated donor may be found, but or her own kidneys to someone who this is not yet widely accepted. needs one. Those who are related to you make the most successful If a live donor kidney transplant is a donors because their blood and possibility for you, your transplant tissues are usually similar to yours. center will have a long list of Living donors can be parents, requirements for the potential donor, siblings, aunts and uncles, children which may include: 10
  10. 10. • Over 18 years of age and in good Deceased donor kidney physical condition (some centers transplant require the donor to be at least 21 years old) Deceased donors are people who have died and donated their organs • Passes all physical and for transplantation. Unfortunately, psychological testing these organs are in short supply, so if this is the procedure for you, you will • Compatible blood type (listed probably be put on a waiting list until a in the table below) and normal compatible kidney becomes available. kidney and liver function It is difficult to estimate how long the • Willing and prepared to handle the wait might be. physical, emotional and financial challenges of major surgery, with full awareness of the risks involved Not everyone who needs a kidney transplant is a candidate for a living donor transplant. In this case, a deceased donor transplant may be an option. Compatible Blood Types Recipient’s Blood Type Donor’s Blood Type O O A A or O B B or O AB A, B, AB or O 11
  11. 11. “The list”—waiting for a deceased Antibodies—These help your body donor kidney. There is a designation fight off foreign cells that might have system in place to ensure that formed in your body because of a those patients in need of a kidney prior transplant, blood transfusion transplant are given priority based on or pregnancy. a variety of factors. This is managed Crossmatch—A test is done to see if by an organization called the United there is anything in your blood that will Network for Organ Sharing (UNOS). react against the cells of the donor. UNOS coordinates efforts among all the different transplant centers in the Time—The longer you’ve been on country to allocate donated organs the waiting list, the better your for transplantation. chance of receiving the next suitable kidney. Every time a kidney becomes Your position on the waiting list available in an area, a list of patients will depend on: potentially compatible with that Blood type (O, A, B or AB)— kidney is generated. If you are not Blood type must be compatible a perfect match with the donor, (not necessarily a match) if you kidneys are allocated based on the have a living donor, but to receive closest match and your time on the a deceased donor organ, the blood waiting list. type must be the same. Your transplant team and the UNOS Tissue type—There are 6 important Web site, www.unos.org, will have antigens that are determined from the most current information. your blood sample. If you match the donor on all 6, this is a perfect match and moves you to the top of the waiting list, even if you have been waiting a short time. 12
  12. 12. You are only on “the list” when As you never know when a donor will your transplant nurse coordinator be available for you, it is important or doctor confirms that you are that you stay in constant contact on the list. Some patients mistakenly with your coordinator. If you move or think they are automatically listed change any of your phone numbers, once they have been referred to a please be sure to give this information transplant center, or after they have to the transplant center, so you can completed testing. If you are not be reached immediately when it is absolutely sure that you are on the your turn to receive a donor kidney. list, talk to your transplant coordinator. 13
  13. 13. What are the possible • Bleeding complications of surgery? • Delayed or no function of the As with any surgical procedure, there new kidney is always a possibility of complications. • Psychological and social changes After a kidney transplant, there may be • Fever a risk of: • Problems urinating • Infection • Abdominal bloating • Rejection of the new kidney • Death • Clotting of a blood vessel 14
  14. 14. Pre-transplant screenings • Kidney and liver function There are a number of tests that • The presence of viruses and/ will be performed and repeated for or antibodies to viruses. anyone who is being considered Exposure to some common for an organ transplant. These viruses will not rule out kidney evaluations reveal your overall health transplantation but will be taken and help your transplant team into account when monitoring determine if transplantation is right your condition after surgery. for you. Some or all of the following In some cases, vaccination tests—and possibly more—may be prior to transplantation may required by your transplant team. be required Blood tests are conducted to rule • Panel Reactive Antibody (PRA) test out certain infectious diseases and is a way of measuring how active provide information regarding: your immune system is. This level is usually higher when more antibodies • Various blood cell counts, such as are being made. It is easier to get a white cells, red cells and platelets kidney when the immune system is • Blood typing (O, A, B or AB), calm or PRA measures 0% which will help determine your compatibility with a potential donor • Blood chemistries, including those that measure glucose and electrolytes 15
