Life Span

[Bajanne]

Those statistics are just numbers to me.  My brother who was a bad type 2 diabetic by age 51 had gone blind and most of his organs were in trouble.  He then went on dialysis in the States where he had been to see the doctor.  When he returned home that same year, the doctor in the States had said he needed to be dialysed 3 times a week or he would not last 3 years.  Well, they only dialysed him twice weekly for about the first two or three years.  Yet after all of that, my brother survived 10 years.  I don't understand the stats at all.  A bad diabetic like him should not have lasted that long.  So I am not giving the stats any kind of consideration.  I am on dialysis 3 time a week -these days I come off feeling really great.  Last week after dialysis, I ran down the stairs to the car that was picking me up.
I know my problem is dealing properly with my fluid restriction and taking my cholesterol and phosporus medication.  I will deal with these things and LIVE LONG AND PROSPER!

[stauffenberg]

The full range of risks which are increased because of immunosuppressive drugs taken for a transplant is quite long and includes cancer, bone disease, type 2 diabetes, infection, heart attack, stroke, excess hair growth, patchy hair growth, overgrowth of the gums, cataracts -- you name it.  But the key factor to keep in mind is that, viewed statistically, the death rate from all these transplant-related problems is lower than the death rate on dialysis, and the morbidity -- the decline in health -- is much less with a transplant than without one. 

Quality of life is a key point as well.  If the way I felt and functioned before developing renal failure was 100, then on dialysis my level was about 20, but with a transplant I am back to about 80.  Instead of dialysis taking up my enitire life, the medical regimen for dealing with the transplant is so minimal that I could live with someone and keep the fact of my being a transplant patient secret from them, since all I have to do is take some pills twice a day.  On dialysis getting to and from the treatment, enduring the treatment, and recovering from it took me about 21 hours a week, and holiday travel was so burdensome that it wasn't worth it, even though it was theoretically possible.  I was unable to work while on dialysis, but within two weeks of receiving a transplant, I was back at my old line of work functioning about as well as I ever had.  I know of no case in the history of medicine when anyone ever voluntarily gave up taking immunosuppressive drugs because they preferred dialysis to transplant as a treatment modality for endstage renal failure, but there are thousands of people counting the days while waiting on the list to move from dialysis to transplant.

[LightLizard]

the list of people who have a transplant and have the new kidney fail in a few years is very long, too.
there are too many factors to make such a decision based on only one person's experience.
your kidney is fine now. will you sing the same tune if it fails and you have to go back to dialysis?
i don't know if you tried the baxter cycler or not. but i find it quite reliable, as far as keeping my energy level up. i tend to side with del's hubby; 'if it ain't broke, don't fix it.'

so far, that is....

[stauffenberg]

To say that the transplanted kidney might fail is no argument against he superiority of a transplant to dialysis. The statistics show that the average kidney transplanted from a cadaver lasts 12 years, while the average kidney from a living donor lasts 24 years.  Both of those graft survival times are longer than my entire life expectancy was on dialysis.

Anecdotal evidence doesn't mean anything compared to the statistics, which are all that you have to judge by if you are reasoning on an objective basis.  There may be a merchant in the Congo who is a millionaire, but that doesn't mean it's a good idea to move from the United States to the Congo to get rich!  You look instead at the statistics, which says that the average income in the U.S. is $43,000 a year, while the average income in the Congo is $1200 a year, and make your decision on the averages.

[LightLizard]

that might be, but the merchant might win the lottery, too.

what i'm saying is that there are far too many variables to base one's decision solely on
statistics and it's not as simple or black and white as you suggest. (a 'no-brainer'?)

my condition, a few years ago, as far as 'statistics' go, should have killed me.

it didn't.

[jbeany]

I believe two other risk factors with a transplant are skin cancer and developing Type 2 diabetes.

Well, I've already got type 1 diabetes, so the risk if type 2 has already been eliminated, and I've never burned or even been able to get a sun tan a day in my life, so I'm pretty sure that eliminates the skin cancer too! 

pbear, my transplant doc said they almost expect a transplant patient to get skin cancer - staying out of the sun will help, but the odds are good you're going to get it anyhow.

[angela515]

your kidney is fine now. will you sing the same tune if it fails and you have to go back to dialysis?

I sang the same tune. This is my 2nd transplant. My first transplant only lasted 5 yrs due to me having 2 children immediately after having my transplant, I do not regret that though. As far as being back on dialysis and still wanting a transplant and thinking just as highly about them never changed.

pbear, my transplant doc said they almost expect a transplant patient to get skin cancer - staying out of the sun will help, but the odds are good you're going to get it anyhow.

