Living transplant-relative donors
1、The requirements of being a living kidney donor
- The donor has to be at least 20 years old, healthy, and related by blood within 5 generations to the recipient, or to be the spouse of the recipient. According to the law, the donor needs to be in the marriage with the recipient for at least 2 years, having children with the recipient, or married to the recipient a year before the recipient is diagnosed having the need of kidney transplant.
- Both kidneys function normally.
- The donor does not have the following diseases: diabetes, high blood pressure and tuberculosis. The donor does not have history of malignant tumors or infectious diseases which are forbidden by law such as AIDS.
- The donor donates his/her kidney of his/her own free will and pure motivations.
2、The blood type requirements of the donors
The same or compatible blood types of the donor and the recipient is the first priority. For instance, a blood type O donor can donate
his/her kidney to the recipient of any blood types; a blood type O recipient can only receive the kidney from a blood type o donor; a
blood type AB recipient can receive the kidney from the donor of any blood types. Under some special circumstances, it is allowed to have kidney transplant surgery with incompatible blood types. However, the survival rate of the transplanted kidney is lower, and the chance of rejection is higher.
Treatments before ABO-incompatible kidney transplantation
- Reducing the remaining blood type antibody: plasmapheresis and giving IVIG.
- Reducing: the active of B cell: giving rituximab 375 mg/m2 ~3 weeks before the surgery.
- Reducing: the active of T cell: giving acrolimus, mycophenolate , Mofetil, pre-transplant basiliximab (optional), and proper antibiotics to prevent infection.
After these medicine treatments, according to the researches, ABO- ncompatible kidney transplantation can lead to the similar results as ABO-compatible cases, including survival of the patient and transplant liver, the function of the liver, the rejection and infection. However, for those whose blood type antibody rate is higher than 1:512, the rate of biopsy-proven allograft rejection is still higher than ABO-compatible transplant. Therefore, the patient whose blood type antibody is higher needs to take the medicine and follow up more carefully to have the best result For more information, please leave your information on “ contact us.” We will reach you back once receiving your information.
Taiwanese and residents：
Taiwanese and residents please refer r to the standard charge of outpatient clinic and emergency service.
Foreigners who do not have the national health insurance will be charged by international medical standard fee.
- Registration: NTD $500
- Examination fee: NTD $1500
- Special service fee (you will have a coordinator helping atsite): NTD $200 per visit
- Psychiatric consultation: NTD $2,500
- You may be charged by other medicine tests and treatments
2、Stay in hospital：
- Inpatient examination and nursing fee: three times the price of the national health insurance standard charge
- General service fee: NTD $5,000 per stay
- NHI covered services/treatments: 2.21 times the price of the national health insurance standard charge
- Self-paid services/treatments: 1.7 times the price of the self-pay standard charge from department of health, Taipei city government. .
Depending on the treatments, we will estimate the medical cost. You will need to pay the deposit before staying in the hospital. The patient will only pay for the service and treatments they use (the hospital will return the rest of the money)
- Exchanging new Taiwanese dollar
- Credit card (VISA card, Master card and china unionpay card)
The evaluation of being a living kidney donor
It takes 4-8 weeks to complete the evaluations step by step. If the donor is in good medical, social, psychological and metal health, the surgery will be arranged after our medical ethics committee approves the application.
(1)Blood test: the function of the kidneys and the liver, blood counting, antiHAV, anti-HBV, anti-HCV, blood type, syphilis, AIDS, hemostasis and tissue matching.
(2)Image check: chest X ray, abdominal ultrasound, breast ultrasound, mammography (female).
(3)Other: electrocardiography, urinalysis and urine cytology.
(1)Blood test: Virus antibodies, tumor indexes, thyroid function and tuberculosis.
(2)Image check: kidney CT and comprehensive renal function test (ERPF).
(1)Metal status examination
(2)Evaluation of social workers
Review of medical ethics committee
According to the Human Organ Transplant Regulations of Taiwan, the comprehensive
information both of the donor and the recipient need to be reviewed by our medical ethics
committee. The surgery will be arranged with its approval.
