Very young kidney donors.

[CD110]

Hi all, this is my first post here. First I'll give you folks my back story.

My father is in need of a kidney. He is 62 years old. My mother has gone through all the testing and she had a date set for the transplant. The surgery was to take place January 29th. There was one final test to be done (I'm not sure which) that the medical team didn't anticipate any issues from so they went ahead and scheduled her surgery anyways. As it turns out, the results of this test were not great - her own kidneys were only operating at 75% and they won't do that transplant unless kidney function is 80% or greater. Talk about a major let-down...

I am considering getting tested to see if I am a match for him. I have been doing nothing but reading information about the donation process for the last week. If I were an older person I wouldn't hesitate about getting tested and going through with the procedure. My concerns are all based around my age; I am only 24 years old. I would have to live with one kidney for the rest of my fifty or sixty years (I hope!). I know the outlook for kidney donors is generally good in the short term, however there is limited information available on the long term effects of donation. I could find limited information for donors who have donated >30 years ago, let alone 40 or 50. I am concerned that having just one kidney for the vast majority of my life could be problematic. I worry about decreasing kidney function in the remaining kidney as I age, as well as my lone kidney not compensating for the loss of the other kidney.

I also worry about my fathers health during the surgery. He has been on dialysis (overnight)  now since March 2013. He isn't overweight, nor does he smoke, however he does have a heart condition. In July 2012 he had a bypass as well as the replacement of his mitral and aortic valves. He has since recovered, but I do worry greatly about the stress of another major surgery on his body.

I would love to hear basically anything anybody has to say, especially if any of you are young donors or know of anybody that has donated at a young age. Thanks for reading.

- Chris

[Karol]

Good luck to you Chris and your dad too.
Here's a recent related thread https://livingdonorsonline.org/ldosmf/index.php?topic=5643.0

[Fr Pat]

Dear Chris,
     Hi. This does not have to do with your question regarding younger kidney donors (I donated at age 56, 12 years ago) but I would like to mention that while you think about possibly donating it would also be a good idea to get out the word about his need for a donor to his friends, neighbors, past co-workers, club members, church/synagogue members, old alumni, etc. There might well be persons of his similar age who would be willing to donate if they only knew about the need and the possibility. There have been cases where persons who were not even close friends stepped forward to offer once they knew the need. It does mean losing some privacy, but it is possible that there may be someone right around the corner, of his age, who would be happy to donate but may be completely unaware of the need.
      Best wishes,
          Fr. Pat

[elephant]

Dear Chris,

I donated to my dad when he was 74 or 75.  The medication used after his heart transplant cause caused kidney failure.  He needed the heart transplant  due to a viral infection that damaged his heart.  So, I donated to an older patient with a heart transplant.  It's been 2 1/2 years and he is doing great!  Yes, surgery is hard for the heart patient, but dialysis is very hard on the heart patient.  In fact, we did a pre-emptive donation so that he would not have to start dialysis since heart transplants do so poorly on dialysis. 

I chose to accept the judgement of the transplant team, and they thought Daddy was a good candidate for a transplant.  I was older than you at donation (47) but I also expect to live with one kidney for 50 or 60 years.  I'd hope you would have 70 or 80 years with yours.   If you do donate, you will want to consider maintaining a healthy weight, good nutrition, and a fitness program. 

Perhaps you could schedule yourself a checkup with a nephrologist outside of the transplant hospital, and in that way feel comfortable that you have an unbiased medical opinion? 

Love, elephant

[Clark]

Dear Chris,

  Best wishes to you, your father, and your mother, dealing with her dashed hopes of being the one to both help him and keep you from this decision. I hope you all manage to hold each other tenderly as you all embrace the issues, fears, and joys of where you've found yourselves.

  Empathy about the paucity of good long term studies despite the 60 years of living donor surgeries. The risks of your life activities will be only slightly modified by both your setting forth on this path, and by actually undergoing surgery to donate, if you eventually do. Our existential risks are many, diverse, and poorly understood emotionally even for those who delve into the topic and learn the amazing realities, so different than our typical day to day worries. In particular, the best conceptual model I've encountered, still only minimally supported by evidence, separates the surgical risks, relatively well studied and as true for us as any patient, the emotional risks, unique and possibly unquantifiable, and the nephron mass loss, approximately equal to one's kidneys aging 20 years.

  The surgical risks you can research, and I urge you to do so, especially the variety of complications and indirect effects, during surgery and the peri-operative period as well as long term. Having a plan can help you and your family prepare practically and emotionally should you be unfortunate enough to experience any of them. No plan, no data, no other person can tell you what your own emotional reaction will be or should be. In advance, one can only do one's best to be informed and hope. As for the the cost of the gift, one cannot know if End Stage Renal Disease will be the limiting factor in our spans. Kidneys go to the grave fully functional in too many cases, and kidneys recovered from even elderly deceased donors grant years of improved quality of life to the majority of recipients every year. Will giving up 20 years worth of the total nephron mass you have mean you'll be a candidate for dialysis or transplant sooner than you might have anyway? Will that be in 20, 40, 60 years? Will technology have changed by then? All unknowns that you have to make peace with to get to yes or no. Again, best wishes for you all.