Eric Tamayo
English 102
kidney donation saves a life
According to the National Kidney Foundation, there are almost 100,000 people in the United States alone on the waiting list to receive a kidney transplant (National Kidney Foundation). With an average waiting time of up to 3 ½ years, most will turn to dialysis. Dialysis is a process that is used to filter your blood; it takes over what your kidneys were meant to do in the first place. When the kidney fails, it can no longer filter the blood in your body, dialysis is the only way to keep your blood filtered and working like a normal functioning kidney. Dialysis treatment can alter one's life dramatically. Treatments are done three times a week for up to four hours per day. You can imagine the affect it would have on your day to day routine, having to schedule appointments, work, activities, and even vacations around your dialysis treatments. Your quality of life lowers, and you are left to wonder what life would be like with a normal functioning kidney. We are born with two kidneys in our body; the benefit that the kidneys provide is that you only need one to survive. One kidney alone does the work to filter out waste and bad chemicals from the blood and keep you living a healthy life. This is where the opportunity arises; the kidney is the most commonly transplanted organ today (UNOS). Kidneys can be transplanted from the deceased and even the living, like any foreign object inside of you; your body doesn't know what it is or why it's there, so the body tries it's hardest to reject it. This is what makes a kidney transplant more difficult, you have to find the right match. You cannot go out and use just any kidney; there are a series of tests involved to make sure the body doesn't reject the kidney.
It is difficult to find a match for kidney donation, the waiting list for a kidney transplant continues to rise as the amount of kidney donors are slowly disappearing, more people should go out and get tested to see if they can be a donor because a living kidney donation far out ways the benefits of a non-living donation.
A living kidney donor is a better option for transplant due to the fact that the donor can be tested early on to see how they can be a perfect match for someone on the waiting list. Typically, a living kidney donor has opted to donate because a family member, close friend, or even a co-worker is in need of a kidney. This gives the recipient a head start into finding out if someone is a match. According to Dr. Didier Mandelbrot who is the Director of the Kidney Transplant Program at UW Health; a living kidney transplant is the best option because the kidney is less likely to be rejected by the recipient. The kidney from a living donor is healthier and will last longer than that of a deceased donor (Mandelbrot).
Every day a life is taken, and from most of those deceased, they have helped someone else in need by donating their organs. Studies from Columbia University and the Department of Surgery have shown that the majority of kidney transplants have come from deceased donors. Of those kidney transplants from the deceased, the kidney that has been transplanted has a lifespan of 10 to 20 years. A kidney from a living donor has a lifespan lasting over 20 years and to top that; a kidney from a matched immediate family member has the potential to last at least 35 years (Columbia University).
An immediate family member who is willing to donate is the best option for a successful kidney transplant. I donated my kidney seven years ago to my mother; she had a kidney function of 9 percent and was in the process of scheduling her dialysis appointments for the coming months. There were multiple people who were willing to be tested to help her out. My Father was the first; he went through a series of tests and found out he was not a match. Next up was a co-worker of my Mother's; her co-worker had made it through the first stages of testing, but when it came to the second stage of testing, the doctors had found out that she had breast cancer. It was a blessing in disguise; without the thoughtfulness of my Mother's co-worker, and her willingness to donate, she would have never known that she had breast cancer. The doctors were able to find it early and to this day she is cancer free. These are some of the benefits to being tested to see if you are a donor, because it makes a person who like most of us hate going to the doctor, be able to check and see if you are healthy enough to donate. Who knows, trying to save someone else's life may work out saving your own. Next up, my turn; my Mother had insisted that none of her children try to donate, but after seeing attempt after attempt and no success, I had to help out. The testing process was fairly simple; I first had to speak with a transplant coordinator to make sure this is what I truly wanted to do. The next step was to make sure my blood was compatible with my Mother's. After a few more blood tests, the doctors had to check to see if I was healthy enough to donate, this consisted of a CT scan to check internal organs, EKG reading to make sure my heart was healthy, and of course, my kidney function.
