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Q: "I am interested in living donation
to a friend, loved one or a stranger who needs a kidney. Where
do I go to find information?"
A: UNOS (United Organ Sharing Network) is an excellent
scource for information on exactly what's involved in the process.
I will be referencing this site often as it is the "go to" site for all aspects of living donation along with Transplantliving.org
and OPTN (Organ Procurement and Transplantation Network). Currently, these organizations organize, facilitate procurement
of organs and manage living donor databases. The initial testing and organ procurement process can be explained
here:
The first steps to donating a kidney
Q: "How is the procedure done to remove the
kidney from the donor and put it into the recipient?"
A: There are 2 types of surgery to remove the kidney from
the donor. The first is Laparoscopic nephrectomy, also known as "keyhole surgery," is a minimally invasive surgical
procedure for obtaining a kidney from a living donor that can make the process easier. In this procedure, the surgeon makes
two or three small incisions close to the belly button. The kidney is removed through the central incision. Through one of
the other openings, a special camera called a laparoscope is used to produce an inside view of the abdominal cavity. Surgeons
use the laparoscope, which transmits a real-life picture of the internal organs to a video monitor, to guide them through
the surgical procedure. In comparison to the standard operation, it results in a smaller incision, reduces recuperation time
and usually shortens hospital stays. Many donors are discharged from the hospital after two days and return to normal activity
within four weeks. Not all donors can undergo laparoscopic nephrectomy. You may not qualify for the procedure if: - You
have had multiple previous abdominal surgeries
- You are significantly overweight
- There is abnormal anatomy
of the kidney
The second is Open nephrectomy and has been the standard for the last 35 years. It involves
a five to seven inch incision on the side of the chest and upper abdomen. A surgical instrument called a retractor is usually
needed to spread the ribs to gain access to the donor's kidney. Sometimes it's necessary to remove part of a rib for
better exposure. The operation typically lasts three hours, and the recovery in the hospital averages four to five days.
Donors can usually return to normal activity within four to twelve weeks.
Q: "What's the risk for the donor?"
A: Kidney transplants are the most frequenty performed type of living
donation. For the donor, there is little risk as the remaining kidney grows and compensates for the missing kidney. It
is not uncommon for people to be born with one kidney and lead long, healthy and productive lives. The only way to tell if
you have two kidneys is by ultrasound or MRI. 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.
Q: "Who is eligible to donate?"
A: Generally, you must be first sure you want to go
through with the procedure and are mentally prepared for it. Then, there are requirements that you be in good health, physically
fit, no high blood pressure, diabetes, cancer, kidney disease and heart disease. Donors can range in age from 18-60 years
old. Race and gender are not determining factors in good matches.
Q: "Can I sell my kidney?"
A: In 1984 Congress passed the National Organ Transplant
Act (NOTA), which prohibits the sale of human organs. 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.
View NOTA in PDF format
Q: "What is the cost of donation to the
donor?"
A: Medical expenses associated with living donor evaluation
are covered by either the recipient's insurance or in certain circumstances, by the Transplant Centers Organ Acquisition
Fund (OAF). In either instance, the living donor should not incur any expenses for the evaluation. However, expenses related
to another health concern that may identified during the evaluation process will not be covered by the recipient's insurace
or the OAF. The actual donation surgery expense is covered by the recipient's insurance. The transplant center will
charge a recipient's insurance an "acquisition fee" when he or she receives a transplant. The medical costs
related to the donation procedure and required postoperative care are also covered by this fee. In some instances, the actual
itemized bill for the donor procedure is submitted to the recipient's insurance. Anything that falls outside of
the transplant center's donor evaluation is not covered. These costs could include annual physicals, travel, lodging,
lost wages and other non-medical expenses. Although it is against the law to pay a living donor for the organ, these costs
may be covered by the recipient. Be sure to check your specific insurance policy or ask a transplant financial coordinator
about concerns related to your specific circumstances. You may also want to learn more about the National Living Donor
Assistance Program which provides financial assistance to those who want to donate an organ.
Q:
"What is the transplant list and how many people are on it?"
A: The transplant list is comprised of people who are
currently waiting for kidneys in the United States. The number is constantly changing, but right now approximately 75,000
people are registered (most on dialysis) to get transplants as kidneys become available. Then, regional and state transplant
centers conduct tests, match compatible donors and recipients and arrange the surgeries. Follow up care for both patients is
provided by the centers.
Q: "I'm hesitant to sign my liscense to
be an organ donor because I heard if you go into the emergency room and the doctors know your an organ donor, they won't
work as hard to save you. Is this true?"
A: This a little off topic as we are discussing living
donation on this site, but I feel this is a very prevalent myth out there. If you are sick or injured and admitted to the
hospital, the number one priority is to save your life. Organ donation can only be considered after brain death has been declared
by a physician. Many states have adopted legislation allowing individuals to legally designate their wish to be a donor should
brain death occur, although in many states Organ Procurement Organizations also require consent from the donor's family.
Q: "My religion prohibits me from donating,
so how is it possible to help?"
A: All major organized religions approve of organ and tissue
donation and consider it an act of charity.
Q: "What about the urban legend that
involves drugging you and removing your kidney(s)? Has this actually ever happened?"
A: This tale has been widely circulated over the Internet.
There is absolutely no evidence of such activity ever occurring in the U.S. While the tale may sound credible, it has no basis
in the reality of organ transplantation. Many people who hear the myth probably dismiss it, but it is possible that some believe
it and decide against organ donation out of needless fear.
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