I KID(ney) YOU NOT!

October 12, 2007 11:31 PM

Did you donate your kidney?

I'm thinking of donating a kidney to a family member whose kidney failure has reached a life-threatening point. I've looked at this site, but its not super informative. I don't even know if I'm a match yet, but for whatever reasons, although I don't want to be cavalier about this decision, I just don't feel a lot of hesitation about taking this on. I'm in good health, my parents are in good health, and both my grandmothers lived to quite an old age (meaning, I think I have pretty 'good genes', for whatever that's worth). Anyway, have you or has someone close to you donated a kidney? Are there things you wish you had considered first? Resources that were particularly helpful? Anything else I should know?

posted by anonymous to health & fitness (9 comments total)

The Washington Post's auto reviewer, Warren Brown, got a kidney transplanted from one of his journalist colleagues a few years ago, and the paper ran a series of articles on the process and recovery for both of them. They then turned it into a book, Black and White and Red All Over. The articles were very good and interesting; I haven't read the book.
posted by LobsterMitten at 12:04 AM on October 13, 2007

Virginia Postrel donated a kidney, and has written about it extensively. A list of her articles is here, and you can scroll through to see which are about kidneys.
posted by happyturtle at 12:42 AM on October 13, 2007

If you actually really don't want to donate a kidney but "everyobody" says that you should/can/will and have a "perfect" kidney to donate?


But you don't want to?

It's ok. Tell the doctor in charge that you don't want to. They can, rightfully, come up with a variety of many good reasons why you aren't the right donor.

There are philosophical arguements on both sides (to cut a part out of you to give to someone else vs. not cutting a non-regenerating organ out of you to give someone else - regarding the liver; a little more complicated question).

Having two (2) kidneys is a good thihng. You can get by with one (1) but no doctor biologist willl say that you're just as well with 2.

Please don't let others 'guilt-trip' you into doing it. Know the potential (and expected) harm to yourself and the potential (and expected) gain for your relative.

To give is good, and I'm registered to give marrow and liver - but you have to consider the risks to all involved. If guilt enters into the equation; sign up and positively identifiy yourself as a donor in case of taumatic death with your local transplantation society.
posted by porpoise at 1:05 AM on October 13, 2007

I spent a few weeks taking care of a donor and recipient. I was really amazed how quickly the donor recovered and got back on her feet. Still, you have my respect. People think I do scary things for fun, but the idea of being a donor scared the heck out of me.

A few tips to avoid complications we experienced:
- Don't try to wean yourself off of the painkillers early without doctor approval, even if you are feeling good.
- Do everything you can to make sure the recipient's medical insurance is working smoothly and don't monkey with it during the process (and pray the politicians don't rearrange things for the worse in the middle of recovery). Not being able to get the medicine on time can be catastrophic.
- The Walmart pharmacy is not worth saving a few bucks.
- Make sure someone who is reliable and detail-oriented is available to sort out all of the medications for the recipient while in early recovery.

That's all that comes to mind, but I'll forward the question and see if there is anything they want to add.
posted by Manjusri at 2:12 AM on October 13, 2007

Your donated kidney could fail, and the recipient could be in the same situation, and you would have only 1 kidney. This happened to someone I know. Make sure you would be able to deal with that scenario. Good luck; this is a fantastic thing to consider. Your family member is very lucky to have you, however it works out.
posted by theora55 at 6:15 AM on October 13, 2007

I donated a kidney 5 years ago. I was 30 years old, and in good health, though overweight.

Things have changed in 5 years, I'm sure, but make sure they'll do it "laproscopically". 5 years ago it wasn't the default. I really hope it is now.

When they describe "laproscopic" as a small incision, take it with a grain of salt. It's still 8 inches long.

I had it done at the Mayo clinic in Minnesota, which was not only rather stuck-up in general, but especially proud of its assembly-line approach to patient care. Healthy people don't fit into their assembly line. I left with few good things to say about the Mayo clinic. For a variety of reasons they were the only option at the time, so we were stuck with them.

All attention gets paid to the recipient. It was hell to get any kind of follow-up care for myself. This is probably a Mayo clinic problem, but it might be worth while to line up an advocate for yourself ahead of time, because you won't feel like it after the surgery.

The recovery time in total was probably close to 8 weeks, but I was back to my admin job part time within 3 weeks and back to full-time within 5. If you have a physically demanding job it'll be a longer for you. For something like 30 days you aren't allowed to lift anything, vaccuum the rug, mow the lawn, etc.

