Live organ donation seems to begin safely enough

If no good deed goes unpunished, living organ donors may have need to worry. L.A. Times columnist David Lazarus weighs in today with a look at one possible effect of organ donation on such donors.

In Organ donors run risk of being denied health insurance, he writes of kidney donor Patricia Abdullah who recently lost her job and thus her health insurance: "Now she wonders what will happen if she can't find another job with group coverage. If she turns to the individual insurance market, will her act of compassion as an organ donor be perceived by insurers as a 'preexisting condition,' resulting in higher premiums or even denial of coverage?"

Advocates for organ donation say such things happen. Insurers say, well, it depends on the person.

Regardless, the need for such donations can't be denied.

What does seem clear is the relative safety of kidney donation for most people. Here's an L.A. Times report from earlier this year: Kidney donors have a normal life span, study finds

And notes this synopsis published this month in the journal Advances in Chronic Kidney Disease: "Living kidney donation continues as the cornerstone of transplantation. ... Currently, it can be stated that living donation is, on the whole, safe, with few perioperative deaths, complications, or long-term medical issues." 

(Click the jump to read more. If you've never seen one, on the jump is a close-up view of a kidney transplant surgery.)

That report goes on to reflect on what demographic changes could mean for such safety, on the varying levels of risk -- and on the need for continued surveillance: "Additionally, the living donor reflects the demographics of the general population including increased rates of obesity with some donors having hypertension and low-grade proteinuria. In the long run, death rates (for the white donor) are no different than for the general population, whereas end-stage renal disease rates are slightly increased over the general population, ranging from 0.1% to 1.1%. The higher risk is especially notable in the black donor. Preeclampsia in female donors may also be marginally greater than in those with 2 kidneys. Thus, the new health age brings a rejuvenated responsibility of the medical community and those in governance to design systems that allow more complete and continued follow-up of the living kidney donor, especially those of color."

But more followup and more assessment begins with more donations.

Here's an overview of living organ donation from the United Network for Organ Sharing. (Most living organ donations are for kidneys, though it's possible to donate a portion of the liver or lung.)

To actually see what's involved, check out this video of a kidney transplant surgery, filmed at Sentara Norfolk General Hospital in Norfolk, Va., earlier this year. And here's Baltimore Sun coverage of a recent domino kidney transplant involving seven pairs of people, plus the man who started it.

As for health insurers who don't want to be seen as an obstacle to organ donation, Lazarus has some suggestions. Among them: "They should reward organ donors by offering, say, a 15% discount on premiums for at least five years as an incentive for helping others."

Of course, that would mean that we can get away with at least some good deeds.

-- Tami Dennis

Photo: A kidney is implanted during a live donor transplant in England.

Credit: Christopher Furlong / Getty Images

 

Comments

[LIFESHARERS]

The generosity of live organ donors like Patricia Abdullah is wonderful. It’s a shame we need so many live organ donors. Americans bury or cremate 20,000 transplantable organs every year.

There is another good way to put a big dent in the organ shortage – if you don’t agree to donate your organs when you die, then you go to the back of the waiting list if you ever need an organ to live.

Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. About 50% of the organs transplanted in the United States go to people who haven’t agreed to donate their own organs when they die.

Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. LifeSharers has over 12,000 members, including 1533 members in California.

Please contact me - Dave Undis, Executive Director of LifeSharers - if your readers would like to learn more about our innovative approach to increasing the number of organ donors. I can arrange interviews with some of our local members if you’re interested. My email address is daveundis@lifesharers.org. My phone number is 615-351-8622.

[LivingDonor101]

While the medical community has been harvesting organs from living people for over 50 years, they have actively resisted a registry that would track and study them comprehensively. Transplant centers do not feel living donors are their responsibility the moment they are discharged from surgery.

Bleeding, blood clots, testicular swelling, hernias, intestinal binding, adrenal gland dysfunction, laceration of the liver, spleen & diaphragm, nerve damage, hypertension, severely reduced kidney function - these are but a few of the possibie consequences of living donation.

It is well known that living donors suffer from depression, anxiety and PTSD, yet only ONE transplant center in the U.S. offers any aftercare or support. The remainder refer the donor to their primary care physician (if they have one) to avoid having to report the complication on their records.

Educate yourself about living donation before encouraging it further. There is no definitive proof it is safe. In fact, nearly 200 living donors since 1993 have been placed on the UNOS waiting list.

www.livingdonor101.com