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Using the Message Board / Re: MOVED: Be aware, the entire world reads our forums!
« Last post by Clark on August 02, 2023, 08:18:22 PM »
Hello, all!

I wish this thread wasn't still relevant. I'm adding this here as this update is due to the changes we made nearly a decade ago.

Please be aware, as part of our vigilance against sellers, brokers, and scammers, we delete completely inactive accounts one year after they've been created. If you've ever posted, even once, and that post wasn't pulled by one of us for violating our acceptable use policy so egregiously we had no other lesser action we could choose, your post(s) all stay up as long as we can keep the site up.

I've tried to do wellness checks from time to time of long time frequent posters who've gone silent. Long timers, newer folks, how are you? Well, I hope! Take good care, all!

Living Donation Forum / August 2023 Living Organ Donation Anniversaries
« Last post by Clark on August 02, 2023, 08:03:20 PM »
We are a hopeful lot, aren’t we? Hope that our actions can make a difference, as so few opportunities in this life so allow us to think. Lives are changed by what we attempt, directly, radically, one by one, and massively through family, friends, and media stories. There are the sad notes to remember this month, as always, but even they, before the event, were brought about with hope on all sides.

Take care wherever this August 2023 finds you, whatever your circumstances. Twenty years ago, when I donated a kidney to an acquaintance, my one daughter had just had her thirteenth birthday. Now she’s the eldest of three, and made me Grandpa JoJo. I never dared hope for the joy my life now brings me.

Every one of these folks have their own stories of family, love, friends, acquaintances, and folks literally unknown, never met, never likely to meet. Though I did once meet someone who had donated after reading the Newsweek article about my donation…

Best wishes, all!

Fifty-sixth anniversary:
Theodore Charles Lombard donated a kidney to his daughter on August 30th, 1967

Forty-third anniversary:
Julie Edmonds donated a kidney to her sister, Susan Martin, on August 21st, 1980

Thirty-first anniversary:
Patrick M. Emmett donated a kidney to his ex-wife on August 28th, 1992

Twenty-ninth anniversary:
Donna Luebke donated a kidney to her sister on August 26th, 1994

Twenty-fifth anniversary:
Michael McGhee donated a kidney to his son, Michael, on August 25th, 1998

Twenty-fourth anniversary:
Lisa Weisenberger donated a kidney to her brother, Chad, on August 5th, 1999

Twenty-third anniversary:
Rita Kocian (deceased 2/12/04) donated a kidney to her mother in August, 2000
Ellen donated part of her liver to her cousin on August 8th, 2000
Laurie donated part of her liver to her cousin on August 8th, 2000
Walter E Kitter donated a kidney to his friend, Roger Kohlhoff, on August 21st, 2000
Myron Thirtle donated a kidney to his father on August 31st, 2000.  His father survived 10 years until succumbing to cancer in 2010

Twenty-second anniversary:
Katherine Coe donated a kidney to a friend on August 8th, 2001

Twenty-first anniversary:
Kristin Barnes donated part of her liver to her father on August 29th, 2002

Twentieth anniversary:
Chuck Swartout donated part of his liver to his stepsister on August 5th, 2003
Julie donated a kidney to her brother on August 20th, 2003
Bruce Dobben donated a kidney to a friend on August 27th, 2003
Kevin Rodgers donated a kidney to a friend on August 29th, 2003

Nineteenth anniversary:
Carolyn Ambrose donated a kidney to her husband on August 4th, 2004
Ana Mora donated a kidney to her cousin on August 7th, 2004
Jennifer Leigh McGuinn donated a kidney to her father on August 10th, 2004
Michele Moeller donated a kidney and bone marrow to an unrelated person she found on LDO! on August 10th, 2004
Alfonso Gaspar became a bone marrow donor to a young child on August 12th, 2004
Jayne Kavanagh donated bone marrow to an internationally matched recipient on August 12th, 2004
Amber D. Murray donated a kidney to her brother on August 17th, 2004

Eighteenth anniversary:
Amber Allen donated a kidney to her cousin on August 9th, 2005
Amber Billings donated a kidney to her cousin on August 10th, 2005
Janet Saulter-Hemmer donated a kidney to her friend, Jim Morgenland, on August 18th, 2005

Seventeenth anniversary:
Jennifer donated a kidney to her father on August 1st, 2006
Ruth Spang donated a kidney to her father, James, on August 3rd, 2006
Lana J. James donated a kidney to her cousin on August 30th, 2006

