Seniors Can Be Organ Donors
Are you a senior considering donating a live kidney to someone in need? Youre not alone. The United Network for Organ Sharing reports 96 people, age 65 and older were living kidney donors in the U.S. in 2011.
The data from existing research on whether seniors should be living kidney donors is promising but also contradictory, and, as the researchers point out, insufficient to draw a definitive conclusion at this time.
A study published in the Clinical Journal of the American Society of Nephrology compared two groups of kidney recipients. One group received a kidney from live donors age 70 or older and their survival rate after five years was 74.5 percent. The other group received an organ from younger donors and had an 83 percent survival rate over the same time period.
An analysis of 12 clinical studies published in the American Journal of Transplantation also found higher five-year mortality rates for older-donor recipients. Additionally, the date showed older organs were more likely to fail during that same 5-year period.
In contrast, a set of researchers from New York-Presbyterian/Weill Cornell Medical Center found survival rates for patients receiving a live kidney from a donor 60 years old or older were equal to those receiving a younger organ.
Older adults considering donating a live kidney should keep in mind that the majority of transplant centers dont currently accept organs from seniors 70 years old or older.
Donating A Kidney Doesn’t Shorten Donor’s Life
ByLive Science Staffpublished 9 March 10
People who donate one of their kidneys are likely to live just as long as someone with two healthy kidneys, assuming they survive the initial somewhat riskier period.
A new study, which involved more than 80,000 live kidney donors in the United States and looked at survival rates over a 15-year period, is the first to use data from a national level, rather than from single-transplant centers with similar populations.
“Whatever happens when people donate kidneys, on average, it doesn’t affect the rest of their lives and that has never been shown before in a study of this size and scope,” said study author Dr. Dorry L. Segev, a transplant surgeon at the Johns Hopkins University School of Medicine.
However, the findings do show a higher rate of death in the first 90 days after surgery for the live kidney donors compared with the control group. And certain subgroups have a greater mortality risk over the long-term than others.
The researchers deem the procedure safe, and encourage it to continue as more studies are conducted to better understand the physiological changes that occur after organ donation.
There were 25 deaths within 90 days of live kidney donation, putting the risk of death at 3.1 per 10,000 donors, compared with 0.4 per 10,000 persons for the NHANES III group.
“While there are never any guarantees with surgery, donating a kidney is safer than undergoing almost any other operation,” Segev said in a statement.
Does Living Donation Affect Life Expectancy
Living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems however, you should always talk to your transplant team about the risks involved in donation. Some studies report that living donors may have a greater chance of developing high blood pressure. It is recommended that potential donors consult with their doctor about the risks of living donation.
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Uncertainty And Sensitivity Analyses
We assumed that many future risks that can impact on life expectancy and ESRD such as cancer, obesity, smoking and so on were not influenced by the act of kidney donation. The lifetime estimates of ESRD were found to be higher in non-donors than published estimates, in part since this model incorporated the possibility that some participants could develop diabetes mellitus and proteinuria. In a sensitivity analysis a lower risk ideal cohort was examined. These ideal non-donors were assigned lower incidence rates of diabetes mellitus, proteinuria and rates of transition to CKD to match projected lifetime ESRD risks rather than calibrating to 15-year ESRD risks. Non-donors were assumed to have lifetime cumulative ESRD risks of 0.43% , 0.29% , 1.00% and 0.85% for white male, white female, black male and black female, respectively. To evaluate a more conservative and more liberal estimate of remaining life years, lost life years postdonation, remaining QALYs and lost QALYS postdonation, we used higher and lower transition rates from normal to CKD states that correspond to the upper and lower bound of the 95% CI of the projected cumulative risk of ESRD from a study by Grams et al.
Strengths And Limitations Of This Study
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The study projects the long-term risk of donating a kidney, including loss of life and the added risk of end-stage renal failure.
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These findings help quantify and communicate risk to potential donors and convey the importance of lifelong follow-up in actual donors.
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The study uses evidence of over 15 years of follow-up in actual live kidney donors and healthy controls.
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The ability to predict lifetime outcomes from 15-year follow-up in donors of all ages and medical conditions is a limitation.
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Emotional And Social Possible Long
- Sadness over loss of kidney
- Anger if the transplant patients body rejects the donated kidney
- Feelings of guilt or regret
- Your mood may depend on your relationship with the transplant patient and what happens to them post-donation, such as if their body rejects the kidney or the transplant works well
Who Makes A Good Donor For Kidney Transplant
Kidney donors do not need to be related to the recipient, although they often are related. They can be friends, coworkers, members of the same religious group or other organization, or any other type of relationship. While many people are willing to be living donors, not everyone can become a living donor. Donors are carefully and thoughtfully evaluated in order to avoid unwanted medical or psychological outcomes.