Surgery approaches and procedures
A living kidney donation is performed under general anesthesia. Therefore, during the surgery, you will not feel anything. In order to
detecting the central venous and blood pressure, a central venous catheter will be inserted in the right part of your neck, and an artery catheter will be inserted in your upper limb. The use of a foley catheter is also necessary.
There are 2 approaches of the surgery: open surgery and laparoscopic surgery
- Open surgery is performed in the abdominal cavity with a 10~15cm laparotomy wound (or flank incision). First step is separating the kidney artery, kidney vain and proximal ureter, at the same time, separating the kidney from the surrounding tissues. Afterwards, the doctor will remove the whole kidney and preserve it in organ preservation solution. After the kidney is completely removed and the bleeding is stopped, the doctor will stitch the incision.
- A laparoscopic surgery offers smaller incisions, equally successful outcomes, less pain, shorter recovery time and less days staying in hospital. First, the doctor will make 3 small incisions (each about 1cm length) and infuse carbon dioxide into the abdominal (or retroperitoneal) cavity. Through these incisions, the doctor can
insert the instruments and a camera in the donor’s body to perform the surgery. In the end, the kidney will be removed from the incision of the lower quadrant of the abdomen. There will be $80,000-$100,000 NTD at the donor’s own expense.
Nursing care plans
The risks and complications of living donors
- The remaining kidney of a healthy donor, who received a full evaluation before the surgery, performs its normal function. According to long term follow-up studies, the life expectancy or the incidence of chronic kidney diseases (uremia) of the
donors is the same with people who have not had the surgeries.
- There are 2 approaches of the surgery: open surgery and laparoscopic surgery, taking 4-6 hours each. The donor needs to stay in the hospital for 5-7 days. The wounds will be different depending on the type of the surgery. According to the statistics, the death rate of living kidney transplant is lower than 1/1,000.
- The incidence of complications is 8%-16%, including infection (2.4%), pneumothorax (1.5%), major bleeding and in need of bleeding control (<1%), pulmonary embolism (1%) and ureter stricture and urinary incontinence (2-10%).
In the long-term, there may be 30% decrease of the glomerulus filtration rate of the kidney, with mild proteinuria or high blood pressure; but the overall renal function and incidence of chronic kidney disease does not increase after donation.
Applying for medical records/certificate of dianosis
The duration and procedure of applying for medical records
- Counter service
- Applying online (taking about 2~7 business days) willsave your time instead of waiting in the hospital. However, when pick up the copies, you need to bring your id to the counter and pay.
- You can directly apply at the medical counter without registration or seeing a doctor.
- When applying for your copies, please tell us the term, the services/treatments and the duration of your record. If you do not know how to find the information, you may ask your doctors for help when visiting them.
- You need to pick your copies within 1 month after informed. If you do not do so, you will need to reapply.
- For videos or images copies, please apply at the image counter 8 of radiation department on the 8 th floor in the Zhongzheng building.
- Please bring your ID and related documents, take a number at the counter and wait your turn.
- Fill out the application form.
- The staff will verify you application.
- Pay and collect your copies.
- For the requirements of applicant and enclosed documents, please refer to Here
The duration and procedure of applying for certificates of diagnosis
- The patient applies for certificates of diagnosis while staying in hospital will need to prepare the draft made by your doctor. Then, bring it to division of medical affairs admission (the inpatient counter on 1st floor in the Zhongzheng building) for an official copy.
- Chinese copy：NTD $100 for the first copy；NTD$50 for the second and more copies English copy：NTD $200 for each copy.
- Outpatients who needs to apply for the certificates of diagnosis please refer to Here
- For reissuing certificates of diagnosis (same copy from the one you have applied before), you need to provide your identification (as the list below) and an application. (Download：(application）
- For the requirements of applicants and enclosed documents please refer to Here
After discharged from hospital, you need to visit your doctor to follow up your condition once a week in the beginning. In the long term, you are advised to take blood tests to measure the kidney functions, test for urinary protein every year.