Sixteenth anniversary:
Tammy Pigion donated part of her liver to her son on August 2nd, 2007
Melanie Hubbard donated a kidney to her friend, Dale Nix, on August 10th, 2007
Amy Covert donated a kidney to a friend on August 15th, 2007
Marsha Moran donated a kidney to her spouse, James, on August 15th, 2007
Matthew Lynette donated a kidney to his brother, Andrew, on August 15th, 2007
Katherine Howe donated part of her liver to her husband, David, on August 20th, 2007

Fifteenth anniversary:
Melissa Swanson donated a kidney to a stranger met on LDO on August 5th, 2008
Marybeth Marshall donated a kidney to her brother on August 12th, 2008
John Tran donated part of his liver to his wife, Christine, on August 14th, 2008
Lonnie Howell donated a kidney to a stranger who had become a close friend by the time of donation on August 19th, 2008
Kayla Asher donated a kidney to her cousin, Julie Mitchell, on August 20th, 2008
Dominion Giventer gave part of his liver to his 1 year old nephew on August 29th, 2008

Fourteenth anniversary:
Marian Mamayek donated a kidney to her friend, Sharlene Bender, on August 6th, 2009
Tania Eggleston donated a kidney to her Dad on August 11th, 2009
Carleen Dickerson donated a kidney to her cousin on August 12th, 2009
Patricia Roussin donated a kidney to Anthony Lopez, an unrelated person, on August 12th, 2009
Rabbi Ephraim Simon donated a kidney to a stranger on August 13th, 2009
Lessa Ennis donated a kidney to an unrelated person, Lee Kingery, on August 25th, 2009
Patti Bartlett donated a kidney to her brother, Mark Manwar, on August 26th, 2009

Thirteenth anniversary:
Samantha Perouty donated her left kidney to her uncle on August 2nd, 2010
Stacie Brane donated a kidney to her sister, Kristie Goade, on August 12th, 2010

Twelfth anniversary:
Avis Lynch donated a kidney to her mother, Winnetta F. Guthrie, on August 10th, 2011
John made a non-directed kidney donation on August 11th, 2011
Rick made a non-directed kidney donation that started an open chain with 17 donor-recipient pairs so far on August 15th, 2011
David Lieu donated a kidney to his twin brother, Michael, on August 23rd, 2011
Jodi Dykstra donated a kidney to her father on August 23rd, 2011
Melinda Stern donated a kidney to her sister, Kristine Brenneman on August 31st, 2011

Eleventh anniversary:
Cathy May donated a kidney to her friend, Amy Gray Light, on August 16th, 2012
Jennifer Ross made a non-directed kidney donation on August 16th, 2012
Jeannette Myers-Whitney donated a kidney to a stranger on August 23rd, 2012, as a paired donation to benefit her husband, Rod
Kim Merrell made an anonymous, non-directed kidney donation on August 30th, 2012

Tenth anniversary:
Margaret Koppelman donated a kidney on August 7th, 2013
Linda donated a kidney to Priscilla's mom, Karen, on August 16th, 2013

Ninth anniversary:
Joshua Davies donated a kidney anonymously on August 8th, 2014
Corey Zaretsky donated a kidney to his brother, Matthew, on August 14th, 2014

Eighth anniversary:
Elle Gillum donated part of her liver to her dad, Dean Toney, on August 12th, 2015

Seventh anniversary:
Diana Castillo donated a kidney to her friend, German Alech, on August 31st, 2016

Fifth anniversary:
Danielle DiMartino donated a kidney to a stranger on August 2nd, 2018
Kelly Thoele donated a kidney to Minh Le, the fiancé of a former employee on August 23rd, 2018

Third anniversary:
Annette donated a kidney to Hailey, her future daughter-in-law, on August 22, 2020

Evaluating a unique enhanced recovery protocol in laparoscopic donor nephrectomy: A single center experience

Clinical Transplantation
Early View
Online Version of Record before inclusion in an issue
Samuel W. Atherton, Michael S. Massey, Tho Nguyen, David W. Wang, Kathirvel Subramaniam, Eman Abdelwahid, Ahmed Bahnaswy, Michael S. Trostler, Manuel Lombardero … See all authors
First published: 19 June 2023 https://doi.org/10.1111/ctr.15051

