Home Dialysis and Transplant

I am going to start home dialysis in a few months. I was told today that it can affect your chances of get a transplant. I was wanting to know if this is true

Judith, I hope you don’t mind if I take a stab at this one.

Doing home dialysis certainly won’t harm your chances of getting a transplant and it may help your chances if by doing dialysis at home you stay healthier. Many people who were on PD or home hemodialysis have had kidney or kidney-pancreas transplants. If you haven’t already been evaluated for a transplant, talk with your doctor and the transplant program where your insurance will pay. Most transplant programs do not require a referral to talk with you. You be evaluated now and be added to the deceased donor transplant “waiting list” when your glomerular filtration rate (GFR) drops below 20. One of the factors that is considered in determining who gets a kidney besides how well the donated kidney “matches” you is time on the waiting list. If your evaluation shows you’re a candidate for a transplant and you have a living donor, it’s even more likely to get a transplant before doing dialysis since surgery on you and your donor can be scheduled to fit what’s best for the two of you.

BTW, here’s a website where you can find data on transplant programs in the U.S., including the number of transplants that they do each year, how their success rates compare to expected rates, and the average waiting time for a kidney from the deceased donor list.

http://www.srtr.org (see Program-Specific Reports)

Just a couple of extra thoughts for you. There are several studies showing that those who are on peritoneal dialysis before a kidney transplant have better outcomes–that is they are less likely to have rejection of the transplant (and more likely for their body to accept the new kidney) than those who are on hemodialysis before a transplant. So going on PD at home is a plus for those hoping to have a transplant in the future. Also, if you start with hemodialysis, many in the US have hemodialysis catheters, a temporary access for dialysis, which carries a much higher risk of infection than a permanent access (fistula for HD or PD catheter for PD). If you are planning a transplant and have an infection, the transplant will have to be postponed. So being on PD before a transplant is probably the best for you. And finally, the allocation of kidney transplants is the same whether you are on HD or PD.

Oh my goodness, no! I have been on home dialysis for two years, and since i’ve been sick, they have been the healthiest yet! Congratulations for choosing home dialysis; if you like being in charge of your health it’s for you. I have three children, and have been able to go back to college. On the incenter dialysis, I left three times a week feeling like a wet washcloth the rest of that day. My bloodwork is soooo much better now. I was able to stop taking all of my blood pressure meds!!! If you have any more questions about home dialysis, give me a shout!!!