  15. 15. Other Common Pre-transplant Tests (Kidney) Test type What it measures Blood urea nitrogen (BUN) Kidney function—the waste product of protein breakdown that is removed from the blood by the kidneys Bicarbonate (HCO3 ) Acid/base balance of blood as controlled by the kidneys Calcium Calcium—needed for blood clotting, building bones and also muscle, heart and nerve function Creatinine (Cr) A protein waste produced by muscles and released into the bloodstream for removal by the kidneys. Measuring creatinine in the blood helps show how the kidneys are working Phosphorous (PO4) Phosphorous levels in the blood—important in creating energy Potassium (K) Potassium levels in the blood; reflects potassium in the tissues that is required to change carbohydrates into energy, build protein and help the heart, muscles and nerves function Proteinuria Protein is not normally present in the urine. If it is present, the quantity of protein may be measured Sodium (Na) The balance between electrolytes and water in the body. Also indicates nerve and muscle disorders, as well as kidney and adrenal gland problems Urinalysis White blood cells, red blood cells, bacteria and protein levels in the urine 16
  16. 16. An increase may mean A decrease may mean • The kidneys are not functioning properly • Liver disease • Diet is too high in protein • Too much water in your body • Dehydration • Some antirejection medications may be the cause • A lung disorder • A sign of diabetes • There has been prolonged vomiting • Kidney failure • Excessive use of antacids • Too much calcium intake due to excessive • Inflammation of pancreas use of antacids • Kidney failure • Bone disorders • Too little vitamin D • Too much vitamin D • Too much water in the body • Problem with the thyroid or parathyroid glands • Dehydration Does not apply • Kidney disease • Some antirejection medications may be the cause • An obstruction within the urinary system • Kidney failure • Bone disorders • Too much phosphorous in the diet • Too little vitamin D • A complication of diabetes • Excessive use of antacids • The kidneys are not functioning properly • Use of diuretics (water pills) is causing • Some antirejection medications may be potassium to be excreted (released) the cause by the kidneys • Heart problems • Muscle cramps • A kidney disorder Does not apply • A complication of diabetes • Excessive sodium in the diet • Chronic kidney disease • Not enough water in body • Inadequate sodium intake • Kidney function problems • Kidney disease Does not apply • Urinary tract infection • Poorly controlled diabetes 17
  17. 17. Chest x-ray will help determine the heart or vascular disease, or have health of your lungs. significant risk factors for hidden, silent (occult) heart disease. Imaging scans can show the size and shape of the kidneys and major Urinalysis can detect and measure blood vessels. Some imaging scans cells and substances that may that may be performed include: indicate disease or infection. • Abdominal ultrasound Pulmonary function tests— breathing forcefully into a tube— • Computerized axial tomography measure how well your lungs are (CAT/CT) working and the ability of your • Magnetic resonance imaging blood to carry oxygen. (MRI), when more detailed Interviews with a transplant information is needed social worker, a psychiatrist and a Electrocardiogram (EKG) shows transplant nurse coordinator may be heart function and reveals any past required to confirm your eligibility damage. Additional heart tests may for transplant. be required if you have a history of 18
  18. 18. 19
  19. 19. Keep a record of all the tests you may need You and your transplant team may use the following table to keep track of the pre-transplant tests you may be required to have. Your nurse can check off those that are necessary for you in the “required” column, or add any additional tests required by your center. Carry this booklet with you, so you always have a record of what needs to happen, when it needs to happen and when it is done. Pre-transplant tests and evaluations Test Required Date Scheduled Completed Blood/Urine Alpha fetoprotein (AFP) Arterial blood gas Blood typing Coagulation profile Complete biochemical and liver profile Complete blood count (CBC) Drug and alcohol screening Hepatitis serologies Renal function Urinalysis Virology studies 20
  20. 20. Test Required Date Scheduled Completed Cancer Screening Colonoscopy Mammogram Pap smear Upper endoscopy (EGD) Prostate specific antigen (PSA) Imaging/Function Cardiac catheterization Cardiac (thallium) stress test Chest x-ray CT/CAT scan Echocardiogram (ECHO) Electrocardiogram (EKG) MRI Nuclear bone scan Pulmonary function test Ultrasound of abdomen Other Dental examination Kidney biopsy 21
