Save a life with a living organ donation

Save a life with a living organ donation
By CAROLE KEENEY HARRINGTON
HOUSTON CHRONICLE
Aug. 2, 2009, 4:54PM

As I rode along the Southwest Freeway last week, a motorcycle rider wearing blue hospital garb passed by without a helmet. First, I thought, “There goes an organ donor,” and then, “How can a medical person ride without a helmet? Don't they know how dangerous it is?” As the parent of a child with a brain disorder, I cringe whenever I see someone without a helmet. Even if they survive a motorcycle accident on a freeway, the head injury is usually so severe as to render the person permanently disabled.

There is a better way to donate organs. The Living Bank recently established The Living Donor Bank to advocate for kidney patients and support them to find their own donors. The new initiative is working with transplant programs in the Texas Medical Center to advocate for and counsel potential donors who might want to give a kidney and support them before, during and after the donation process.

True, the motorcycle rider who becomes an organ donor at death would be able to donate seven organs (two kidneys, heart, pancreas, liver, lungs and small intestine) and tissue such as corneas, skin, veins and tendons. However, the organ most needed is a kidney.

And living kidney donors are better than deceased ones. Kidneys from living donors begin to function immediately while patients who receive kidneys from deceased donors may need to stay on dialysis until the new kidney begins working. Living donor kidneys have higher success rates and last nearly twice as long as deceased donor kidneys. Additionally, patients will have to wait two to eight years for a deceased donor kidney.

Of the 102,000 people on the national organ donor waiting list, more than 80,000 need a kidney. The waiting list for kidneys among the five transplant programs in the Texas Medical Center totals approximately 1,500 patients.

Donating a kidney is not nearly as dangerous as riding the freeway without a helmet. Today, with laproscopic surgery, it is usually a brief stay in the hospital of one to two days. Depending upon how physical the work, most patients return to work in two to three weeks. Studies show kidney donors have the same life span and health issues as someone who has never donated.

Cost savings are also a big plus when a kidney patient can receive a kidney earlier. Patients who receive a kidney before going on dialysis have better outcomes. Plus, there is the cost savings of transplantation versus dialysis.

Researchers at the University of Maryland Medical Center found it is significantly cheaper to have a transplant than to stay on dialysis. The break-even point was 2.7 years for all cases analyzed back in 1999. The cost of kidney dialysis averaged about $44,000 a year at the time (it's more like $65,000 today). The cost for transplant surgery was $89,939, including all follow up for a year. After the first year, costs dropped to $16,043, mostly for anti-rejection medications.

With the increase in obesity that is leading to more diabetes and high blood pressure (“9.1 percent of health costs linked to obesity,” Houston Chronicle, Tuesday), the need for kidneys is expected to continue to rise even higher. In searching for ways to improve kidney donation rates, the University of Toledo and Dr. Michael Rees created the Alliance for Paired Donation and donor chains. In 80 percent of the living kidney donations, a family member or close acquaintance is the donor. However, if the family member or willing donor does not match, a kidney “swap” or “paired donation” may be possible.

In paired donation, a donor/recipient pair who do not match “swap” kidneys with another unmatched donor/recipient so that both patients receive a kidney. With an altruistic donor who has no designated recipient, a donor chain can be started that has led to up to 16 successful kidney transplants. It is estimated that paired donation will one day allow for an additional 3,000 living donor renal transplants per year in America. Of all advances in the last 25 years, the alliance says paired donation has the greatest potential to extend lives of patients with kidney disease.

That motorcycle rider on the Southwest Freeway needs to know if he is willing to take a big risk like riding without a helmet, he could take a smaller risk by donating a kidney to someone who needs it — and walk away a healthy individual.

Harrington is president/CEO of The Living Bank, a nonprofit organ donation education and advocacy organization.

http://www.chron.com/disp/story.mpl/editorial/outlook/6558145.html