Opinion: Consider giving a part of yourself

[Clark]

http://www.newsobserver.com/2014/12/05/4379561/consider-giving-a-part-of-yourself.html?sp=/99/108/

Consider giving a part of yourself
BY CAROL OFFEN

Question: If Mary donates one of her kidneys to John, Mary will have one left. How many will John have? (A) one, (B) two or (C) three.

Most of the time, the correct answer is (C). If leaving the failing kidneys in place isn’t causing a problem (say, high blood pressure), the surgeon will just tuck the third one into the patient’s belly.

It’s one of the many little-known facts about living kidney donation, a medical marvel that remains shockingly underused.

Living kidney donation has become simpler, safer and easier on the donor thanks to minimally invasive laparoscopic surgery. Yet the number of such transplants each year in the United States has been dropping almost steadily, down 14 percent over the past decade, with only 5,733 last year (about a third of all kidney transplants).

Meanwhile, the waiting list for a kidney from a deceased donor has surpassed 100,000 – and about 12 kidney patients die each day nationwide while often waiting years for a transplant.

Given that a kidney from a living donor often provides a better match, lasts about twice as long as one from a cadaver, usually starts working immediately and allows the surgery to be scheduled at an optimal time, the case for increasing living donation is compelling.

Congress and the public health community have been exploring innovative ways to attract more donors: with financial or in-kind incentives, such as college tuition – controversial because of the taint of turning body parts into saleable commodities – as well as reasonable accommodations such as ensuring that a donor would go to the top of a transplant list if the remaining kidney ever failed.

As a living kidney donor, I offer my own modest proposal: Let’s demystify kidney donation.

We’ve done it with breast cancer. Just as BRCA1 and BRCA2 genes have become part of the national conversation, so can CKD (chronic kidney disease) and PKD (polycystic kidney disease).

Clearly, many more people would be willing to consider donating a kidney – be it for a family member, a friend or even a stranger – if they were more familiar with the process and knew what it was like today.

Question: How long does a kidney donor stay in the hospital after a transplant? (A) two weeks, (B) one week, or (C) two to four days.

Answer: (A) might have been true in the days, more than a decade ago, when doctors usually had to remove a few of the donor’s ribs to take out a kidney. (B) is closer to current practice, but (C) is the answer. With the overwhelming majority (100 percent at some centers) of living donor kidney surgeries now being done laparoscopically (think: bikini incision ), most donors can go home with a moderate painkiller after a few days.

Obviously, it’s not a walk in the park – and certainly there are risks to any major surgery – but I was expecting something far worse. As a lifelong wimp who has passed out during an eye exam, after a flu shot and in anticipation of a blood test that didn’t even happen, I figure that if I can do it, anyone who’s healthy enough certainly can.

When friends visited soon after I came home from the hospital, I shocked them by answering the doorbell in street clothes. They couldn’t believe how well I looked (true, I got a new hairdo shortly before the surgery, but I don’t think that’s what they meant ) and acted. Hearing that repeatedly prompted me to confide in a friend, only half-jokingly, that I felt so good, I had to wonder if the surgeon had done it right.

Question: How soon can a kidney donor go back to work? (A) three months, (B) two months or (C) two to four weeks.

Answer: (C) Unless the job requires heavy lifting or much physical exertion, most people go back to work in a few weeks.

To be a kidney donor, you don’t have to be under 30. It depends on the health of the kidney. I was 58 when I donated my kidney to my son.

Research has shown that acts of kindness and charitable giving light up pleasure circuits in the giver’s brain. Can you imagine the light display when you’ve literally given a part of yourself?

I can.

Carol Offen lives in Chapel Hill.

[Clark]

http://www.newswise.com/articles/living-organ-donors-to-give-and-to-receive

Living Organ Donors: A Chance to Give and to Receive
New life for those with transplants and for nurses who couldn’t bear to stand by

As a clinical nurse specialist with the Incompatible Kidney Transplant Program at The Johns Hopkins Hospital, Janet Hiller, MSN, RN, often hears about patients who are getting sicker while waiting to find donors. Wanting to help, Hiller decided to run her name through the tissue typing database in late 2009. “It only takes one new donor to stimulate a lot of matches,” she says. Out of a pool of 100 recipients, she was a match for one, a young woman in her 20s, whose name was surprisingly familiar to her.
Earlier that year, the same young woman was scheduled to be part of a national kidney exchange at Hopkins. A program like this often begins with an altruistic donor who offers his kidney to Patient 1. A friend or relative of Patient 1 donates a kidney to Patient 2, whose friend or relative donates to Patient 3, and so on. But one donor had to drop out of the exchange for medical reasons. That left the young woman without a donor. Two months later, in early 2010, Hiller donated her kidney.
“It’s easier than a lot of people think it is,” says Hiller, who has never met the recipient. Hopkins employees who become living donors get an additional four weeks of leave to recover from surgery. As for long-term complications, “It has been four years since [my donation], and I feel absolutely no different. There aren’t even any scars.”
Since 1954, when the first such donation took place, there have been more than 50,000 living kidney donors, according to the National Kidney Registry. Most donors at Hopkins give a kidney directly to a loved one or participate in a paired exchange. But there are also a few Good Samaritan donors like Hiller who donate a kidney to anyone in need.
[Transplant Team's Guiding Hands]
For Susan Humphreys, PhD, RN, kidney donation was the second item on her bucket list. (The first was to complete her doctoral dissertation.) The Johns Hopkins Hospital nurse manager became interested in donating when she started taking yoga lessons and reading Eastern philosophy three years ago. Realizing that she was a healthy 64-year-old woman who had never had surgery, “I wanted to do something with my good health,” she says.
Humphreys donated her kidney in early 2014. A week later, her recipient, a woman in her 20s, wanted to meet her at the hospital. There, Humphreys found out that the woman had been on dialysis after losing the kidney her mother gave her when she was a child. “It’s very special to get to know your recipient and to incorporate them into your close relationships,” Humphreys says. They continue to keep in touch through Facebook.
No matter how committed they are, Good Samaritan donors naturally have doubts at some point during the process, especially if loved ones aren’t completely supportive of the decision. Hiller’s youngest daughter, 15 at the time, was concerned about complications.
“Her dad said, ‘There is a 1 in 10,000 chance that mom could die,’ ” Hiller says. “All she could hear is, ‘Mom could die.’ She didn’t hear [the odds].” Because of her reaction, “I thought seriously about [the idea of donating] in relation to her and the family. If my family wasn’t OK with it, then I wouldn’t do it.” After they talked more about the surgery, Hiller’s daughter eventually agreed she should go through with it.
Humphreys—who also has a daughter who was initially upset about her decision—was anxious about the surgery herself. Having once worked in the kidney program, “I know that things can go wrong, and I know no one is immune to [that],” she says. Humphreys also worried whether her kidney would work with the recipient, considered a “high-risk” patient because of her history.
Humphreys actually talked to Hiller about these concerns. “She was reinforcing to me that at some point you decide [to donate] regardless of the risks,” Humphreys says.
And on surgery day, Humphreys had a “wonderful experience.”
“[Donating] gave me joy and that very deep feeling of being interconnected with people in the world,” she says. “If I had two kidneys [to spare], I’d do it again.”