Interesting story I heard - would you take this kidney???

[RichardMEL]

I don't know how true this is but my dialysis nurse told me aparently this happened last week.

At 0200 the on call specialist called 3 potential recipients with the great news - they were being offered a kidney for transplant!!

But here's the catch: The donor is (was?) 75 years old and has high cholesterol. Oh yeah, the kidney is not close to a perfect match.

All 3 declined the kidney and the specialist agreed they made the right decision.

Several thoughts come to mind if this is an accurate story:

* My understanding was that donations, live or cadaveric were only accepted up to age 60-65. 75 seems too extreme

* Why would they offer a non matching kidney to these patients? Maybe the patients in question were seriously in need of a transplant. I do not know. I can't think of any other reason


My nurse asked me how would I respond to that question - remembering you've been woken at 2am in the morning and offered a kidney. I thought about it for about 10 seconds and said no, I would decline. HOWEVER if they told me it was  a 6/6 match I would definitely consider it and ask if I could speak to a senior neph or transplant specialist about the option and their opinion on likely outcome. Not sure I'd want the registrar on call to help make such a decision.

I suppose the end thought to take from this story, which may or may not be accurate, is that you MAY be faced with a decision at any time, and it may not be as straight forward as "We have a kidney for you. Come to the hospital ASAP" and that perhaps we should be prepared to ask questions regarding the shape of the donor (eg age, any other pre-existing stuff checked for - eg HIV, hep B, C) if they used drugs etc.

food for thought anyway.

[Lucinda]

I would have thought that 75 would be way too old.  Aside from the non-match, I certainly wouldn't want the kidney of a 75-year-old unless I was absolutely desperate and it was only a very temporary interim solution.  That would be the first question I would always ask.  AGE.  At your age particularly Richard you don't want a kidney that is twice your age when it might be only a few more months before you get one the same age or thereabouts.  I can absolutely understand why all three of them said no.  Far greater chance of complications.  They made the right decision - definitely! 

[kraze]

that's an interesting story.  I was transplanted on June 10th and my brother was the donor.  HOWEVER, in an unbelievable turn of events, I was called at 3:00 AM on June 2 with a similiar situation, telling me that they had a cadavar kidney that was a relatively good match and that it was from a lady in her mid 40's who was a victim of an assault.  3:00 AM remember - this TOTALLY freaked me out - I was a total mess. Anyway, they said they would call me back if I was a better match than the 5 other people who were relatively good matches.  I was up the rest of the night, went to work the next day and was worthless at work b/c it was all I could think about.  They eventually called and said someone else was the winner.  WHY oh WHY did they feel the need to traumatize me in the middle of the night on a MAYBE?  I was confused.  still am now that I think about it.  I guess I've blocked that memory out until just now....it's been a busy few months !

[RichardMEL]

kraze it's so wonderful you're about to celebrate 6 months with your beautiful gift!!

I'm interested that you use the phrase "traumatize" in your post. Certainly being called and told you're 1 in 5 would be stressful and not knowing if it might be go or not would be horribly stressful, but I think if it was me (or will be potentially....) it would be so uplifting to know that I was so *close* to one. Maybe not this one... but perhaps the next sort of thing. Of course you would have had your brother's transplant scheduled till then - did you inform them of this fact? I think if it was me I would have declined the offer saying "I have a week to go till a scheduled live donor transplant" Why? Because we all know a live donor transplant is usually going to have a better outcome and I'm sure your brother was a better match for you than the cadaver.

I guess this opens another area for discussion - with a pending live donation from a relative or friend if you were offered a cadaver kidney would you take it to "spare" your live donor? (I am not sure what I would do in that situation myself)

[Jess21]

I would never be asked that.  I did not sign the "Extended Criteria" form.  The neph even said he wouldn't sign it at my age...I most likely need multiple transplants in life..getting an older kidney that would work for an even shorter period of time...no.

[vandie]

kraze it's so wonderful you're about to celebrate 6 months with your beautiful gift!!