I guess every dr looks at different statistics or something because my transplant dr said he has transplant patients  with no skin cancer and they are over 10+ yrs post... he advices a high SPF sunblock for whenever your going to go outside and of course staying out of the direct sun if you can for long periods of time. I don't know how long it takes to develop skin cancer, so far, I don't have it..

[George Jung]

I look at my current state of living as the biggest bet I have ever made (each day there is), with no guarantees.  The bigger the risk the greater the reward.  Usually when I play poker I have the mentality that I can't loose what I don't put in....but then I don't win much either (status quo).  When I do play a hand it is first based on probability (statistics) and then on feeling (my gut). 

When first hit with my (health) condition I had a very clouded mind and was not capable of good decision making.  Since learning the rules I have become confident about making decisions and I do plan on putting all of my chips on the table, I am simply waiting for the right time to do it. 

Nothing is for sure, so what it comes down to is how you want to play the game.  I am young and a lot less conservative than some other may be so unless anyone wants to give their chips to me all I have to worry about (make decisions for) is myself.

There is no right or wrong.  Everyone has a different set of circumstances and unless you know what cards they are holding, when they are holding them, you can only speculate,  therefore it is up to that individual on what they choose to do.

After all, it is the choices we make that dictate who we are, nothing else.

[del]

I agree totally George!! 

[paddbear0000]

pbear, my transplant doc said they almost expect a transplant patient to get skin cancer - staying out of the sun will help, but the odds are good you're going to get it anyhow.

Well that definitely goes on my list of reasons not to get a transplant!

[BigSky]

the list of people who have a transplant and have the new kidney fail in a few years is very long, too.
there are too many factors to make such a decision based on only one person's experience.
your kidney is fine now. will you sing the same tune if it fails and you have to go back to dialysis?
i don't know if you tried the baxter cycler or not. but i find it quite reliable, as far as keeping my energy level up. i tend to side with del's hubby; 'if it ain't broke, don't fix it.'

so far, that is....

Actually the list of those kidneys that fail within a few years is quite short.  In fact much shorter than the death rate in the first few years of those that start dialysis.  First year alone 24% of dialysis patients do not make it.

Some people do thrive at dialysis.  However the vast majority do not as they find it hard to maintain the renal diet and fluid restrictions.  The failure to follow those two things can cause many problems and usually leads to other co-morbidities.

People have to decide for themselves.  However, even as good as I felt the first time while on dialysis it doesnt even compare to how great you feel when that kidney kicks in working overtime to process years of toxins out.

[LightLizard]

an important factor for me, which not many, if any, have to consider here, is the fact of my hep C.
the stats and experiences of hep c patients in my position that get a transplant is morbid and not anywhere near the results of non-hep C patients.

[st789]

For some of us, kidney failure is not the only medical condition we have.  We must weight that heavily on our decisions to do transplant or not.

[Zach]

Choose wisely, Grasshopper.
 

[okarol]

I believe two other risk factors with a transplant are skin cancer and developing Type 2 diabetes.

Well, I've already got type 1 diabetes, so the risk if type 2 has already been eliminated, and I've never burned or even been able to get a sun tan a day in my life, so I'm pretty sure that eliminates the skin cancer too! 

pbear, my transplant doc said they almost expect a transplant patient to get skin cancer - staying out of the sun will help, but the odds are good you're going to get it anyhow.

This is from the Mayo Clinic:

Kidney transplant: Does it increase my cancer risk?

Question:
Is it true that having a kidney transplant increases the risk of cancer?

     ---  Mayo Clinic urologist Erik Castle, M.D., and colleagues answer select questions from readers.

Answer:
Yes, having a kidney transplant increases your risk of cancer. Even before getting a transplant, just having end-stage kidney disease may slightly increase your risk of cancer.

People who've received a kidney transplant or any other solid organ transplant, such as a liver, pancreas or heart, are more likely to develop cancer than are those who've not had a transplant. The long-term use of immunosuppressive drugs that prevent rejection of the transplanted organ appears to be a contributing factor. A suppressed immune system may permit abnormal cells — which are normally kept in check by your immune system — to become cancerous. It's unclear whether certain immunosuppressive drugs increase this risk more than others.

Viruses, such as Epstein-Barr, play a role in some cancers in transplant recipients. Very rarely, a cancer may already be present in the transplanted organ, either as a primary or metastatic cancer.

Skin cancers are the most frequent cancers in transplant recipients. For this reason, it's important to protect your skin from sun exposure after an organ transplant. You should also discuss with your doctor a schedule of cancer screenings appropriate to your specific circumstances.

In general, the risk of developing a serious cancer is low compared with the many benefits of a successful kidney transplant when needed.

