Wednesday, March 07, 2007

If Anyone is Interested in Being a Donor...Read This. Thanks!

Hi there everyone! Stacy here! We are moving ahead full steam on getting Julian's Transplant Evaluation completed. This Friday is his EKG and his Ultrasound, as well as more labs! They've got to take 40 ml of blood in total for the tests, so we are trying to space it out so he has 3 or 4 draws over a month and a half or so, since he's still such a little guy and borderline-anemic. We resumed giving him Epogen shots once a week a few weeks ago, and boy does that break my heart! We have to do it ourselves. He is so confused after it's over, that we could stick him like that! I don't know who cries more, him or us! The Epogen is to try to increase his red blood cell production, as he needs to be "tanked up" for the transplant.

Several of you have inquired about what being a kidney donor looks like, so I wanted to post the information on the Blog incase you are interested in looking into it further. Especially any of you with O+ blood!

First off, let me say we would be humbly grateful to any of you who decided to be tested. Once you have decided you would like to be a potential donor, which is an intensely private decision and should be decided by your whole family, the next step is for you to call the Transplant Coordinator at Denver Children's Hospital. You must initiate the first call, and then she will work with you every step of the way. The first test is a simple blood/tissue typing test I believe, which would either give you a green light (ie you are a match) or would rule you out. The Transplant Coordinator's name is Diane Dovel, and her direct phone number is (303)764-8463.

Next, I looked in our manual we were given last week and it contains the following information, verbatim

"Living donor kidney donation is when a living person donates a kidney to the potential transplant recipient. Live donors must be healthy individuals that have been evaluated and identified as capable of undergoing surgery safely and living a healthy life with only one kidney. These donors are usually genetically related, such as a parent, an adult sibling or child, aunt or uncle, young grandparent, or other close relative (*sidenote from Stacy---they do not NEED to be related they just need to be a perfect match).

Potential live donors will undergo a complete evaluation before a final decision is made. Only those persons who are compatible and have no contraindications will be considered as potential donors. Sometimes people who are interested in being a living donor are not approved because of certain medical and/or psycholosocial circumstances.
Contraindications include (*meaning you'd probably be ruled out if you had the following):

*Significant health history (history of cancer, childhood diseases or other medical problems)
*Surgical history (abdominal surgery scar tissue may complicate nephrectomy)
*Current medical problems (high blood pressure, obesity, diabetes)
*Age (18 years to 55 years)
*Infectious diseases (hepatitis, HIV)
*Anatomy of kidneys (single kidney, multiple arteries)
*Social circumstances (single parent without significant support or extended family)
*Mental health illness (would require current mental health care provider evaluation)
*Alcohol or drug use (significant history of substance abuse)

The transplant team wants to ensure that the kidney donation is a safe and uncomplicated procedure for the donor and the best option for your child. If there is any concern about the safety of the donor, the procedure cannot be done. Being a kidney donor requires a great deal of commitment and responsibility to follow through with the many tests and examinations. The Living Donor Information Section has complete details of the evaluation, surgery and recovery.

The kidney donor must be healthy, and free of kidney disease or any other illness. The evaluation begins when the donor comes to the transplant team and has made the decision to become a live donor. Blood typing is one of the first tests performed to confirm their compatibility with the recipient. If the donor's blood type is compatible with your child's, the donor will then have a complete history physical examination.

It is important that the primary physician is involved when possible, because they are the most familiar with the donor's history and health. During this exam, several tests are performed that involve drawing blood, collecting urine and stool samples and an EKG and chest X-ray are performed. Most of the initial tests are part of the potential donor's annual physical exam. The next phase, and each consecutive phase, is taken only if nothing contraindicated is discovered that can eliminate the individual as a potential donor. When the evaluation is completed, the potential donor will have been screened for any infections, diseases and anypathology of the kidney that would eliminate them as a potential kidney donor.

Once an individual has been accepted as a live donor, the surgery can be scheduled and final preparations are made. The operations are done at the same time at The Children's Hospital. Two perating rooms are reserved and two to three transplant surgeons are scheduled for the day of surgery. The operation to remove the healthy kidney from the donor is called a nephrectomy. It is major surgery, and the surgical technique to remove the kidney and the risks involved will be discussed in detail with the donor prior to the operation. Post-operative
recovery occurs at The Children's Hospital and hospitalization can be up to five days, depending on the type of nephrectomy. Pain management is important allowing the patient to recover more comfortably. Following discharge, an additional 2 to 6 weeks may be necessary for a full recovery.

Your child's insurance, or Medicare, covers surgery expenses and may cover some of the donor evaluation. It is important that the potential donor's insurance company is notified of the indiviual's desire to donate. Any benefits or policies regarding insurance coverage need to
be discussed and understood before the evaluation. Written financial approval and generated referrals in compliance with their insurance policy are the donor's responsibility. Time off from work and cost of living expenses that may occur during the recovery time are the responsibility of the donor and you family. The transplant program is committed to helping your family utilize available resources that can help when addressing these issues.

In summary, the benefits of receiving a kidney from a live donor are
many, and include:

*Scheduling surgery at a convenient time for the donor and recipient
*Improved compatibility with genetically related donor (for example,
increased number of matching antigens with parents and siblings)
*Improved health of the kidney (no trauma related to the cause of
*Decreased ischemia (time kidney is on ice)
*Decreased episodes of acute rejection
*Immediate recovery of kidney function

Disadvantages to live donor transplant are mainly related to the risks of requiring a healthy individual to undergo a medically unnecessary surgical procedure. Any surgical procedure has risks that include anesthesia, risk of bleeding or blood clot formation, wound infection, and the experience of pain."