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Author Topic: I am interested in donating a kidney  (Read 8018 times)

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JayDar

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I am interested in donating a kidney
« on: November 04, 2011, 11:10:14 PM »
I'd like to interview possible recipients of my kidney. I don't know if this is ethical for me to do, but I'd like to choose someone who has goals in life...someone who would live life to it's fullest...and is also interested in helping to change to world into a better place to live for all.

This is a kind of pay it forward idea that I have.

I know this may offends some who are in serious need..and I am truly sorry to offend anyone...I wish I could help everyone...but I can't...and I'd like to know that I am making the right choice when I choose someone to recieve my kidney.

Is there a way that I can do this...morally..ethically...and legally?

Sincerely,

JayDar

Offline Clark

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Re: I am interested in donating a kidney
« Reply #1 on: November 05, 2011, 12:44:43 PM »
Dear JayDar,

  While it's _possible_ for you to do this morally, ethically, and legally, the practicalities make this almost impossible.  How will you safely, for both yourself in reality, and by perception of potential recipients, arrange interviews?  How will you avoid judgements of social worth, whether or not in complete agreement with your own values?  How will you convince a transplant team that you haven't made an unlawful arrangement for compensation with whomever you finally select?

  Are you, for whatever reason, unwilling to be a non-directed donor, whether or not you can be a start to a chain of donations thereby?  If so, articulating why not, honestly, will be an essential explanation to a transplant team.  Assuming that reason or those reasons are not based on unlawful discriminatory criteria, and that your chosen candidate, among those you interview, is demonstrably fairly chosen, you might manage the moral, ethical, legal act you understandably want to achieve.  Best wishes.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

Offline WilliamLFreeman

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Re: I am interested in donating a kidney
« Reply #2 on: November 06, 2011, 01:49:57 PM »
JayDar,

As a non-directed donor myself, I am glad to see that you would like to be a non-directed donor, too.  My strong motivation was, like yours, to "pay forward."   :)  I would like to tell a brief story related to your question.

I am a family physician.  My medical career has been entirely working with American Indian and Alaska Native tribes and communities.  (I am not Native.)  A young woman came to me to be treated during my first years in a tribal clinic, with a series of black eyes (= domestic violence), and sexually transmitted infections, and a few other alcohol-related, temporary, problems.  I knew she was, in a word, a "loser."

Then I went to the graduation ceremony at a near-by college.  Among the people graduating who received a diploma -- dressed to the nines, beaming -- was the "loser." (And this "loser" has continued her career trajectory of more and more success and achievement ever since, for decades now.)

I certainly learned my lesson that night of graduation -- the lesson that judgements of the worth of people, and predictions of their future, are likely to be not accurate at best, and demeaning as well.

From whom have I received much, and thus the kind of people I want to "pay forward"?  My parents, from whose ethics became my ethics of wanting to be a non-directed donor, and who instilled in me a love a learning upon which my becoming a physician was built, among other things?  The achievers and movers-n-shakers who contributed to and built universities and medical schools?  The scientists and scientific physicians before me, that produced modern medicine including the science and practice of surgical transplantation and control of recipients' rejection of the transplant?  The nurses and social workers and ... -- all essential, full, contributors to health care?  Did (and do) I want to pay forward to people whom I judge are or will become those people?  Yes, of course -- because whatever I have achieved has depended on the work and life of all of them.

The people who built the interstate highways, and other roads, and airports, and airplanes, and the buildings in the universities, and ...?  The custodians, that keep clean and livable all those buildings, including medical centers and hospitals and clinics and ...?  The soldiers, who defended our country, even in wars that in retrospect we probably should not have started, some of whom end up with PTSD and/or drunk, on the street, violent, "losers"?  (I was a soldier in one such war.)  The children, many of whom bring joy to their parents, some of whom are abused and become people in prisons or abusers?  People and children with developmental delays, such as children and adults with Downs Syndrome -- many of whom bring joy to their parents and friends, some of whom are abused by their families or friends or neighbors -- and many of whom do not receive the education and support that would enable them to reach their full potential (unlike I, who did receive that education and support)?  Some people on all those groups, after all, were uneducated, non-achievers, illiterate, slaves in American slavery, gays, despicable in some people's eyes, "losers."

Did (and do) I want to pay forward to *those* kinds of people, or people whom I judge are or will become those kinds of people?  Yes, of course -- because whatever I have achieved has depended on the work and life of all of them.

Well before the transplant program started to see who could be a match, I told the surgeon that I would be perfectly happy if the best-match recipient was of a race, or sexual orientation, or education level, or with developmental delay such as Downs Syndrome, or whatever, different than my own.

