Objectives Students should learn: that a kidney transplant involves the replacement of a diseased kidney by a healthy one from a donor that precautions need to be taken to prevent the rejection of the transplanted kidney by the immune system that there are advantages and disadvantages of kidney transplants vs Dialysis

Outcomes Most students should be able to: replaced by a healthy one explain the problems of rejection by the immune system list the ways in which rejection is prevented list the advantages and disadvantages of having a kidney transplant. Some students should also be able to: evaluate in detail the advantages and disadvantages of treating kidney failure by dialysis or kidney transplant explain the issues of rejection and the advantages of close tissue matches for success.

Specification In kidney transplants, a diseased kidney is replaced with a healthy one from a donor. However, the donor kidney may be rejected by the immune system unless precautions are taken. [B3.3.1 g)] Antigens are proteins on the surface of cells. The recipient’s antibodies may attack the antigens on the donor organ as they do not recognise them as part of the recipient’s body. [B3.3.1 h)] To prevent rejection of the transplanted kidney: a donor kidney with a ‘tissue-type’ similar to that of the recipient is used the recipient is treated with drugs that suppress the immune system. [B3.3.1 i)] Evaluate the advantages and disadvantages of treating kidney failure by dialysis or kidney transplant. Controlled Assessment: B4.5 Analyse and interpret primary and secondary data. [B4.5.1a) b)], [B4.5.4 b) c)]

KIDNEY TRANSPLANTS p.252-3

Workbook homework p

Labelling the kidney

Kidney transplants answer questions from the sheet using p What is a transplant? 2. Who receives the transplant? 3. Who gives the kidney? 4. What are on the surface of the cells of the donated kidney? 5. Why is this a risk to the recipient? 6. How can rejection be minimised? (2)

Transplants Pros Immunosuppressant drugs are cheap compared to dialysis Doesn’t have to make as regular trips to hospital e.g. can go on holiday Cons Wait for a donor can be a long time Kidney transplant can be rejected Take lots of immunosuppressant drugs Need a new transplant after, say, 10 years

Kidney transplant data

Transplants Vs Dialysis Worksheet on the economics Produce a table of pros and cons (Q3 p.253)

Answers to questions 1. £350M spent on transplants (17,500x£20,000) 2. Annual cost to the country: Dialysis – 1 year = £30,000 x 10 = £300,000 Transplant – 1 year = £20,000 + (£6500x10) = £85, Next slide for table

Comparing dialysis and transplants DialysisTransplants Machines availableNeed donor – often not available No problem with tissue matching Need tissue match 2x a week at least for lifeSurgery every 10 years or more Expensive long termAfter surgery relatively low cost of medicine Always have to watch diet Can lead to relatively normal life

Kidney snakes and ladders Decide whether the statement is ‘good’ (ladder) or ‘bad’ (snake) Draw an appropriate sized snake or ladder and copy the statement onto it Colour transplants in one colour and dialysis in another Play your game!

Dialysis Long term cost high Risk of infection with each dialysis Not as effective as a transplant Get connected easily as lots of dialysis machines available (compared to donated kidneys) Eat a fried breakfast whilst dialysing Between dialysis strict breakfast is needed It hurts the arm Dialysis needed 2 or 3 times a week

Transplants Need a new transplant after 10 years Wait for a donor can be a long time Kidney transplant rejected Take lots of immunosuppressant drugs Transplant helps you to lead a normal life Immunosuppressant drugs are relatively cheap Doesn’t have to make as regular trips to hospital e.g. can go on holiday Find a donor with same tissue type

Multiple-choice quiz