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Ask The Kidney Donor

Posted Jul 13 2009 10:38pm
I’ve been answering a lot of email questions lately from prospective kidney donors trying to decide whether to go forward with the procedure. The same questions always seem to crop up. Here they are:

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-- I’m thinking of donating a kidney and my friends and family are freaking out! What should I tell them?

I'm happy to answer any questions, but I don't want you to think I'm talking you into donating. It is a very personal issue, and you should make it based upon the facts of your life.

My friend Virginia Postrel wrote a great article called:

"Here's Looking at You, Kidney: How and why I became an organ donor -- and how I kept people from talking me out of it."

http://www.dynamist.com/articles-speeches/opeds/kidney.html

Her article started me thinking about donating, and her patience with my many dumb questions helped me during my own discernment process.

Most family members' objections boil down to:

1. Fear of the surgery
2. Fear of living with one kidney

Remind your friends and family of the following things:

The donation of a kidney is laparoscopic surgery, meaning small incision and quicker recovery. Most donors are out of the hospital on the next day, back at work in two weeks, and back to normal in a month. The surgery is no more dangerous than any procedure done under general anesthesia. The anesthesia is the real risk factor. Check out your doctor and transplant center. Get comfortable with both. Ask a lot of questions.

There is no scientific evidence in 50 years of living kidney donations that there are any ill effects to living with one kidney. Within five weeks of donation, the remaining kidney swells in size and increases its filtering power (the "glomerular filtration rate") to match the power of two kidneys. In short, you'll have a single super-kidney instead of two simply adequate kidneys.

When kidney disease occurs, it nearly always strikes both kidneys at the same time. It's not like one kidney fails and you find yourself knocking on wood, thankful that you've got a spare. If I should develop kidney disease, I will need treatment or a transplant – just like I'd need if I had two kidneys. If a kidney donor needs a transplant, they go straight to the front of the line on the kidney transplant list, which seems like a very fair deal to me.


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--- What about saving your kidney in case one of your kids needs it someday?

This is the best argument I've heard against donating. That said, I couldn't justify not saving a life today because it might inhibit my ability to possibly save one in the future. My wife has a spare kidney for them, and we both have loving families who may be willing to help if one of my kids is in need of a kidney. Moreover, neither my family nor my wife's has any history of kidney disease, obesity, or diabetes.

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--- What if something happens to your remaining kidney and you end up needing your second one?

Again, my family has no history of kidney disease. When kidney disease occurs, it nearly always strikes both kidneys at the same time. It's not like one kidney fails and you find yourself knocking on wood, thankful that you've got a spare. If I should develop kidney disease, I will need treatment or a transplant – just like I'd need if I had two kidneys. If a kidney donor needs a transplant, they go straight to the front of the line on the kidney transplant list, which seems like a very fair deal to me.

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-- What if the transplant fails? It will have been a waste!

It happens. Then you will probably feel a real sadness but no regret about your ultimate decision. All you can do is all you can do. The rest is up to the doctors, God, and your recipient's body. Blood donors don't expect accountability and ultimate success regarding the ultimate success of their donations. Kidney donors shouldn't expect it either.

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-- Have you had any residual pain or a feeling as if something is "missing?"

Nope, not even a little. In fact, if this were a science-fiction thriller where I was "missing" the memory of the 6 months following surgery, I would not have known it happened at all. Except for some small scars on my abdomen (see below).

The recovery process works in stages where there is some abdominal swelling (only you and your pants will notice) and the incision points will be tender for maybe six weeks after the surgery, but nothing permanent.

I found myself rather sleepy at night for six months following the surgery (like 9:30 p.m., rather than 11:00 p.m.). I think I was still healing internally. I think that evolved into a habit where I now go to bed earlier than I once did. I don't think this is kidney-related as much as I just became accustomed to being well-rested and getting an appropriate amount of sleep. I only mention it because I have spoken to many others who found themselves rather sleepy at night long after the pain of the surgery had gone away.


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-- Have you had to make any significant changes in your diet and/or exercise routines?

Not really. No more knife fighting for me. I used to be an amateur boxer, but I gave that up long before my surgery. Had I continued boxing through the time of my surgery, it would have been wise for me to stop since repeated blunt trauma to the one remaining kidney could evolve into a melancholy situation.

There are some drugs synthesized in the kidneys, such as ibuprofen, that you may want to avoid as to not over-task your remaining kidney. Tylenol is fine. I still take ibuprofen once in a while because it works better.

I've been a strict vegetarian for nearly 20 years. In theory, I guess it would be unwise for me to start gorging on buttsteaks, become obese, and contract Type 2 Diabetes. But that would be a dumb idea anyway... A kidney donation should not affect your diet.

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-- Will I have to give up drinking alcohol?

There are a million reasons to quit drinking, but a kidney donation is not one of them. Feel free to drink all you please. The liver takes the beating from your boozing, not the kidney.



-- How have your scars healed?

There are three scars. The two right beneath my left ribcage look like healed bullet holes which accentuates my gangsta image. The three inch scar along the elastic-line of my boxer shorts is generally hidden from the public. None of them are particularly unsightly. They are pinker than my skin, but I did absolutely nothing to treat them or care for them. Now that I live in Hawaii, they're probably getting too much sun.

This may call for some airbrushing when you appear in a 2010 swimsuit calendar, but I'm certain you won't be alone.



-- Have you seen any changes in your overall health?

None whatsoever. My blood-work continues to be far within the normal range, and I feel like a million bucks. Again, I want to stress, there is absolutely no difference in my health or my life before and after (pending recovery) the procedure.



-- What have you learned?

From a public policy perspective, I think “altruistic” donors should consider starting a kidney chain where they could save a dozen lives with their kidney, rather than just one. Here’s a great article describing how it works:

http://www.theatlantic.com/doc/200907u/kidney-donation

These were less common a few years ago when I set out to give away a kidney, and I’m overjoyed to have helped my recipient, Brenda. But for people who have no recipient in mind, kidney chain donations clearly do the most good for the most people.
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