Enhanced recovery after surgery (ERAS) protocols have been associated with a reduction in opioid consumption and a hastening in recovery in abdominal surgery. However, their impact on laparoscopic donor nephrectomy (LDN) has not been fully elucidated. The aim of this study is to evaluate opioid consumption and other relevant outcome measures before and after implementation of a unique LDN ERAS protocol.
244 LDN patients were included in this retrospective cohort study. Forty-six underwent LDN prior to implementation of ERAS, whereas 198 patients received ERAS perioperative care. The primary outcome was daily oral morphine equivalent (OME) consumption averaged over the entire postoperative stay. Due to removal of preoperative oral morphine from the protocol partway through the study period, the ERAS group was further subdivided into morphine recipients and non-recipients for subgroup analysis. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), length of stay, pain scores, and other relevant measures.
ERAS donors consumed significantly fewer average daily OMEs than Pre-ERAS donors (21.5 vs. 37.6, respectively; p < .0001). There were no statistically significant differences in OME consumption between morphine recipients and non-recipients. The ERAS group experienced less PONV (44.4% requiring one or more rescue antiemetic postoperatively, vs. 60.9% of Pre-ERAS donors; p = .008).
A protocol pairing lidocaine and ketamine with a comprehensive approach to preoperative PO intake, premedication, intraoperative fluid management and postoperative pain control is associated with reduced opioid consumption in LDN.

Social network interventions to reduce race disparities in living kidney donation: Design and rationale of the friends and family of kidney transplant patients study (FFKTPS)

Clinical Transplantation
Early View
Online Version of Record before inclusion in an issue
Jonathan Daw, Ashton M. Verdery, Selena E. Ortiz, Rhiannon Deierhoi Reed, Jayme E. Locke, Robert R. Redfield III, David Kloda, Michel Liu, Heather Mentsch, Deirdre Sawinski … See all authors
First published: 03 July 2023 https://doi.org/10.1111/ctr.15064

Racial/ethnic disparities in living donor kidney transplantation (LDKT) are a persistent challenge. Although nearly all directed donations are from members of patients’ social networks, little is known about which social network members take steps toward living kidney donation, which do not, and what mechanisms contribute to racial/ethnic LDKT disparities.
We describe the design and rationale of the Friends and Family of Kidney Transplant Patients Study, a factorial experimental fielding two interventions designed to promote LKD discussions. Participants are kidney transplant candidates at two centers who are interviewed and delivered an intervention by trained center research coordinators. The search intervention advises patients on which social network members are most likely to be LKD contraindication-free; the script intervention advises patients on how to initiate effective LKD discussions. Participants are randomized into four conditions: no intervention, search only, script only, or both search and script. Patients also complete a survey and optionally provide social network member contact information so they can be surveyed directly. This study will seek to enroll 200 transplant candidates. The primary outcome is LDKT receipt. Secondary outcomes include live donor screening and medical evaluations and outcomes. Tertiary outcomes include LDKT self-efficacy, concerns, knowledge, and willingness, measured before and after the interventions.
This study will assess the effectiveness of two interventions to promote LKD and ameliorate Black-White disparities. It will also collect unprecedented information on transplant candidates’ social network members, enabling future work to address network member structural barriers to LKD.

How the websites of high-volume US centers address the risks of living kidney donation

Clinical Transplantation
Early View
Online Version of Record before inclusion in an issue
Robert W. Steiner, Walter Glannon
First published: 03 July 2023 https://doi.org/10.1111/ctr.15054

The websites of US transplant centers may be a source of information about the renal risks of potential living kidney donors.
To include only likely best practices, we surveyed websites of centers that performed at least 50 living donor kidney transplants per year. We tabulated how risks were conveyed regarding loss of eGFR at donation, the adequacy of long-term ESRD risk data, long-term donor mortality, minority donor ESRD risk, concerns about hyperfiltration injury versus the risk of end-stage kidney diseases, comparisons of ESRD risks in donors to population risks, the increased risks of younger donors, an effect of the donation itself to increase risk, quantifying risks over specific intervals, and a lengthening list of small post-donation medical risks and metabolic changes of uncertain significance.
While websites had no formal obligation to address donor risks, many offered abundant information. Some conveyed OPTN-mandated requirements for counseling individual donor candidates. While actual wording often varied, there was general agreement on many issues. We occasionally noted clear-cut differences among websites in risk characterization and other outliers.
The websites of the most active US centers offer insights into how transplant professionals view living kidney donor risk. Website content may merit further study.