  21. 21. What does all this Is everyone a candidate testing mean? for kidney transplantation? Most of the tests and interviews Not everyone is a candidate for you will undergo are performed kidney transplantation. The following to help your transplant team decide may prevent a person from receiving how best to increase your chances a transplant*: of achieving the most successful • Severe liver, heart or lung disease results from your kidney transplant. These tests and discussions will • Advanced cancer determine if: • Active use of alcohol or • Your disease can be treated illicit substances effectively with a kidney transplant • Advanced HIV disease (AIDS) • There are any problems, such as blocked or closed blood • Proven history of not following medical directions (noncompliance) vessels, that could interfere with successful surgery The most important consideration is that you are healthy enough to have • Your heart, lungs and liver are able the surgery. to withstand transplant surgery • There are emotional, psychological or family issues that must be addressed * Each transplant center has its own criteria for potential transplant candidates. Be sure to check with your center about the particular factors that might exclude you from being considered for an organ transplant. 22
  22. 22. Who are the members of The transplant surgeon evaluates your transplant team and whether you qualify for a kidney what do they do? transplant and will perform the actual surgery. After surgery, he or she looks It is important for you to know the for possible surgical complications. medical professionals who will be This is the physician who can answer taking care of you and exactly what many of the questions you may have they do. Each of these experts about the surgery and its risks. is a specialist in his or her field with a very distinct job. Following The transplant nephrologist is is a description of the typical a kidney specialist who usually team members involved in kidney monitors all nonsurgical aspects of transplantation, but your team may your care, such as kidney function, be slightly different. You can use this rejection episodes and post- information as a guide to understand transplant medications. You will see your available resources. this doctor often—feel free to ask as many questions as you want. 23
  23. 23. The consultant physicians may laboratory results, educating you include cardiologists, infectious post-operatively, providing discharge disease specialists, hematologists/ instructions and serving as the oncologists, anesthesiologists, keeper of all your medical information. psychiatrists, psychologists, Think of him or her as the center of pulmonologists and hepatologists. the wheel of professionals around With transplant care, many medical you—someone who will keep track specialties are involved to make sure of how you are doing throughout the you have the complete care you need. entire transplant process. The transplant nurse coordinator The physical therapist will create is a licensed, registered nurse who an exercise plan to help you prevent is responsible for many duties, muscle deterioration, control your some of which include organizing weight and maintain a normal level your patient evaluations, monitoring of activity after your surgery. 24
  24. 24. The dietitian/nutritionist is a The pharmacist can help licensed professional trained in the oversee and coordinate the many science of diet and nutrition. This medications you will be taking after team member will design healthy the transplant, as well as explain any meal plans for you both before and side effects you may experience. after your transplant. He or she Other team members may include will also develop special diets for physician assistants, operating room patients with medical issues. Be and intensive care nurses, nurse sure to ask about any food or practitioners, medical residents, fluid restrictions. procurement coordinators, case The financial planner/coordinator managers and transplant assistants. is specially trained to help patients You play an important role in the and their families deal with the transplant process and are one of financial burdens of an organ the most essential members of the transplant. This professional will team. Help yourself by being an explain what your insurance will and active participant in your own care. will not cover; help you determine Share your feelings, ask questions, if you qualify for coverage from talk about issues that are important to Medicare, Medicaid or private you—open communication is how the insurance and direct you to rest of your team will know how you available financial resources. are doing and what you are thinking. The social worker can help you and your family cope with the nonmedical aspects of the transplant. By working closely with you, the social worker can identify emotional or family issues that need attention, and link you to community services, such as support groups, you might find useful. 25