While the individual circumstances of each potential donor are considered and testing must be done to determine compatibility, all potential donors must be:
- At least 18 years of age
- Genuinely willing to donate
- In good general health and reasonably physically fit
Certain medical conditions can make it likely a person will not be healthy enough to be a kidney donor but many other conditions may be acceptable . It is best to ask rather than assume someone cannot be a donor.
Individuals considered for living kidney donation are usually between 18 and 65 years of age. Gender and race are not factors in determining a successful match. Hypertensive donors over the age of 50 may be eligible under certain conditions. While the risk to the donor is minimal, there is always some degree of risk associated with any surgical procedure. The procedure is done laparoscopically which helps minimize discomfort and ease recovery after the procedure. Donors undergo an education process about the operation and its risks, and are able to confidentially decide not to donate at any time.
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Legal Issues Related To Payment For Donation
The National Organ Transplantation Act of 1984 specifically prohibits the exchange of valuable consideration for a human organ .
Therefore, it is illegal to sell organs if this occurs, it is punishable by fines, imprisonment, or both.
However, the payment of the expenses of travel, housing, and lost wages incurred by the donor of a human organ in connection with the donation of the organ is expressly permitted by section 301 of NOTA.
Learn more about the National Organ Transplantation Act .
How Much Can I Make Selling My Eggs
Compensation can vary quite a bit, depending on where you donate your eggs. Usually, egg donors are usually paid between $5000 and $10,000 per cycle. At Bright Expectations, we offer our egg donors a compensation package that is a bit higher than the average, which includes: A payment of $8000 to $10,000 per cycle.
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What Are The Types Of Living Kidney Donation
There are two kinds of living kidney donation:
Living related : Donation from parents and sibling.
Living unrelated: Donation from friends or from person who isnt related by blood to the recipient.
Different types of kidney donation include:
- Directed: You choose who gets your donated kidney.
- Paired kidney exchange: Organ transplants work best when the donor and recipient have the same blood type or tissue type. If you and the recipient arent a compatible match, you can donate your kidney to someone else who is a match. In return, a family member or friend of the recipient donates a kidney to your loved one.
- Nondirected or altruistic: You dont know the person who gets the donated kidney. Instead, you choose to help someone unconditionally.
What If The Person Who Wants To Donate A Kidney To Me Or To My Child Is Not Compatible
If you or your child needs a kidney transplant and find a willing living kidney donor but medical tests show that person is not compatible based on blood type or other factors associated with high risk of organ rejection, you may still be able to have a transplant.
Ask your transplant center to explain your options if someone wants to be a living donor but is not compatible. And, if one of these options is right for you, it could help someone elses living donor transplant happen as well.
KIDNEY PAIRED DONATION
Living kidney donation and the power of computers helps match willing donors and recipients who may live nearby or even across the country. Think about it as a swap or an exchange. Heres how it works:
- A living donor who is willing to help you or your child is matched to another compatible transplant candidate
- A special computer then finds someone else’s willing donor who is compatible with you or your child
Matching patients with compatible living donors allows hundreds of people to get transplants each year. Participating in an exchange also may help you or your child receive a transplant more quickly.
USING AN INCOMPATIBLE KIDNEY
Another option may be for a transplant center to prepare your body to receive an organ from an incompatible donor. This includes getting medical treatments before transplant to help the body accept the organ. Talk with your transplant center about the availability, risks and benefits of these options.
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Reasons For Having One Kidney
Again, most people are born with two working kidneys.But sometimes, just one kidney works. And some people are born with only one kidney.
The reasons for this may vary and can include:
- Renal agenesis a condition where someone is born with only one kidney.
- Kidney dysplasia a condition where someone is born with two kidneys but only one of them works.
- Kidney removal certain diseases may require you to actually have one of your kidneys removed.
- Living-donor kidney transplant you can donate one of your kidneys to a person who needs a kidney transplant.
What Will Be Expected Of The Donor
The donor will be assigned a nurse coordinator who will be responsible for educating them through the donation process. The coordinator will work only with the donor and cannot disclose any health information to their family or the recipient. It is very important for donors to keep the recipient informed of the process as it moves along.
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What Can I Expect During Kidney Donation Surgery
Surgeons typically remove a donated kidney using a minimally invasive laparoscopic procedure. Surgery to remove a kidney may take two to three hours. Your surgeon will:
- Make several small abdominal incisions.