Single versus multiple renal arteries in living donor kidney transplantation: A systematic review and patient-level meta-analysis

Clinical Transplantation
Early View
Online Version of Record before inclusion in an issue

Ee Jean Lim, Khi Yung Fong, Jingqiu Li, Yiong Huak Chan, Edwin Jonthan Aslim, Lay Guat Ng, Valerie Huei Li Gan
First published: 06 July 2023 https://doi.org/10.1111/ctr.15069
Ee jean Lim and Khi Yung Fong are the co-first authors.

Grafts with multiple renal arteries (MRAs) were historically considered a relative contraindication to transplantation due to the higher risk of vascular and urologic complications. This study aimed to evaluate graft and patient survival between single renal artery (SRA) and MRA living-donor kidney transplants.
An electronic literature search was conducted on PubMed, EMBASE, and Scopus for prospective or retrospective studies comparing SRA versus MRA in living donor renal transplantation, with the provision of Kaplan–Meier curves for recipient overall survival (OS) or graft survival (GS). A graphical reconstructive algorithm was used to obtain OS and GS of individual patients, which was then pooled under random-effects individual patient data (IPD) meta-analysis using Cox-models to determine hazard ratios (HRs) and 95% confidence intervals (CIs). Meta-regression of baseline covariates versus HRs of OS and GS was performed for variables reported in 10 or more studies.
Fourteen studies were retrieved, of which 13 (8400 patients) reported OS and 9 (6912 patients) reported GS. There were no significant differences in OS (shared-frailty HR = .94, 95%CI = .85–1.03, p = .172) or GS (shared-frailty HR = .95, 95%CI = .83–1.08, p = .419) between SRA and MRA. This comparison remained non-significant even when restricted to open- or laparoscopic-only studies. Meta-regression yielded no significant associations of GS with donor age, recipient age, and percentage of double renal arteries within the MRA arm.
The similar rates of GS and OS between MRA and SRA grafts suggest that there is no need for discrimination between the two when evaluating donors for nephrectomy.

Advances and innovations in living donor liver transplant techniques, matching and surgical training: Meeting report from the living donor liver transplant consensus conference

Mark Sturdevant, Swaytha Ganesh, Benjamin Samstein, Elizabeth C. Verna, Manuel Rodriguez-Davalos, Vineeta Kumar, Marwan Abouljoud, Oya Andacoglu, Medhat Askar, Dieter Broering … See all authors
First published: 11 April 2023 https://doi.org/10.1111/ctr.14968Citations: 1
Mark Sturdevant and Swaytha Ganesh are co-first authors.
Nazia Selzner Sukru Emre are co-senior authors.

The practice of LDLT currently delivers limited impact in western transplant centers. The American Society of Transplantation organized a virtual consensus conference in October 2021 to identify barriers and gaps to LDLT growth, and to provide evidence-based recommendations to foster safe expansion of LDLT in the United States. This article reports the findings and recommendations regarding innovations and advances in approaches to donor-recipient matching challenges, the technical aspects of the donor and recipient operations, and surgical training. Among these themes, the barriers deemed most influential/detrimental to LDLT expansion in the United States included: (1) prohibitive issues related to donor age, graft size, insufficient donor remnant, and ABO incompatibility; (2) lack of acknowledgment and awareness of the excellent outcomes and benefits of LDLT; (3) ambiguous messaging regarding LDLT to patients and hospital leadership; and (4) a limited number of proficient LDLT surgeons across the United States. Donor-recipient mismatching may be circumvented by way of liver paired exchange. The creation of a national registry to generate granular data on donor-recipient matching will guide the practice of liver paired exchange. The surgical challenges to LDLT are addressed herein and focuses on the development of robust training pathways resulting in proficiency in donor and recipient surgery. Utilizing strong mentorship/collaboration programs with novel training practices under the auspices of established training and certification bodies will add to the breadth and depth of training.

A survey of transplant providers regarding attitudes, barriers, and facilitators to living donor liver transplantation in the United States

AnnMarie Liapakis, Uchenna Agbim, Therese Bittermann, Mary Amanda Dew, Yanhong Deng, Geliang Gan, Sukru Emre, Heather F. Hunt, Kim M. Olthoff, Jayme E. Locke … See all authors
First published: 20 March 2023 https://doi.org/10.1111/ctr.14967Citations: 1
AnnMarie Liapakis and Uchenna Agbim are co-first authors.

