Donating kidney with better (60%) function question

[kkdonor18]

Hello, I am a 25 year old looking to donate my kidney to a family member. I have kidneys with uneven function (one is 40% while the other is 60%), and due to unusual kidney anatomy, they can only remove my better kidney, leaving me with the 40% one. The doctors and surgeon don’t advise this due to my age (eg. I could get sick in the future), but says it’s my decision.

My question is, have you or anyone (or any research you’ve read) donated a higher function kidney? Or do you have a 40% functioning kidney? Will my kidney function improve to compensate for the lost? Are my risks higher due to only having 40% and not 50%?

Thanks

[Fr Pat]

I donated a kidney 16 years ago, and I'm not sure if they tried to measure each kidney's capacity or not. But here are a couple of things to keep in mind:
--- As we age (although I realize that you are still rather young) our kidneys naturally and slowly reduce their capacity. So you have to keep in mind what the capacity of your remaining kidney might be 30 or 40 years down the road.
--- Although I read at the time that the remaining kidney would "grow" to increase capacity after the donation, others have pointed out that the "growth" may not be quite so desirable. If I understand it right (I'm not a medical professional) the remaining kidney will not grow new nephrons, but rather the existing ones will expand and "hyperfiltraste" to handle the extra load. Some suggest that this hyperfiltration (extra burden) over the years may explain why we kidney donors tend toward high blood pressure over the years.

    Well, that's about all the info I can offer. You might want to post your question also at the  FaceBook page of Living Donors on Line, as many more donors check in there rather than here these days. There is also a FaceBook page of "Living Kidney Donors Support Group".
     Fr. Pat

[Michael]

I agree with Father Pat's observations. Your questions are also good ones to ask a nephrologist and/or someone on the transplant team.

[sherri]

KKdonor18,

I'm glad to hear that you have undergone testing which reveals that your kidney function is not 50-50 as most of us assume. not everyone is tested in that way and some donors find out only after donating that the kidney that was taken was the stronger one and are now left with a weaker kidney and therefore less reserve. So now the question is what do you do with that information? Surprisingly (well not so surprisingly) the doctors have asked what you would like to do after telling you they do not advise this. So this means that they knowingly are aware that if they remove that higher functioning kidney and give it to your family member this would leave you with compromised kidney function.And this surgeon would remove that kidney if you said yes. I think that is autonomy taken  to the nth degree. What happened to "do no harm".

I wonder if you were an unrelated donor if they would say the same thing? Recipients can generally go on dialysis to bridge them to transplant. There are also other people who could test in the meantime to see if they are healthy enough to donate or enter into a paired exchange if they are not compatible. So there are other options for your recipient.

At age 25 it would be prudent to look towards your future. Get a second opinion outside the transplant center if it helps you making a decision. Also ask for the living donor advocate. there should be someone who is appointed to protect the donor's interests. As a related donor it is unfair (in my opinion) to ask you to make the decision whether you should compromise your own health. I am so sorry that this has been thrust upon you.

there is a facebook page for living donors with complications. you may be able to glean some more information from them.

Does your recipient know that you are a high risk donor and would they still be willing to accept a kidney from you? How would they feel knowing that they may be putting your health in jeopardy and should you become dialysis dependent? just as the doctors gave you the decision an express your autonomy the recipient should know the circumstances under which they are accepting a kidney.

Please keep us posted and best of luck to you and your family. personally, I hope another more suitable donor will be found.


Sherri