Kidney failure occurs when the organ’s filtering capabilities are lost. It is a very serious condition that can go un-diagnosed over time. Typically, most sufferers will have lived with kidney disease for a considerable period before things start to break down.

In the event of kidney failure, waste material builds up which can alter the chemical makeup of your blood. For more information, click here.

If it looks like kidney failure is progressing towards end-stage renal failure (ESRF), then transplantation may be an option to you.

Living with Kidney Disease

By Dr Richard Moore

I have been involved in the management of patients with chronic kidney disease since 1980 and I have developed a special interest in kidney transplantation.

Perhaps one of the most important developments over the decades has been the introduction of Erythropoietin (EPO) to treat the anaemia of chronic kidney disease with such marked benefits in terms of quality of life and survival. However, I still marvel at the benefit that a successful kidney transplant brings to a patient with almost instantaneous improvement in symptoms and wellbeing.

From my perspective, seeing a patient’s life change following a kidney transplant and to see them grow older and mature with their family is immensely rewarding. There are of course tragedies which occur in terms of a kidney transplant failing or even the patient dying. It is thus distressing to see over the years, the number of patients waiting for a kidney transplant grow and far exceed the number of donor organs available.

In the last few years, there has been a downturn in the number of deceased donor organs and we have had to explore other avenues including expanding living donation including blood group incompatible and HLA antibody incompatible donor recipient pairs as well as returning to the use of non heart beating deceased donor organs. It is now not unusual for a patient to wait around 3 years to receive a deceased donor organ and there may be a further period of time spent waiting to get onto the transplant waiting list because of the unavailability of appropriate investigations and assessment.

I welcome the recent public debate in Wales on Soft Opt-Out because it highlights the opportunities and challenges the community faces if we are to provide timely transplants to those patients awaiting them. For the heart, lung and liver transplants a successful procedure is a life saving manoeuvre and not only quality of life. Moreover, a widening range of organ transplants have been performed including the pancreas and small bowel. The donor taskforce groups recommendations are long overdue and their implementation is to be applauded.

It is most disconcerting as a transplant doctor to see patients suffering on the transplant waiting list and even dying, when we know that with an alteration to our attitudes as a broader society and mechanisms within the hospital environment a larger proportion of suitable organs would be made available to improve the quality and quantity of life for our patients with end stage organ failure.



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