Once all of the tests came back as a match, I was ready to donate. It was a great feeling of accomplishment, to know that I have a chance to save someone's life. There is nothing holding me back, I have passed every test and now it is up to me to decide if I still want to donate. I went over the pros and cons of donation; yes something can happen during surgery, which is a risk everyone is going to take. I could have complications with my one remaining kidney; by being a kidney donor you are placed at the top of the waiting list should anything happen to the one remaining kidney left. Then I started thinking about my Mother and her quality of life; she would literally be attached to that dialysis machine four hours a day three days a week. How would her quality of life be? Assuming she would be on the waiting list for over three years, to wait that long not knowing where a kidney would be coming from. Would it be from a living donor? What if it was from a deceased donor? Knowing what I know now and the potential life span of a living donor's kidney, if I was not a match, I would have done everything in my power to help my Mother ask someone for help to see if they could donate.
The hardest part of any donation is having the courage to ask someone to donate. Hollywood plays a big part in creating awareness for kidney donation. A movie was recently released in theatres called "Going in Style"; without getting too much into the movie, Morgan Freeman who plays Willie Davis, is in need of a kidney. His friends had no idea that he was in need and offer to help, this is a small portion of the movie, but what has lead up to this point is interesting. Like most movies before they are released, they have trailers that showcase the movie, press releases, and interviews with the cast. This time, The National Kidney Foundation got involved and had a short commercial not only about the movie, but a PSA on kidney donation. Using high profile actors, they use just over 1 ½ minutes to educate people on kidney donation and even refer a link to the National Kidney Foundation on how to ask for a kidney donation (The National Kidney Foundation). Creating awareness plays a big part in kidney donation, because it not only educates the person in need of a kidney, but it also educates someone who may have never thought of donating a kidney.
Most of us are familiar with how it works, we stroll into the DMV to get our license and we check a box that says "organ donor". In the event that something happens to us and we are now deceased, any of our organs can be donated to help someone in need. The majority of kidney donations come from a deceased donor (kidney link). A kidney can be flown in from anywhere for transplantation, the kidney can last up to 72 hours outside of the body before it is transplanted (kidney link). A transplant recipient will be on the waiting list and is registered through an organization called the United Network for Organ Sharing (UNOS). Once a match is found from the deceased, it is then transported to the hospital that will then perform the transplant. This happens very quickly, as I stated earlier the kidney will last up to 72 hours. UNOS works to find a match as close as they can and leave the rest to the surgeons to perform the transplantation, the doctors will find out soon enough if the body wants to reject the kidney or not. The deceased do not have the option on who they would like to donate to, or when they would like to donate. When we are alive, we decide first if we want to donate and second who we want to donate to. The first step is being willing to donate.
The advancement in kidney transplants over the years is remarkable, new machines to help surgeons perform transplants and the advancement in medicine to help extend the life of a kidney. The best of all is the new ideas that doctors have come up with to utilize the living donors that we currently have today. An article in the Seattle Times that came out in 2015, talks about the new idea to help all parties involved when it comes to kidney transplants. Doctors had come up with an idea of a 3-way kidney swap. An exchange between six different people that took place between two hospitals in Oregon and Washington State. An Altruistic donor is someone who is willing to donate and does not have anyone to donate to, this person is part of a kidney chain, and according to this article in the Seattle Times; kidney chains are becoming more and more popular across the United States (Aleccia, paragraph 11). An Altruistic donor is different from a Paired donor, whereas the paired donor has a specific recipient in mind. This is where the 3-way swap comes in; around the same time three different pairs of people were testing to see if they were a match to donate and to receive a kidney. Throughout the testing, the three different parties had realized that they were not a match for their specific recipient. Doctors had collaborated and through new technology, were able to swap all three donors with all 3 recipients; the 3-way kidney swap was a success.
The success of these swaps is due to new technology that is being tested today. A company by the name of BiologicTx is using software to help match donors and recipients through their medical checklists (Aleccia, paragraph 18). Weekly matches are ran through the system and according to the article are just like a match dating site, but for kidneys (Aleccia, paragraph 19). This is a great step in the right direction to help find living donors and better matches to ensure that the transplanted kidney has the ability to last longer than expected.
