Thursday, April 22, 2010

Living Donor Facts of the Day

Compliments of an OPTN/UNOS policy change in 2002, 1/3 of the wait list is 'inactive', meaning the individuals aren't eligible for an organ, even if one were to become available. This has perpetuated the myth of the 'growing' organ shortage where none exists.


"Fifty plus percent of the people that start the live donor workup get turned down because we find something that's wrong," says Dr. Charles Shield of St. Francis Hospital, Kansas.*


Over 50% of transplant professionals do not believe living kidney donation increases one's risk of cardiovascular disease (Housawi, 2007). Yet extensive research exists establishing renal insufficiency as an independent factor in cardiovascular disease. According to medical guidelines, a GFR of 60-89 is considered Stage II kidney disease, which includes living donors.

BTW, two bothers, one recipient and one donor, are currently suing UPMC for 'lack of informed consent'.


OPTN (aka any regulatory agency) did not begin collecting living donors' social security numbers until 1993/4. Therefore, approximately 40 years of living donors cannot be located, tracked or studied.


Since 1993, 300 living kidney donors are known to have registered on the wait list in need of their own transplant. Because the only indicator is the use of the 'points' living donors receive on the wait list, the real number is believed to be much higher. This stat also doesn't include the LKDs currently on dialysis, or diagnosed with ESRD, or foregoing transplant.(SRTR presentation at 2008 ACOT meeting).

Kido et al. in 2009 released the first study examining why some LKDs develop ESRD. In their case studies, ESRD developed irrespective of pre-donation renal function or absence of risk factors such as proteinuria, hypertension, obesity or diabetes. In most cases, renal function stabilized for a long period (13.1 years) before declining after an initiating event.

The psychological status and distress scores of ONE-THIRD of living donors worsened 1 and 3 months after surgery, with cases of depression, anxiety, sensitivity, paranoia, aggression, intractability and obsession noted (Toghavi 2001). Yet not a single transplant center has a structured mental health services available for the living donor.