  25. 25. Stay healthy prior to • Do not drink alcohol or use illicit transplantation substances. If you smoke and have had difficulty quitting, ask Physically your team to direct you to the help you need • Stay as active as you can, and take care to keep your muscles toned • Lose weight, if necessary, to within your physical limitations reduce the risk of complications during and after your transplant • Eat healthy, well-balanced meals. and, most importantly, to protect If you have any food restrictions, your overall health you can get information about an appropriate eating plan from your • Get treatment for other transplant center, or meet with healthcare problems, including your dietitian to customize a plan high cholesterol, high blood that accommodates your tastes, pressure and diabetes health and habits 26
  26. 26. Emotionally • Join a support group through your transplant center. This forum for • It is very important to be learning and sharing can be very as mentally and emotionally valuable to you and your family healthy as possible. If you are having trouble coping, there • Keep connected—even though are relaxation techniques you you may often be very tired— can try or counseling might make every effort to stay in be a consideration. This can touch with the people you care help you have a more positive about; your support group is transplantation experience very important at every stage in the transplant process • Depression is not uncommon among people awaiting • Try to let people help you when transplantation. Your transplant they offer. Learn to say “yes,” even team wants to know how you’re if accepting help is hard to do. handling the stress of your situation. Those who offer usually really want They can advise you about all of to help but don’t know what would your options from support groups be most useful to you. Allow them to antidepressant medications to pick up groceries, run errands, cook a meal or two—whatever will save you time and energy 27
  27. 27. Be prepared Surgery and recovery timeline Be prepared financially. Be proactive in finding out what your options Surgery are through private insurance and Medicare/Medicaid, and what Kidney transplantation typically takes supplemental coverage you may 3 to 4 hours. It is hard to definitely need. Rest assured that there is predict how long the operation someone at your transplant center will take, but your surgeon will who is eager to help you make the update your family while surgery financial plans that will minimize your is in progress. Removing your stress and prepare for your future. nonfunctioning kidneys is usually Ask your team. not necessary unless there is a special reason to do so. Be proactive Recovery Arrange for someone to: Prior to transplant, your surgeon • Transport you to the center when will discuss the actual procedure the call comes and possible risks with you in detail. Many patients want to know how • Prepare food and care for you long the recovery time following following surgery transplantation will be. Your • Accompany you to the center condition prior to the surgery often for your follow-up visits and help affects your recovery time. keep track of your medications When you first wake up after the • Clean, do laundry and straighten surgery, you will probably feel up for you when you’re not able groggy and a little sore. However, to “do for yourself” most patients are surprised at how well they feel right after the transplant. Typically, you will be in 28
  28. 28. the intensive care unit for 1 to 2 days After everything you will go through and in the transplant unit for about 7 together, your transplant team will days. A longer stay may be needed, seem like family. They will closely depending on your individual case. monitor your progress post-transplant. You’ll receive clear instructions and You might anticipate a 2- to 6-month encouragement about taking your disability period, or even longer if medications, monitoring your health your physical condition dictates. and making the most of your second Physical therapy may be needed to chance at life. help build up your strength. After a transplant, most patients feel better and stronger as each day passes, with their new kidney doing the job it’s supposed to do. 29
  29. 29. 30
