Every person receiving renal replacement therapy is considered for a kidney transplant: an exchange kidney. Depending on the age and medical condition of the kidney patient, a balance is made between the advantages and disadvantages of a kidney transplant.
Since there are more candidates for a swap than there is supply, there is obviously a "waiting list”. The average waiting time is currently more than 3 years. In case of a kidney transplant, a kidney from another person (called the donor) is inserted into the body of the kidney patient through a surgical procedure. This donor can be a living person who gives one of his/her healthy kidneys, but it can also be a person who is brain dead, but whose organs still function properly.
Someone can act as a living donor if he/she is related to the patient (e.g. parents, partners....). There should be no suspicion of coercion or financial obligation to donate the kidney. The donor and the patient must therefore undergo a psychological test to check the ‘voluntariness’ of the organ donation. Once it is agreed that the donor has only noble intentions and there is no compulsion, the donor will also undergo a full medical examination to make sure that the procedure and removal of one of the two kidneys will not harm him/her.
For people who do not have a suitable living donor, we rely on organs from brain-dead patients. The organs of these donors are allocated through a complex but fair system that takes into account the ‘match’ between the tissues of the donor and the patient. Much also depends on how long the patient has been on dialysis and the distance between the donor and the patient. This system is coordinated by Eurotransplant, an international organisation whose members include Belgium, the Netherlands and Germany.
The transplant itself takes place at a university hospital. Once the condition has stabilised after transplantation, the patient is referred back for further follow-up to his own nephrologist in his own dialysis centre close to home.