Daily Checkup: Living donation is a key to finding kidney compatibility

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Daily Checkup: Living donation is a key to finding kidney compatibility
Those with healthy kidneys donate one in exchange for another that will go to the donor's intended recipient

BY KATIE CHARLES / NEW YORK DAILY NEWS

SUNDAY, APRIL 21, 2013, 2:00 AM

Dr. Antonios Arvelakis, assistant professor of surgery at Mount Sinai, says, 'The exchange can be two-way, three-way, or even a domino of kidney swaps.'
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THE SPECIALIST: Dr. Antonios Arvelakis

As assistant professor of surgery at Mount Sinai, Arvelakis is a transplant surgeon who specializes in kidney, pancreas and liver transplantation. He performs about 100 transplants a year.


WHO’S AT RISK

Thanks to segments on “Scrubs,” “ER” and “Grey’s Anatomy,” most Americans are familiar with the idea of ­living donors exchanging kidneys to find a compatible match for their intended recipient.

“Living donation is a great way to improve the current shortage of kidneys for transplant,” says Arvelakis. “Not only do living donor kidneys perform better than kidneys from a cadaver, but extensive research shows that down the line, donors are just as healthy as people with two kidneys.”

The kidney is the most commonly transplanted organ. “We do about 18,000 kidney transplants a year in this country, but another 33,000 people are added to the wait list,” says Arvelakis. “At this moment, there are 102,000 Americans waiting for a kidney, and the average wait time is six to eight years — that’s up from less than two years in the early 2000s.”

Kidney pair donation came about as a way to overcome blood group incompatibility between donors and their intended recipients. “About 30% of all potential donors are turned down due to a mismatch,” says Arvelakis. “Kidney pair donation matches incompatible living donors and their intended candidates with other incompatible living donor/intended candidate pairs — the exchange can be two-way, three-way, or even a domino of kidney swaps.”

The root cause underlying the need for most kidney transplantation is uncontrolled diabetes or high blood pressure. “Over time, hypertension and diabetes cause kidney damage that eventually leads to kidney failure,” says Arvelakis. “Most patients start dialysis and go on the transplant wait list when kidney function drops below 20%.”

Other rare conditions and some medications can also cause kidney failure.


SIGNS AND SYMPTOMS

Because the kidney is a resilient organ that continues to function despite serious damage, the indications of kidney disease often appear late in the process. “The symptoms often build slowly over time, especially when the cause is uncontrolled diabetes or hypertension,” says Arvelakis. “Many patients only get diagnosed when they go to the hospital for some other reason and get a blood test.”

As kidney failure grows more advanced, more serious symptoms begin to develop. “Warning signs include fluid buildup in the legs and arms, fatigue, weight loss, less urine, muscle cramps, sleepiness, forgetfulness,” says Arvelakis. “When the kidneys are really not working, the patient can fall into a coma.”
 

TRADITIONAL TREATMENT

The first steps toward donating a kidney are a long workup period to ensure that all prospective donors are fully informed and prepared.

“All donors and recipients go through an extensive workup to make sure that they are ready — medically, financially and socially,” says Arvelakis. “Our number one goal is to give the information to people — there’s never any obligation to go through with a donation, and it’s essential that potential donors don’t feel any coercion or pressure of any kind.”



Read more: http://www.nydailynews.com/life-style/health/daily-checkup-key-kidney-transplants-article-1.1321010#ixzz2T7p0Chnm