Cells, tissues and organs

1. Cells, tissues and organs All living organisms are made up of cells. Large numbers of cells group together to form tissue. Tissues can combine to form organs.

2. Kidney function The kidneys act as sieves. As blood passes through they filter out: Water Glucose Urea (waste) Ions (salt) Blood cells and large molecules, such as proteins, stay in the blood (they are too big to be filtered). Then the kidneys reabsorb what the body requires. The rest of the filtered chemicals go to the bladder to make up urine.

3. Kidney failure You have two kidneys, but you can manage with just one. But if both kidneys fail, urea (waste) rises and the body is poisoned. So if your kidneys fail, there are 2 options: Option 1: Dialysis • You are attached to a kidney machine via a tube from a vein. • Your blood flows into the machine, is cleansed, and returns to your body. • You are attached for about 5 hours, 3 times per week. Option 2: A kidney transplant • You have an operation to remove your failed kidney and replace it with a working kidney from a donor. • One or both kidneys may need to be transplanted

4. Dialysis or transplant? • Kidney dialysis works quite well, but is a time-consuming burden. • Apart from taking drugs to stop their body rejecting the new kidney, someone with a successful transplant can lead a completely normal life. • A transplant costs about £42,000 for the operation plus £6,500 a year in drugs and check-ups. BUT • Dialysis isn’t cheap – about £23,000 per year, for life. Watch the film about Andrew Samuel waiting for a transplant

5. Where do the donor kidneys come from? • A living person can donate one kidney. • To donate a kidney (or any organ) after death, you have to have died in hospital – they have to be removed quickly. • Most people die at home so there is a serious shortage of donor kidneys for transplant. • There are around 7,000 people waiting for a kidney transplant. • Around 2,000 kidney transplants are carried out annually and each year 2,000 more people go on the kidney transplant list

6. Organ transplants • After death, the following organs can be donated for organ transplant: kidneys heart liver lungs pancreas small bowel • In life, some organs can be donated too: • kidneys, because we can manage with just one. • part of the liver, because it can regenerate (grow back) • part of the lung • part of the small bowel (small intestine) • For a successful organ match, the donor and transplant patient ideally should have compatible: • Blood group and Human Leukocyte Antigen type

7. Blood group

8. Matching donor organs to recipients – Human Leukocyte Antigen (HLA) tissue type A kidney donor needs to be a close HLA type match with the recipient. HLA type can make the difference between a patient’s body accepting or rejecting a donated organ. HLA type is defined by six principal pieces of protein: HLA antigens. Each newly discovered HLA antigen has been numbered. Doctors aim for at least a four HLA match between a donor and patient. Which of these donors is the best match for someone in need of a kidney transplant, with HLA numbers 2 3 6 9 10 13? Recipient 1: 2 6 7 10 11 13 Recipient 2: 3 6 8 9 11 12 Recipient 3: 2 6 9 10 12 13