A. Dialysis: two kinds: HD and PD. PD is gentle to the body. For HD, if you need dialysis right away, you need emergency access (graft), mostly like in your neck. Fistula is the best choice, but it needs time to mature.
B. Donor evaluation: normally, the patient needs to pass the transplant evaluation before the potential donors can be evaluated.
1. A healthy donor needs to pass two tests for donating his or her kidney: (1) with compatible blood type and (2) with negative cross test. You can send your blood sample to China for cross test. If the patient is a man without any blood transfusion before, his PRA value is likely 0%, so the cross test will be surely negative. In the U.S., more than half of potential donors are not healthy enough for donation.
2. HLA does not change over time. The higher matching of HLA, the better, but it is not necessary to have a full HLA match for a kidney transplant. There are good chances that there will be some HLA matches. Even 0 out of 6 HLA matches, a living donor transplant is still better than a 6 out of 6 HLA match deceased donor transplant. Among A, B and DR pairs of HLA, DR pair are more important.
3. A donor may need at least 3 weeks of rest after surgery before returning to office work. For physical work, it takes longer rest.
4. Location of transplant: I think China has done well with kidney transplant, so the consideration is cost and care. In the U.S., the cost should be more than $250k, much higher than in China. Also the health insurance should cover most of cost in China. In the U.S., it commonly takes about 3 months to do the patient and donor evaluations before the transplant.
B. Donor evaluation: normally, the patient needs to pass the transplant evaluation before the potential donors can be evaluated.
1. A healthy donor needs to pass two tests for donating his or her kidney: (1) with compatible blood type and (2) with negative cross test. You can send your blood sample to China for cross test. If the patient is a man without any blood transfusion before, his PRA value is likely 0%, so the cross test will be surely negative. In the U.S., more than half of potential donors are not healthy enough for donation.
2. HLA does not change over time. The higher matching of HLA, the better, but it is not necessary to have a full HLA match for a kidney transplant. There are good chances that there will be some HLA matches. Even 0 out of 6 HLA matches, a living donor transplant is still better than a 6 out of 6 HLA match deceased donor transplant. Among A, B and DR pairs of HLA, DR pair are more important.
3. A donor may need at least 3 weeks of rest after surgery before returning to office work. For physical work, it takes longer rest.
4. Location of transplant: I think China has done well with kidney transplant, so the consideration is cost and care. In the U.S., the cost should be more than $250k, much higher than in China. Also the health insurance should cover most of cost in China. In the U.S., it commonly takes about 3 months to do the patient and donor evaluations before the transplant.
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