- Insert a laparoscope into an incision.
- Use tiny instruments to remove the kidney through an incision.
- Close the incisions with dissolvable stitches.
Some cases are done open if there are anatomic issues, but this happens in less than 5% of the surgeries.
Often your kidney recipient will be in a nearby operating room in the same hospital. Another team of surgeons operates on the recipient.
A Living Donor Transplant Can Shorten Your Wait
Only about half of the people in the United States sign up to donate their organs when they die. This number is different in every state and region, so the wait can be longer depending on where you live.
Every year, thousands of people get removed from the waitlist because they have grown too sick to make it through a transplant.
Living donor transplantation can help shorten or eliminate the wait by:
- Giving you more options about where and when a transplant happens
- Helping you get an organ transplant even before you begin dialysis if you are a kidney patient
“When we found out my brother needed a transplant, we also learned that African Americans are more likely to have medical conditions that lead to kidney disease. More than anything, I wanted my brother to get off of dialysis and get back to his life. For me, the best way to do that was to be his living kidney donor. Id do it again in a heartbeat. – David
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What Are The Risks Of Being A Living Kidney Donor
Like any surgery, kidney donation carries the risk of surgical complications like blood clots and others, but these risks are low. You will lose a certain percentage of your kidney function after donation. This sounds scary, but after the surgery your remaining kidney will get bigger and you wont notice any difference.
Donating a kidney doesnt increase your future risk of kidney failure. However, if kidney failure occurs for whatever reason, UNOS has a priority system that ensures living organ donors are at the top of the waitlist and get it quickly. This happens very rarely.
Other risks of kidney donation include:
- Nerve damage .
How To Use Social Media To Find A Living Donor
If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
When Malkia White found out her kidney was functioning at 12 percent, she knew finding a living donor would increase her chances of receiving a transplant. So, she created a Facebook page called That Girl Needs a Kidney to spread the word on how to be a living donor and why its so important.
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What Should A Living Donor Expect After Surgery
Ordinarily, there will be some pain after surgery, which will diminish and can be controlled with pain medication. For kidney donors it will be about one week and for liver donors about 2 to 3 weeks. Donors should plan to have a caregiver after returning home from surgery for a short time period. Check with the transplant hospital for more details.
Living Donor Transplantation Can Improve Your Chances Of Success
Kidneys from living donors generally have high success rates:
- On average, living donor kidney transplants work longer than kidney transplants from deceased donors
- On average, living donor liver transplants also have as good or better outcomes compared to liver transplants from deceased donors
Living organ donors make about 7,400 transplants possible each year.
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When Can You Return To Normal Activities
Most people can return to regular life within a few months. You may be able to return to work between two to eight weeks after your surgery, depending on your job.
Your doctor may restrict you to lifting no more than 10 pounds in the first eight weeks after surgery, and no more than 20 pounds until week 12.
For more strenuous activities like competitive sports and core abdominal exercises, you may have to wait until six months after your surgery.
Living Donation Improves Kidney Transplant Success Rates
The ten-year graft survival rate for kidneys received through living donation is 15 percent higher than kidneys received from a deceased donor, according to the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients . There are many reasons a living kidney donation enhances outcomes and is the preferred approach to kidney transplantation.
- Optimal health for donor and recipient Living donor transplants can be carefully planned so the recipient and donor are in the best possible health.
- Living donors are evaluated according to strict guidelines, and donors with potential medical problems are not accepted.
- Kidneys removed from living donors are in excellent condition and are immediately transplanted, which minimizes possible damage to the organ.
- Living donor transplantation can be performed pre-emptively – before the transplant candidates condition worsens and requires dialysis – which can take its toll on the candidate health and affect outcomes.
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What Happens When Someone Says They Might Be Interested In Being My Living Organ Donor
Once someone says theyre interested in being a living donor, a long process begins with education. The potential donor and the transplant program have to figure out if living donation is right for that person.
When someone steps forward to consider living donation, they are really stepping forward to learn more about the process from transplant professionals. The education process also lets your transplant team learn about that person. Decisions about whether living donation is right for that person are still a long way off for both the potential donor and the transplant center.
THE LIVING DONOR TEAM
The transplant program assigns the person a living donor team, including their own:
- Nurse
- Social worker
- Independent living donor advocate
THE FIRST STEPS
Basic information. The first step is often as simple as the potential donor giving the transplant team staff some basic information by phone or email or even online. This might include the potential donors relationship to you and some very basic medical history.
THE DECISION