I'm interested that you use the phrase "traumatize" in your post. Certainly being called and told you're 1 in 5 would be stressful and not knowing if it might be go or not would be horribly stressful, but I think if it was me (or will be potentially....) it would be so uplifting to know that I was so *close* to one. Maybe not this one... but perhaps the next sort of thing. Of course you would have had your brother's transplant scheduled till then - did you inform them of this fact? I think if it was me I would have declined the offer saying "I have a week to go till a scheduled live donor transplant" Why? Because we all know a live donor transplant is usually going to have a better outcome and I'm sure your brother was a better match for you than the cadaver.

I guess this opens another area for discussion - with a pending live donation from a relative or friend if you were offered a cadaver kidney would you take it to "spare" your live donor? (I am not sure what I would do in that situation myself)

I had just that happen to me.  I had several donors declined for a plethora of reasons.  A friend stepped up and was beginning her testing.  I got a call soon after for a perfectly matched cadaver donor.  I didn't hesitate.  After having so many potential donors either turned away or change their minds, I wasn't going to miss this opportunity.
I haven't a regret.  It's been 17 months and I am so pleased and so grateful that I have this amazing gift.

[petey]

When I was being evaluated to be Marvin's donor (July of 2000), my "team" (neph, surgeon, transplant coordinator) kept reminding me during the four or so months of testing that if a cadaveric donor matched for Marvin and his number was called, I would be put on "hold" as his donor.  They didn't give us a choice; they said automatically that Marvin would get the cadaveric over the living (me) donor.  No cadaveric came during that time, and I was Marvin's donor.  Unfortunately, the kidney only lasted a little over three years.     However, being a living donor was a life-changing experience for ME, and I'm so glad I got that opportunity.

[Chris]

I would have said no to if I knew all that information.

However, at the time of my transplant I was not educated enough to ask those type of questions. I am more educated today than I was 8 years ago about dialysis and transplants and would ask questions if I need to on the next time around.

[RichardMEL]

I would never be asked that.  I did not sign the "Extended Criteria" form.  The neph even said he wouldn't sign it at my age...I most likely need multiple transplants in life..getting an older kidney that would work for an even shorter period of time...no.

interesting. Down here I never signed anything (!) it was just "you're on the list" so I am not quite sure what the deal is. I guess THEY decide if you're matched enough to even make an offer and then you decide. I don't know. Never had a call to experience that side of it and the transplant team never went over that part of it. It was all about "when you get the call ... be prepared to come in" - as more though that it would be more like "the kidney is yours come in" rather than "we're offering you a kidney" or even "you're number 2...." or something.

[BigSteve]

Richard: At my transplant center(UCLA) I signed on two lists, the normal cadaver list and the Extended Criteria list
which is basically kidneys from older people.  I signed on the EC list since I am now 70 and would take even a
relatively short time away from dialysis. I don't know about a kidney from a 75 year old person. Maybe if it was
a six point match.

[Sunny]

At my age (48 yrs) I would never agree to an extended criteria transplant. I wouldn't want to go through the whole surgery process knowing I would be getting a kidney from a 75 yr old.
I'm glad this web site has educated me enough to know what kind of questions to ask regarding a kidney donor because my own transplant center never brought it up. They simply told me I was on the list.

[RichardMEL]

That's interesting that it appears in the US (and perhaps other places) you get a choice if you wish to be offered an older kidney (the EC list). Here as far as I'm aware there's no choice, and the seminar I attended the question was actually asked about how old they would go for a cadaveric kidney, they suggested 65 was the limit, but that flies in the face of this story that I heard from one of my nurses that allegedly happened in the past month. Who's to know I guess. I suspect the story a little to be honest as it sounds a bit far fetched to me. Not that I don't believe my nurse as she's very reliable, but perhaps whoever told her got things mixed. Who knows.

Anyhoo, at least I've learned something new from this thread - the EC list!

I think given I'm 38 I'd also be reticent about going on such a list just because the chances are a kidney from an older donor would not last the 20+ years I could hope in my wildest dreams a donor kidney could last for me. Certainly if you're older, like Steve, that makes a lot of sense.. and I guess it's why they are offering that option - both to widen the availability of potential organs, and also give more people a considered option.