For what it is worth, that was what I understood "paying forward" to mean as a non-directed donor.

Bill
Bill - living kidney donor (non-directed, Seattle, Nov 24, 2008), & an [aging] physician  :-)

Offline Fr Pat

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Re: I am interested in donating a kidney
« Reply #3 on: November 06, 2011, 07:36:17 PM »
      Such interviews might present difficult temptations for the potential recipients. If I needed a kidney and a stranger offered to give me one IF I could show that I was a "worthy" candidate I think I would be tempted to provide the potential donor with whatever sort of answers he/she wanted to hear. It would really put the potential recipients on the spot.
     best wishes,
        Fr. Pat

Offline rdr321

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Re: I am interested in donating a kidney
« Reply #4 on: November 07, 2011, 03:05:52 PM »
    This is comming from someone who went to the hospital and told the Transplant coodinater that I wanted nothing to do with the selection process.
    The only thing I wanted was for the kidney to start a non direct chain. I donated 3 months ago and the last time I heard was 15 people had recieved kidneys because I donated mine.
  I saw problems with picking who got the kidney.
    1. It will probably not start a chain which will not help alot more people
    2. I believe the doctors and transplant coodinaters know alot more about what is going on with the patients than I do.
    3. It just really creeped me out to almost play some sort of God to a poor suffering person.

    4. The suffering of all those in need of kidneys and thier families is equall.
    5. How would I like to have someone judge me based on thier perception of me? If I had let myself I would have only wanted to donate to a cute woman. And she could tell me how wonderfull I am. I am just being honest. That would not have been good.
    6. The person whom you feel is "worthy". Could get in a car accident and die on the way home from the hospital afer recieving your kidney
   If you do feel the need to inteview people to recieve your kidney. You could go to MatchingDonors.com and do it there.
  I have read about those who needed a kidney and get played and let down by people who said they would donate. Please do not do that to anyone. YOU NEED TO REMEMBER THAT YOU ARE PLAYING WITH SOMEONES LIFE

JayDar

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Re: I am interested in donating a kidney
« Reply #5 on: November 07, 2011, 03:42:47 PM »
I'm not trying to play god. My idea was to talk with people who need to undergo dialysis and ask them what they would do if they were free of the worry of dying from diseased kidneys and free from the ordeal of necessary dialysis.

Not looking to help the "cute girl" or to be the hero...actually I would remain an anonymous donor , if that is possible.

I'd like some insight into what they would do with their lives if they were free from this burden.

My heart goes out to everyone who is suffering. and eveyone deserves a chance to live. I am powerless to give that gift to everyone...but I can provide that gift to one or two, perhaps even 3  people while I am alive.I could donate a lobe of my liver...I could donate bone marrow...I regularly donate blood.

It's really not a power trip at all and I know I would feel guilt by making a choice...That said...there are persons in the world who if  given the opportunity can and would help to make the world a better place.

I suppose I would be seeking out an unusual person with unusual perspective.

Again...I mean no offense to anyone.

JayDar

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Re: I am interested in donating a kidney
« Reply #6 on: November 20, 2011, 10:03:30 PM »
I am blood type O+....are there other markers that are needed to be a match?

Offline Fr Pat

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Re: I am interested in donating a kidney
« Reply #7 on: November 21, 2011, 01:02:48 AM »
Dear "JayDar",
     At the home-page of this site you can click "living kidney donation" in the box at the upper left and read a lot of the details about testing and matching.
     If the blood types of the donor and recipient are compatible (type "O" is a "universal donor", compatible to donate to any blood type, whether "+" or "-"), differences in antigen matching can usually be overcome by the anti-rejection medications that the donor receives. In the final "cross-match" portions of the potential donor's and recipient's blood are mixed to see if there is a bad reaction due to other anti-bodies. Sometimes an otherwise compatible donor may be excluded due to failure of the final "cross-match".
     One of the advantages of non-directed donation is that all the testing can be done to find a suitable recipient from the waiting list without having any particular patient get his/her hopes up waiting for the test results from a particular donor. The chosen recipient is only informed when a completely suitable donor has been found.
   best wishes,
      Fr. Pat

Offline Snoopy

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Re: I am interested in donating a kidney
« Reply #8 on: November 21, 2011, 02:11:38 AM »
     One of the advantages of non-directed donation is that all the testing can be done to find a suitable recipient from the waiting list without having any particular patient get his/her hopes up waiting for the test results from a particular donor. The chosen recipient is only informed when a completely suitable donor has been found.

