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Live organ donation seems to begin safely enough

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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?’

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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.

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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

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