  30. 30. Keeping your kidney schedule may be changed, and healthy sometimes other medications will be added to stop the rejection. Once To continue to enjoy the healthy the rejection is under control, you functioning of your transplanted will probably be able to go back to kidney, there are 3 things to your regular medication schedule. always remember: 2. Have your follow-up 1. Take your medications laboratory work done To your body, the donor kidney as scheduled may seem like something from It is also important that you have the outside that doesn’t belong. the follow-up laboratory tests Your body’s protective immune done as frequently as advised by system will recognize your new your transplant team. That way the kidney as foreign. This is why you team can monitor the health of your will need to take a number of new kidney, and make certain the medications for the rest of your medications are working. life. They are called “antirejection” or “immunosuppressive” drugs. 3. Communicate with Before you leave the hospital, your your transplant team transplant team will make certain Always tell them of anything that has that you fully understand what your happened to change your health. If medications are for, and how and you have any questions, no matter when to take them. how small they might seem, call your If your body begins to reject your transplant team and ask them. They new kidney, you may not feel ill. But are there to help you. They’ve been your kidney function will weaken, with you from the beginning of your and this can be detected by journey and will be with you as you laboratory tests. If organ rejection start your new life. is taking place, your medication 31
  31. 31. Kidney Dictionary The following is a list of terms you Coagulation (coe-ag-u-LAY-shon). may hear your healthcare team use The process of blood clotting; during the transplant process. usually the body’s way of controlling bleeding. Acute rejection. The body’s way of trying to destroy a transplanted Compliance (com-PLY-ants). The organ because it senses the organ is process of a person following the a foreign substance. If it is going to instructions of his or her transplant happen, acute rejection usually occurs team or center, usually regarding within the first year after the transplant. the taking of medication. Antibody (AN-tee-bod-ee). A Crossmatch. A test for recipient protein that is produced by the antibodies versus donor antigens. body’s immune system when it Cytomegalovirus (sigh-toe-MEG- detects a foreign substance, a-lo-vie-rus) (CMV). A common such as a transplanted organ. viral infection that may affect organ Antigen (AN-tah-gin). A substance, recipients as they usually have a such as a transplanted organ, that weakened immune system. can trigger an immune response; Deceased donor. Someone who an immune response may be the has died and donated his or her production of antibodies. organs for transplantation. Candidate. A person who is waiting Deceased donor organ. An organ for an organ transplant. from a person who has been Chronic rejection. The slow failure declared brain dead. of a transplanted organ over time. 32
  32. 32. Diuresis (die-yur-EE-sis). An Immune system. The body’s natural increased production of urine. defense mechanism to fight what it detects as foreign bodies. In Donor. Someone from whom an transplantation, the body may sense organ or tissue is taken and used the new organ as a foreign body for transplantation into someone and the recipient’s immune system else’s body. will naturally want to defend itself by End stage renal disease (ESRD). trying to reject the organ. Failure of the kidneys to function, Immunosuppressant. A drug that requiring the patient to need dialysis helps the body recognize and accept or a kidney transplant to survive. a transplanted organ by suppressing Graft. A transplanted organ or tissue. the immune system. 33
  33. 33. Noncompliance (non-com- Tissue typing. A blood test to identify PLY-ants). Failure of the patient to how closely the tissues of the donor follow instructions provided by his match those of the recipient. or her transplant team or center. United Network for Organ Sharing Recipient. The person receiving a (UNOS). A national organization transplanted organ. that makes sure all patients have a fair chance to receive the organ they Side effect. An unplanned (but not need. UNOS matches donors with necessarily unanticipated) reaction recipients and manages the list of to a drug. those people waiting for a transplant. 34
  34. 34. Important Resources The following is a partial list of where you can turn for support, information and education. American Kidney Fund National Kidney Foundation 1-800-638-8299 1-800-622-9010 www.kidneyfund.org www.kidney.org American Transplant Transplant Living Association (ATA) 1-888-894-6361 1-800-494-4527 www.transplantliving.org www.americantransplant.org Transplant Recipients Children’s Organ Transplant International Organization Association (COTA) (TRIO) 1-800-366-2682 1-800-874-6386 www.cota.org www.trioweb.org Life Options TransWeb 1-800-468-7777 1-734-998-7314 www.lifeoptions.org www.transweb.org National Foundation for United Network for Transplants (NFT) Organ Sharing (UNOS) 1-800-489-3863 1-888-894-6361 www.transplants.org www.unos.org 35
  35. 35. The Transplant Patient Partnering Program™ consists of educational materials provided by Genentech Transplantation, your partner in patient education. © 2009 Genentech USA, Inc. 104472

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