2nd time around? kidney donation after liver donation

[billp]

I donated a liver lobe to a sister in 2003.  The donor surgery went easy enough for me although some complications kept me in hospital for 10 days and I did have follow-up surgery for an incisional hernia a few years later.  It has been much less than a walk-in-the-park for my sister who has had lot of biliary complication. Apparently the liver remains healthy (in spite of sister's Hepatitis C) and there is no indication of rejection.  I have absolutely no complaints or regrets about my liver donation experience.

Last week a different sister tells me that she has been diagnosed with Stage 4 ESRD; her doc says that dialysis and/ or transplant is in her future. 

W/o reservation, I will give her a kidney.  Sister is a wonderful person, who deserves better than to suffer dialysis in her 'old' age (she is 67).

I do though have a couple questions that someone on this list might be able to answer.

1) I am 64, in good health and active.  UNOS stats show that 1200+ kidney donors were more than 65 years old at time of donation.  Age would not seem to be an absolute dis-qualifier then, but much of the transplant literature (from transplant centers) is written as if it is.  Can anyone share their experience with this age bias?  What might I say or do or act to overcome this bias.   

2) I encountered a few surprises following the liver donation:  eg, the new 'arrangement' of organs following the section; the hernia rate of about 30% in procedures using the mid-line incision < regardless of any post surgical 'lifting').  I don't expect that there would be anything exceptional about kidney donation after liver donation ... Am I wrong?  should I suspect to be surprised?  if so, how?

thanks


 

[Fr Pat]

     If I understand it correctly, hospitals may be more willing to remove a kidney from a healthy older donor when it will be transplanted to a recipient of similar age. If a 67-year-old kidney were transplanted to a 20-year-old and lasted 25 years the recipient would then have an 92-year-old kidney, and kidneys tend to lose function gradually with the years. So your hospital may be willing to take into consideration the age of your intended recipient.
     Fr. Pat

[dodger]

I donated in March, 2011.  I was 59 1/2 at the time.  I came through the testing with flying colors.  My recovery was good and I was back to felling normal at 4 months.

I will say, be in the best physical condition you can.  I wasn't and it did make a difference I believe.  If you have weight to lose, lose it, now.  If you don't excercise, start.  This is a major surgery and you are a few more years older.  The old saying, use it or lose it is soooo true, especially as we age.

It would be a fine thing you do for your other sister, you are wonderful to be so giving and loving of your family members. 

[Snoopy]

I will say, be in the best physical condition you can.  I wasn't and it did make a difference I believe.  If you have weight to lose, lose it, now.  If you don't excercise, start. 

Hi, Dodger.  I know it's important to be in good shape, and lose weight (for those who are overweight), before the surgery.  But nobody ever told me exactly why.  How, exactly, does losing weight assist recovery from surgery?
      Thanks, Snoopy (who's very close to the BMI his surgeon ordered)

[Orchidlady]

Snoopy, I had to lose weight prior to donation, and both the transplant team and surgeon gave me several reasons why. First, they said that the excess weight does hamper recovery - particularly as regards activity after surgery. In addition, they pointed out that with donors they want evidence up front that you are committed to a healthy lifestyle both prior to, and after the donation - "first do no harm.....".. The surgeon also commented that excess weight made it more difficult for him to get to the kidney and that difficulty could compromise his ability to do laparscopy, thus reverting to open surgery.

I deal in the workers compensation realm, and I can tell you from experience that being overweight truly does compromise and delay recovery. One of the big issues facing the industry at this time is obesity, as the problems it causes and the excess time delay in recovery is adding untold dollars onto the cost of claims.

[Fr Pat]

Dear Snoopy,
      Apart from the actual surgery and recovery, the hospitals push for a healthy weight because overweight is a serious contributing cause to high blood pressure and diabetis, both of which can destroy the remaining kidney. So they want donors to maintain a good weight permanently AFTER the donation, in order to protect the health of the remaining kidney by avoiding high blood pressure and diabetis as much as possible.
     best wishes,
        Fr. Pat

[dodger]

Snoopy, good for you.  Dieting isn't easy.  I am almost at my goal weight, just 3 more lbs.  Why are those the hardest?  I want it off in 2 more weeks so, I must make it happen, haha. 

All the above responses are great.  You have much better circulation when you are thinner.  Easier on the heart, and all organs to get good blood flow. Especially that special little kidney we treasure.

Hubby and I are now checking into a health club membership as winters are long here and neither of us want to go back to where we were, ever.  For me it is a life choice, hubby, well he likes that he has lost weight, but still wants his old food! haha.  I eat to live, he lives to eat.

[Snoopy]

Thanks to everybody's explanations of the specific reasons why it's good to lose weight.  I would just add--start early.  I'd figured the last couple of pounds would be easy, since I'd finally gone back to the gym.  Surprise--soon after, the doc banned me from the gym for one month, because the exercise seems to have been dumping protein into my urine, raising questions about my kidney function.  So, to "clear my kidneys' good name", I'm out of the gym, and have to lose the last weight by watching my diet even more carefully. My own experience has been that it's much easier to lose weight with dieting plus working out!
   Good luck to everybody, Snoopy

[Orchidlady]

LOL! That is so true Snoopy! I had never dieted before in my life and I thought all would have to do was cut out white bread, do a little walking, and the weight would slide right off - Wrong!  I remember the transplant coordinator patting me very kindly on the shoulder and saying "Oh honey! Women our age (who's she talking about!? - women OUR age!!) can expect to lose only about a pound or two a week." What a wake up call that it was easier to pack it on than to take it off!