  Yes, that type of system makes sense to me. 
   However, in the case of my own non-directed donation (I don't live in the US), the system kind of throws the donor candidate and the recipient candidate together from the git-go:  we came together to be cross-matched.  I actually went through this for four candidates; I matched them all, but the first three found other solutions before I had completed most of my testing.  With the third and the final candidates, we came together to the hospital several times to undergo various tests and evaluations (social work, psychiatrist, etc.).  We were interviewed separately, of course, but we were scheduled back-to-back.  Since I don't have a car and my candidates did, they ended up driving me to the hospital, in a different city from where we lived.
   It all worked out very nicely for me.  I got to know candidates #3 and 4 (#4 was in the end the actual recipient) well, and love them both.  On the other hand, it did create a certain kind of pressure.  For example, I always wanted to laugh out loud when members of the transplant team reminded me, over and over, that I could always back out at any time. Yeah, right I could, I thought.  How could I do that to somebody I've come to know, who's expecting my kidney?  What kind of option is that?  When I decided to donate, I committed myself to stick with it till the end--assuming the testing did not reveal any unexpected risks.  (Still, it is true that, had a close relative suddenly needed my kidney, I would have had to consider "abandoning" my intended recipient.)
   Another form of pressure involved my (very long, involved) testing period.  I was fairly stressed out about the possibility that my body would "let down" my intended recipient.  I actually remember kicking a garbage pail in rage directed at my own blood pressure for "betraying" me and my intended recipient with a borderline reading.  (No wonder I'm so much calmer since the donation. :) ) If I hadn't known my "partner" so well, I might have been at least a bit calmer about that.
   Interestingly, I was told that my center throws the two sides together on purpose, to see how they get along.  I'm not 100% sure that makes sense to me.  I mean, it's great I love my recipient, but I didn't really need to.  In any case, as I said, it worked out fine for me.
   Good luck, JayDar
   Snoopy
PS--On the original question about interviewing recipients, I would add to what's been said only that--assuming that a donation chain is not an option, for some reason--anyway your kidney can only go to one person: no matter how anybody slices it, in the end, somebody (and only one somebody) will get your kidney.

Offline Fr Pat

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Re: I am interested in donating a kidney
« Reply #9 on: November 21, 2011, 02:54:25 AM »
Dear Snoopy,
     Yes, there seems to be a LOT of variation from one hospital to another as far as contact between non-directed donors and their recipients is concerned. As you explained, some hospitals encourage pre-donation face-to-face meetings. Other hospitals forbid any contact before the surgery, or for six months afterwards! Where I donated (10 years ago) they were super-protective of the privacy of the recipient, even making sure that families of donor and recipient did not cross paths in waiting rooms during surgery. I guess each system has its pluses and minuses. So it is important that a potential donor find out ahead of time what their hospital's policies are, to avoid any misunderstanding or disappointment.
   Fr. Pat

Offline lawphi

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Re: I am interested in donating a kidney
« Reply #10 on: November 21, 2011, 10:08:17 PM »
It will be very hard for you to interview potential recipients, as there is no guarantee you will be an HLA match.  The better the match, the longer your kidney will last. 

You can talk to a center about giving additional points to a recipient that match you HLA profile and have characteristics you find desirable.  Surprisingly, there is case law that you can direct organs be donated to recipients of the same religion.  Better yet, donate to a child. 

I think your line of questioning would be a red flag to the center and potential recipient.  You are deciding to give a gift and you have to accept that you are giving up control.  Will you ask for it back if the person decides to stay at home after the surgery?
Bridge Paired Exchange donor on behalf of my husband (re-transplant) at Johns Hopkins.

Offline Scott337

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Re: I am interested in donating a kidney
« Reply #11 on: November 22, 2011, 01:57:48 AM »
Jay,

I'd like to weigh in.  I donated last year to a young man I'd never met.  I decided early on, I would not get caught up in who the recipient was, were they worthy, would they cherish the opportunity of a second chance at life or might the recipient simply squander something I gave so easily? I decided the gift needed to be given without conditions.

When I met my recipient and his family for the first time, the day before surgery, they asked why I was doing it.  When I told them I felt it was something I did simply because my recipient had the need and I had the ability.  I told them I normally believed a gift was not a gift if it came with conditions and that I tried hard to live my life in this way, but in this circumstance, I did have one condition;  in return for the gift, my recipient and his family promised me they would find a way to pay the gift forward, sometime in EACH of their lives.  I figured, in this way the gift continued to give.

I get what you you're saying about knowing the kidney is going to someone who will move in positive directions, who will appreciate the chance for bettering their health and life.  I think the feeling you're having is difficult to come to terms with relative to such an important and life-altering and selfless gift.  Thanks for wanting to be someone's hero.  I hope this helps in some way.  Good luck moving forward.

Scott   8)
Scott

 

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