Living Kidney Donation

It is important that anyone considering donating a kidney is aware of the risks involved. 

Firstly let me say that altruistic donation (the operation and recovery etc) is no different to someone donating to a loved one. Here are some statistics *.

In the UK between 1 April 2009 and 31 March 2010:

• 3,709 organ transplants were carried out, thanks to the generosity of 2,021 donors.
• 978 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney, liver/pancreas, heart/kidney or liver/kidney/pancreas transplant.
• A total of 2,739 patients’ lives were dramatically improved by a kidney or pancreas transplant. 160 of whom received a combined kidney/pancreas transplant.
• A further 3,099 people had their sight restored through a cornea transplant.
• A record number of 552 non-heartbeating donor kidney transplants took place and accounted for one in five of all kidney transplants.
• Living donor kidney transplants are increasing – 475 in 2004-05, 589 in 2005-06, 690 in 2006-07, 831 in 2007-08, 927 in 2008-09 and 1,038 in 2009-10 – and now represent more than one in three of all kidney transplants.
• Almost a million more people pledged to help others after their death by registering their wishes on the NHS Organ Donor Register, bringing the total to 17,400,213(September 2010).

 

As you can see from the above, more than 1 in 3 kidney transplants are via living donors.  There may only have been a small amount of altruistic donors so far, but the law allowing that only came into force at the end of 2006.

Did you know that a kidney transplant from a deceased person – the kidney has a life expectancy of only around 10 years. A kidney transplant from a Living Donor – the kidney has a life expectancy of around 20 years!

Yes there are risks involved. There are in any operation.  What must be pointed out though is the doctors would not allow this operation to take place on any individual if the risks were not minimal. The rigorous tests a donor is put through prior to being accepted as a donor makes sure they are very fit and healthy.  It was explained to me that a reaction to the anaesthetic could occur. Something unexpected could occur during the operation itself.  This is very unlikely but no operation is without some risk however small.  There could be post op complications but again, very minimal and doctors are on top of watching out for any complications. It is also up to the donor that once they leave hospital to make sure they take care of themselves during recovery and seek advice from a doctor should they suspect anything unusual.  Regular checks after the operation will ensure kidney function is performing as it should. 

Immediately after the operation there is a small risk of chest infection, being a non smoker certainly reduces that risk …. but it can happen after any operation, even though the risks are small.  A blood clot could form – again very unlikely.  I asked what precautions are taken to prevent blood clots and was told that my bloods ability to clot was tested before hand. That for the operation I would wear these special long socks – anti-embolism stockings (do a google but I am not sure if they are full length ones or below knee ones).  Some special calf wraps that gently compress the lower leg to aid blood circulation.  I would be given heparin to thin the blood slightly. I would be constantly monitored.  More details on the above can be given by any Transplant unit or your doctor.

As for living with only one kidney afterwards that does not present a problem to me.   The remaining kidney will slightly enlarge as it takes on some extra work.  There is no reason why I can’t go back to a totally normal life afterwards.  Very active people have donated and carried on with an active life afterwards just as before. Some people are born with only one kidney but don’t know it. They feel perfectly well with just one. I am no more likely to get kidney disease becuase I only have one kidney.  Generally a kidney problem would affect both kidneys, so having one would present no greater risk.  Playing a contact sport (boxing, rugby etc) where a blow could occur to a kidney should be avoided if possible or a protective belt worn. I don’t think I am likely to take up one of those sports! …. me = wimp!   After the operation the GFR levels do drop slightly then then rise again.  There can be slightly less function with one kidney but one has to remember that we have a surplus of available “function” that is never used. So a slight drop in function and the kidney still works just as good as before. There is an extra risk of hypertension occuring later in life but a good and healthy lifestyle is the rule to follow.  I had all the risks thoroughly explained to me and I asked many questions relating to them. I also did a lot of research myself as to what complications donors have had. Some have had nerve pain for a while afterwards, digestion problems and other things that with time disappeared. Every answer given was more than acceptable to me as a very lo risk indeed.   With only one kidney drinking sufficient amounts of water each day is helpful. If possible NSAID’s should be avoided as they “may” cause a problem for the kidney.  Normally with two kidneys not a great problem but when you only have one then perhaps being that little bit more aware of what does or does not go into our bodies should be considered.  There can also be a huge emotional surge within us. Some people have told me they got quite bad depression, rather like post natal depression that lasted many weeks. If that happens to you, don’t just take it. Ask for help in dealing with it.

To me there is a greater risk each time I get into my car and go on the road where I am likely to come across drivers with no licenses, drivers under the influence, drivers that are just plain bad drivers. They don’t wear stickers on their cars saying “avoid me”. Yet I choose to take that risk.    People who smoke know they are taking a huge risk and putting  their health at risk.  People who regularly go out and drink excessively…. they know they are damaging their health, yet still do it!  People climb huge mountains; jump out of airplanes;  take part in extreme sports – they love the adrenaline rush and the challenge, yet know there are risks.   They are hailed as amazing people for achieving these things – yes they are – they have far more courage than I do. We all do things, knowing the risks, accepting them – yet the risks involved in donating a kidney to me are far far far less than a lot of those risks. 

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