I want to be a Living Donor

[zildjian212]

I made the decision to donate a kidney recently but I have many questions. Aftercare is a concern since I am uninsured. Lost wages is another concern as I live week to week and cannot afford to lose even 1 weeks wages. Another concern is will being a donor adversly affect my ability to obtain insurance in the future and will I pay higher premiums as a result? I really want to do something for someone in need out of love and have accepted the health risks, immediate and long term, but there are some hurdles I will need assistance with. If anyone can offer any advice, I would greatly appreciate it!

[Fr Pat]

Dear "Zildjian",
      Hi. Congratulations on your willingness to consider organ donation! Here are some thoughts on your questions, and I hope others will reply as well.
--- regarding wages: while it is not legal to be paid for a donated organ, it IS legal to be reembursed for lost wages and other expenses involved in the surgery (travel, lodging, meals, etc.) However there are very limited sources for such re-embursement. If your recipient is willing and able, he/she can reemburse for lost wages etc.  Fund-raisers can also be held for that purpose. There is also a government program that can provide such help IF the income of the recipient is below a certain level. Info on this at www.livingdonorassistance.org . There is paperwork and documentation involved, and perhaps the social worker attached to the transplant hospital of your recipient can help on this. Some donors have also received "disability" pay depending on the State where they live and/or their employer. A big problem is that you cannot know for sure in advance how long you will be out of work after donation. Some (few) donors are back to not-heavy work in two weeks. Most are out of work for 6 weeks or more. Some (few) suffer serious medical complications that keep them out of work for longer periods.
--- Some donors have reported difficulty in obtaining medical insurance after donation, while others have not had difficulties. The new health care law tries to address this, but I'm not sure just how, nor when those parts of the law take effect (if it is not repealed). Some hospitals will not accept a donor unless she/he already has insurance. The hospital is SUPPOSED to take care of any post-donation complications without charging the donor, but some hospitals have done a bad job on this and some donors have had difficulties over hospital bills.

     You should be able to talk these points over with the transplant coordinator or social worker at the recipient's hospital. It is good to get these matters very clear before proceeding.

     best wishes,
      Fr. Pat

[Michael]

Frankly, you have significant barriers to being a living donor at this time.

Lost wages are just part of the financial challenge of being a donor. Fr. Pat notes a few potential resources. However, most living donors do not get all (or even any) of those expenses paid for. Here's a link to a draft spreadsheet (you don't need Excel) that will give you an idea of what's involved financially: https://spreadsheets.google.com/ccc?key=0AvtwuW2PRLgMdHZqTVRzcVVDUUZkeF9tNy1yQUVSU2c&hl=en&authkey=CJm6zrEP#gid=0

I'm going to be uncharacteristically blunt and say it is irresponsible to undergo a major medical procedure without personal health insurance. While the recipient's medical insurance will cover the cost of the testing and surgery, post-surgery complications happen and who covers them isn't always clear. Besides, you'll want insurance protection to help you cover regular annual exams and ongoing testing for hypertension, proteinuria, and GFR.

Sorry for being so direct. In my view, this is not a good time for you to donate an organ. Perhaps there will be a time when you have insurance and financial stability when it will make more sense. In the meantime, you might consider donating blood. It is the same life-saving gift as organ or bone marrow donation without the same level of risks or requirements.

I realize this isn't what you wanted to hear, but I hope you'll take it in the positive constructive spirit I offer it.

[WilliamLFreeman]

Zldian212,

Michael was blunt (indeed uncharacteristically), but focused on core issues.  I would like to supplement his focus.

The underlying ethics of living kidney & other solid organ donations has been somewhat problematic, because this is the only type of surgery in which the person undergoing the surgery (i.e., the person being harmed by the surgery, because all surgery harms that person) is not the person who receives the primary benefit.  (Yes, we donors receive benefit, often immense benefit -- the satisfaction of trying to help another person -- but we are not the primary beneficiary.)  Thus, the possible harms to the potential donor must be minimal for the surgery to be ethical.  The potential harms to you are not minimal at this time.

A key phrase is "at this time" -- and Michael says that, too.  From your e-mail moniker, I guess you might have turned 51 recently.  If a concern of yours is that you should donate now or else you will grow to old to donate, you should know that you have a few years to go yet!    (I donated when I was 67.)  You do not mention whether other people are dependent on you, possible other responsibilities you have, etc.  Granted, getting re-employed at that age (or any age) in this economy with good life & health insurance is not easy, but for all those reasons, the issues Michael outlined are basic priorities.

If you have an identified person who needs a kidney, you may want to donate immediately, irrespective of your age.  But Michael's issues still are basic priorities at this time.

I/we all on LDO appreciate your desire and values.  So does, or will, the potential recipient.  I/we all truly wish you all the best as you deal with -- and solve -- these issues!

Bill