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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on October 29, 2008, 11:49:43 PM
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Living transplant
By Jen Christensen
Wednesday, October 29, 2008 at 9:20 a.m.
The Kidneys
The kidneys are a pair of bean-shaped organs located near the middle of the back. As blood enters the kidneys, it passes through tiny filtering units, where waste products and extra water are removed. The waste becomes urine and is sent to the bladder for storage until elimination. Every day, the kidneys filter about 200 quarts of fluid and produce about two quarts of urine.
The kidneys regulate the levels of sodium, phosphorus and potassium in the body. In addition, the organs produce and release three important hormones: erythropoietin (EPO) to stimulate production of red blood cells, rennin to regulate blood pressure and calcitriol (the active form of vitamin D) to control calcium metabolism.
Kidney Failure
The kidneys can take a beating and lose quite a lot of function before problems develop. People can even live with just one kidney because the remaining kidney will take over the lost function. When kidney function drops below about 25 percent, patients start to develop signs of kidney failure (high blood pressure, protein or blood in the urine, frequent need to urinate and eye puffiness). Once kidney function drops below 10 to 15 percent, patients can’t survive without some kind of treatment, like dialysis or a kidney transplant.
According to the National Kidney Foundation, about 26 million people in the U.S. have chronic kidney disease. Roughly 470,000 are being treated for kidney failure. The leading cause of kidney failure is diabetes (accounting for about 45 percent of all new cases). The second leading cause is uncontrolled or poorly controlled high blood pressure (27 percent of new cases). Other causes of kidney failure are glomerulonephritis (an inflammation of the kidney’s filtering units) and polycystic kidney disease (characterized by formation of cysts in the kidneys).
Kidney Transplants
A kidney transplant is an important option for many people with kidney failure. In 2007, more than 16,600 kidney transplants were performed in the U.S. But there aren’t enough donor organs to go around. As of September 19 of this year, 76,968 candidates were waiting for a kidney transplant. Many patients have been waiting a year or more for a new kidney.
In most cases, an organ for transplant comes from a deceased donor (cadaver). However, since a person can survive with just one kidney, sometimes a healthy kidney can be obtained from a live donor. In fact, more than half the kidneys transplanted in the U.S. since last year have come from live donors.
There are several categories of live kidney donation. A living related donor is a blood relative of the transplant recipient. A living unrelated donor is someone who is unrelated but has close emotional ties to a transplant recipient (like a spouse, in-law or friend). Nondirected donation is made by a living donor who is neither related nor known to the recipient.
There are several advantages of live kidney donation. Transplants between blood relatives often provide a better genetic match than a cadaver kidney and may reduce the risk of organ rejection. Cadaver kidneys may not fully function immediately, requiring a continued period of dialysis. On the other hand, live kidneys are harvested fresh and begin functioning immediately. The donor and recipient can schedule the transplant surgery at a time that is most convenient for both parties. And getting a live donation means there is one more cadaver kidney available for someone who doesn’t have a living donor.
Increasing Rates of Live Kidney Donation
Henkie Tan, M.D., Ph.D., Transplant Surgeon with the University of Pittsburgh Medical Center, says the decision to become a live donor is not always easy. Donors must endure a major procedure, risk of complications, post-surgical pain and a recovery time of at least four weeks. Donors aren’t paid for giving up an organ. However, the health insurance policy of the kidney recipient will cover the cost of care for the donor.
After the surgery, live kidney donors are typically off of work for four weeks or more. And for many people, the lost wages are a limiting factor in the decision to donate. Now, the American Society of Transplantation is urging Congress to adopt a universal “Organ Donor Leave Act” which would provide employees with four weeks of paid leave for recovery after live organ donation. The organization is also urging Congress to consider ways to ensure insurance coverage for care of the donor if the recipient dies (the insurance policy would then be cancelled and the donor may be left with unanticipated health care charges).
AUDIENCE INQUIRY
For information about the Employee and Organ Donation Program, go to:
http://www.a-s-t.org/index2.cfm?Section=public_policy
For general information on kidney disease, transplants or organ donation:
National Institute of Diabetes and Digestive and Kidney Disease, http://www.niddk.nih.gov
National Kidney Foundation, http://www.kidney.org
United Network for Organ Sharing, http://www.unos.org, or http://www.transplantliving.org
http://www.hoinews.com/news/news_story.aspx?id=214014