A successful living donor liver transplant (LDLT) is the culmination of a multifaceted process coordinated among key stakeholders.
We conducted an electronic survey of US liver transplant (LT) centers (August 26, 2021–October 10, 2021) regarding attitudes, barriers, and facilitators of LDLT to learn how to expand LDLT safely and effectively in preparation for the American Society of Transplantation Living Donor Liver Transplant Consensus Conference.
Responses were received from staff at 58 programs (40.1% of US LT centers). There is interest in broadening LDLT (100% of LDLT centers, 66.7% of non-LDLT centers) with high level of agreement that LDLT mitigates donor shortage (93.3% of respondents) and that it should be offered to all suitable candidates (87.5% of respondents), though LDLT was less often endorsed as the best first option (29.5% of respondents). Key barriers at non-LDLT centers were institutional factors and surgical expertise, whereas those at LDLT centers focused on waitlist candidate and donor factors. Heterogeneity in candidate selection for LDLT, candidate reluctance to pursue LDLT, high donor exclusion rate, and disparities in access were important barriers.
Findings from this study may help guide current and future expansion of LDLT more efficiently in the US. These efforts require clear and cohesive messaging regarding LDLT benefits, engagement of the public community, and dedicated resources to equitably increase LDLT access.

Financial, policy, and ethical barriers to the expansion of living donor liver transplant: Meeting report from a living donor liver transplant consensus conference

Anjana Pillai, Elizabeth C. Verna, Neehar D. Parikh, Matthew Cooper, Carrie Thiessen, Julie Heimbach, Elisa J. Gordon, Gonzalo Sapisochin, Nazia Selzner, Amit Mathur, Emily R. Perito … See all authors
First published: 07 March 2023 https://doi.org/10.1111/ctr.14955Citations: 1
Anjana Pillai and Elizabeth C. Verna contributed equally to this study and share co-first authorship.

In October 2021, the American Society of Transplantation (AST) hosted a virtual consensus conference aimed at identifying and addressing barriers to the broader, safe expansion of living donor liver transplantation (LDLT) throughout the United States (US).
A multidisciplinary group of LDLT experts convened to address issues related to financial implications on the donor, transplant center crisis management, regulatory and oversight policies, and ethical considerations by assessing the relative significance of issues in preventing LDLT growth, with proposed strategies to overcome barriers.
Living liver donors endure multiple obstacles including financial instability, loss of job security, and potential morbidity. These concerns, along with other center, state, and federal specific policies can be perceived as significant barriers to expanding LDLT. Donor safety is of paramount importance to the transplant community; however, regulatory and oversight policies aimed at ensuring donor safety can be viewed as ambiguous and complicated leading to time-consuming evaluations that may deter donor motivation and program expansion.
Transplant programs need to establish appropriate crisis management plans to mitigate potential negative donor outcomes and ensure program viability and stability. Finally, ethical aspects, including informed consent for high-risk recipients and use of non-directed donors, can be perceived as additional barriers to expanding LDLT.

Living donor liver transplant candidate and donor selection and engagement: Meeting report from the living donor liver transplant consensus conference

Michelle T. Jesse, Whitney E. Jackson, AnnMarie Liapakis, Swaytha Ganesh, Abhinav Humar, Nicolas Goldaracena, Josh Levitsky, David Mulligan, Elizabeth A. Pomfret … See all authors
First published: 09 March 2023 https://doi.org/10.1111/ctr.14954Citations: 1
Michelle T. Jesse and Whitney E. Jackson are co first authors.
Dianne LaPointe Rudow and Hyosun H. Han are co senior authors.

Living donor liver transplantation (LDLT) is a promising option for mitigating the deceased donor organ shortage and reducing waitlist mortality. Despite excellent outcomes and data supporting expanding candidate indications for LDLT, broader uptake throughout the United States has yet to occur.
In response to this, the American Society of Transplantation hosted a virtual consensus conference (October 18–19, 2021), bringing together relevant experts with the aim of identifying barriers to broader implementation and making recommendations regarding strategies to address these barriers. In this report, we summarize the findings relevant to the selection and engagement of both the LDLT candidate and living donor. Utilizing a modified Delphi approach, barrier and strategy statements were developed, refined, and voted on for overall barrier importance and potential impact and feasibility of the strategy to address said barrier.
Barriers identified fell into three general categories: 1) awareness, acceptance, and engagement across patients (potential candidates and donors), providers, and institutions, 2) data gaps and lack of standardization in candidate and donor selection, and 3) data gaps regarding post-living liver donation outcomes and resource needs.
Strategies to address barriers included efforts toward education and engagement across populations, rigorous and collaborative research, and institutional commitment and resources.
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