The Old Man: Should I Get a Kidney Transplant?

August 3, 2009, 11:52 am
The Old Man: Should I Get a Kidney Transplant?

By Hilding Lindquist

Hilding Lindquist writes about aging, ageism and end of life issues, all of which he believes are better understood by experience.

My daughter offered me one of her kidneys when she learned of my acute kidney failure in the summer of 2002. I didn’t really need it then so the decision was easy: “Maybe later.”

Following the acute failure, my kidneys rebounded moderately and I didn’t have to go on dialysis until April 2008. I started my transplant evaluation process in January 2009.

And kidney transplants are now in the “above the fold” headlines here in New Jersey. The market for live donor kidneys is — what should I say? — brisk (and black).

I can understand. One of the first things the transplant center told me was that — generally speaking — a healthy live donor kidney would give me 10 years, and a cadaver kidney only five years.

In the early stages of my transplant evaluation process, the transplant center informed me that I was a good prospect for a transplant at my age of 70 with a strong cardiovascular system — among other things — and an active life. I only needed to clear up a few “issues” to get on the “list” … with a multiple-year wait for a cadaver kidney. Whereas I would be able to have a transplant relatively quickly … after the few “issues” were cleared up … if I had a good match from a live donor … which could even be handled in a “multiple-match” exchange between more than one set of candidate-donor.

Options. With a live donor I have options. I understand how the pressure can mount.

Why not clear up the remaining medical issues and accept my daughter’s offer?

Because at 70 I don’t think it is worth the risk — however miniscule — to the live donor, certainly not my daughter. Even Senator Byrd developed a staph infection in a recent hospital stay. And quoting NPR’s Web site, “Each year 90,000 people die after picking up a bacterial infection in a hospital, according to the Centers for Disease Control and Prevention.”

But that’s me. Others decide differently.

In the context of current New Jersey headlines relating the arrest of the person from Brooklyn charged with acting as a human organ broker, the question of whether or not I would be willing to buy a kidney from a living donor, not a friend or relative, comes to mind. And yes, it comes to mind because I might not be so resistant to the risk to the donor if I could tell myself that I was “paying” for the person to take the risk … and if they were willing to accept it … I look at a friend or relative as facing an indecipherable amount of coercion.

The answer is again easy. First — to provide full disclosure — I wouldn’t know how to go about it. If I did? I still wouldn’t.

What if I were younger — 50, 40, 30, 20? Ah, that’s the rub, isn’t it? It is for me. I am not so sure that at 20, with the relatively small amount of cash required at hand available …

I have to admit I probably would at least get to the talking stage.

And that means — IMHO — that we should be discussing this issue.

http://maplewood.blogs.nytimes.com/2009/08/03/the-old-man-should-i-get-a-kidney-transplant/