------- http://www.mayoclinic.com/health/kidney-transplant/AN01612

[stauffenberg]

Having a kidney transplant quadruples your risk of developing cancer.  But it is important to note that many of those cases of cancer are skin cancer, which is the most curable of all cancers.  If you are frequently checked for early skin lesions, skin cancer is nothing to fear.

Keep in mind as well that cancer rates are also higher than normal among dialysis patients.

The statistics say that you double your life expectancy if you go from dialysis to a kidney transplant and suffer from no other no other diseases.  If you are a diabetic on dialysis and get a transplant you triple your life expectancy.  Now, to clarify the analysis, suppose you could pick one of two hospitals to have a major operation, and one had double the operation success rate of the other.  Would you remain undecided on which hospital to pick on the theory that "you never know what may happen"?!  Sure, you could be very unlucky at the better hospital or very lucky at the worse hospital, but you have to judge by the averages.

[Zach]

To say that the transplanted kidney might fail is no argument against he superiority of a transplant to dialysis. The statistics show that the average kidney transplanted from a cadaver lasts 12 years, while the average kidney from a living donor lasts 24 years.  Both of those graft survival times are longer than my entire life expectancy was on dialysis.

Anecdotal evidence doesn't mean anything compared to the statistics, which are all that you have to judge by if you are reasoning on an objective basis.  There may be a merchant in the Congo who is a millionaire, but that doesn't mean it's a good idea to move from the United States to the Congo to get rich!  You look instead at the statistics, which says that the average income in the U.S. is $43,000 a year, while the average income in the Congo is $1200 a year, and make your decision on the averages.

Here is some additional wood to put on the fire:

More Kidney Transplants Are Failing
http://www.medicineonline.com/news/10/1734/More-Kidney-Transplants-Are-Failing.html

Patients who have had a kidney transplant face higher melanoma risk
http://www.medicalnewstoday.com/articles/31177.php

 

[angela515]

Well said stauffenberg. 

[George Jung]

Now, to clarify the analysis, suppose you could pick one of two hospitals to have a major operation, and one had double the operation success rate of the other.  Would you remain undecided on which hospital to pick on the theory that "you never know what may happen"?!  Sure, you could be very unlucky at the better hospital or very lucky at the worse hospital, but you have to judge by the averages.

Puts things into a nice perspective.  I like it a lot! 

[okarol]

Here is some additional wood to put on the fire:

More Kidney Transplants Are Failing
http://www.medicineonline.com/news/10/1734/More-Kidney-Transplants-Are-Failing.html

HEY! This is so old!  SOURCE: University of Florida, news release, March 2004
Last Updated: Mar-10-2004

Patients who have had a kidney transplant face higher melanoma risk
http://www.medicalnewstoday.com/articles/31177.php

This is more recent - Article Date: 27 Sep 2005 - but not THAT current!

 

[Zach]

You can find a full table of statistics for the varying life expectancies of people with endstage renal failure according to age group, presence of absence of diabetes, and treatment modality (transplant or dialysis) in a medical text by Professor Gabriel Danovitch, Handbook of Kidney Transplant (Philadelphia: Lippincott, 2001) p. 16.

And the above is not old?


   to you okarol!

[okarol]

You can find a full table of statistics for the varying life expectancies of people with endstage renal failure according to age group, presence of absence of diabetes, and treatment modality (transplant or dialysis) in a medical text by Professor Gabriel Danovitch, Handbook of Kidney Transplant (Philadelphia: Lippincott, 2001) p. 16.

And the above is not old?


   to you okarol!

touché mon ami 

[Bajanne]

My personal feeling is that at my age (57) I don't need a transplant (even if I could get it, which is not usual here).  I support transplants for people like Jenna who now have a life to live and enjoy with the encumbrance of dialysis.  But for me, it is not necessary and I prefer to finish out my days this way.  I just want to do the right things to prolong my existence, but if and when the end comes, I have had a tremendous life.  I just don't expect to be gone in 5 years as the statistics seem to want to predict!

[bolta72]

I feel the same way.

[LightLizard]

those are my feelings, as well, bajanne2000. if i were younger (i'm 58) and had a lot that i wanted to do with my life still, AND if i didn't have hepatitis C, i would probably be of a different mind, but, i too have had a great life, i have fathered three beautiful girls-becoming-women, two grandchildren, and achieved as much professional success as i could deserve and want. i don't really understand how some can just brush past the hep C issue so casually with this question. i guess they would feel differently too, if they were in my position. i've pretty much decided a transplant is out of the question, for me.
i have yet to have a 'sit-down' with my nephrologist on the subject, but there isn't much he could say that would change my thinking on this.

love

~LL~