Companies like BiologicTx and their software can help find more and more living donors and continue to grow the number of successful transplants, but as of now it's still not enough. According to the National Kidney Foundation; out of the 17,107 kidney transplants that took place in 2014, 11,570 of those transplants were from deceased donors (National Kidney Foundation). There are too many people on the waiting list whose bodies are just not compatible with other kidneys. Their blood type and tissue type attack the newly transplanted kidney and it ends up failing. There are new alternatives for this; a process called desensitization will help alter a patient's immune system so that it can accept a kidney from any donor (Kolata, paragraph 3). According to the article, about 20 percent of the 100,000 people on the waiting list are so sensitive to any kidney being transplanted, that they may never receive one Kolata, paragraph 5). Desensitization will filter out antibodies from the patient's blood and then infuse new antibodies so that they will not attack the kidney after transplantation. This process will be able to help almost 20,000 people who are currently on the waiting list by either giving them the option to receive a living kidney donation or that of a deceased kidney donation.
Another alternative is being introduced to further help get people off of the waiting list. Artificial kidneys are currently being tested to see if they can be a viable solution to do the same job as a regular functioning kidney. Throughout this paper, I have talked about being a match; a recipient cannot receive a kidney without being a match. Researchers at the University of California, San Francisco may have found a way to get around being a match. "The Kidney Project" a new way to overcome the shortage of kidney donations, an artificial kidney that would work to filter waste from the blood stream just like a normal functioning kidney (Hodsden, paragraph 1). The size of the artificial kidney is that of a coffee cup and uses silicon and actual kidney cells to filter the blood; microchips help power the functions of the artificial kidney and the recipient will not run the risk of their body rejecting the kidney (Hodsden, paragraph 6). If these trials succeed, this could end the wait list for everyone and give them a successful transplant and a better quality of life.
Advancements in technology will help with shortage of kidney donations like you read above. Technology has come a very long way to help shape and create new ideas and combat the complications that doctors are having with all organ donations. The first successful kidney transplant in the United States was performed in 1954 (Kaserman, paragraph 2). Much like today, the donors were mainly from the deceased and the transplanted kidney had a short life span. With new technology, doctors have a better understanding of how the kidney will react to the newly donated organ and can create an almost perfect match to make sure that the quality of life and the life span of the kidney will reach more years than expected.
Medicine has also advanced since 1954, since then; doctors have been able test newer anti-rejection medicine so that if the patient with their new kidney runs into complications, they have a way to stop the body from rejecting the kidney.
The process of finding new ways to get patient's the kidneys that they need is continuing to grow. The wait lists and the time it is taking to receive a new kidney are far too long. By educating everyone around us, it will help create awareness and help change the minds of some that may never had thought of offering to donate. Technology, medicine, and new ideas for successful transplants are getting better and better, but that can take time. Time is what people on the donor waiting list do not have; we have people healthy enough to donate, it takes courage and the willingness to step up and help someone in need. Living donors have the highest transplant success rate than that of deceased donors; their healthy transplanted kidney will last far longer than that of a deceased donor's kidney. It is up to the people that are capable of donating to donate. One kidney donation can change the lives of many.
Works Cited
Aleccia, Joel. "3-way kidney swaps shorten waits for transplants." The Seattle Times
Columbia University. "Deceased Donor Kidney Transplant." Columbia University Department of Surgery
Hodsden, Suzanne. "World's First Implantable Artificial Kidney Could Enter Human Trials By 2017." Med Device Online
Kaserman, David L. "Fifty Years of Organ Transplants: The Successes and Failures." Issues in Law & Medicine
Kidney Link. "Deceased Donations."
Kolata, Gina. "New Procedure Allows Kidney Transplants From any Donor." The New York Times
Mandelbrot, Didier. "Living Kidney Donation."
The National Kidney Foundation. "The Big Ask: The Big Give."
United Network for Organ Sharing. "How Organ Matching Works." UNOS