I did have pain from the incision. The first 2 days SUCKED and eventually the hospital caved and gave me morphine. I left the hospital for a nearby hotel after 2 or so days. I was in pain a few more days after that, probably because the pain pills made me nauseous so I quit taking them. I was so afraid of throwing up and wrecking my incisions! Plus I just hate nausea more than I hate pain.

After the first week I wasn't in pain unless I did something stupid.

What I did feel was tired tired tired! Every day I felt less tired than the day before, but it took 8 weeks to feel pretty normal.

I have had no ill-effects since then. I get my kidney functions checked regularly and they're fine. I got a lecture from the nephrology department on drinking extra water, but when pressed, the MD admitted he gave the same lecture to everyone, regardless of the number of kidneys they had.

The kidney recipient was up and about in 10 hours, looking and feeling better than I'd ever seen him. It was a miracle! And 5 years later, he's still doing great, and is off nearly all the anti-rejection drugs he was on. And we weren't a perfect match- maybe 4 out of the 6 markers, or whatever they call them.

It was totally worth it. Obviously I'm still disgusted with the Mayo clinic. And I wish they'd prepped me better- they expected me to know which drugs did what, and wouldn't give me advice because they believed in "patient directed" recovery. Before I did it I researched the hell out of the after-donation effects etc but it never occurred to me to research the after-surgery effect (what pain meds are good, what's good to eat).

I was lucky enough to have my mom come with me, who's an RN, so I had an interpreter. I couldn't have done it without someone sticking by my side the whole time.

Oh yeah- the surgeon gave me an opportunity to back out every single day, including the day of the surgery. He said he would tell everyone that there was a legit medical reason why the transplant couldn't go forward, and he said he wouldn't be lying- it WAS a legit reason. I don't know if your surgeon would be the same way, but I thought it was cool of him. (In fact, he made some comment that made me think he felt a little guilty about performing surgery on someone completely healthy.)

If you have any questions feel free to email me, though my info might be out of date by now. Not to mention my memory, which is pretty terrible even without meds to blame. Now I wish I'd kept a journal or something.
posted by small_ruminant at 12:22 PM on October 13, 2007 [24 favorites]

A reply from the kidney recipient:

"On Jan 2, 2007 my wife donated a kidney to me. While it is a major operation and there is always a risk with surgery, the transplant went off with no hitches.

At the time of the operation, I was 66-years-old and she was 65. I had been on dialysis for 8 1/2 months.

Dialysis is very rough on the body. I went 3-hours, 3-times a week. The procedure takes a lot out of a person. It wiped me out for the day. In order to function at all, I had to take a 2 to 3-hour nap afterwards. Besides that, a person who is on Dialysis has a very limited diet. He/she must also drink as little liquid as possible. It is a miserable time, to say the least...

Before the transplant can take place, both the donor and recipient must undergo extensive testing. The Doctors said that the tests would take approximately 4-months. As it turned out, they took 6-months. I had to really push them to get it done as we wanted to make a trip overseas.

My wife and I were not a close match; Out of 6-markers, we only matched on one. the anti-rejection drugs are so good now days, that being a close match is not as critical as it once was. She is A Neg and I am A pos. I understand that if the blood types had been reversed, I would not have been able to accept her kidney.

The operation seems to be a little tougher on the donor. I am not exactly sure why this is. Perhaps it is because the recipient is pretty sick already and the new kidney makes him/her feel better immediately. Or maybe because in the process of getting the kidney from the donor, the surgeons have to move some of the other organs around a bit.

A little known fact is that with the recipient, the old kidneys are left in. The new kidney is placed in the front, just above the groin on either the left or right side, and the plumbing is changed.

I am a professional musician. Three weeks after the surgery, I was able to begin playing gigs. However, it was 3-months before we both were fully recovered. We had to be very careful not to lift anything over 10-pounds.

A person can live very well with only one kidney. There are no side-effects or problems.

Donating a kidney to someone is a wonderful thing to do. Also making sure that your body parts can be harvested after your death is something that everyone should do."
posted by Manjusri at 5:07 PM on October 13, 2007

I didn't donate a kidney, but I received one (well, actually, two - baby kidneys from a deceased 18 month old. An experiment). I had several people offer to donate one, but they couldn't get medically cleared. (As porpoise says, any transplant doctor will provide you with a fake medical excuse to get out of donating a kidney if that's what you want. But i know the medical problems with the people who wanted to donate to me were real). If you do volunteer to donate, the doctors will check you very, very thoroughly. About 50% of those who want to donate are ruled out for medical reasons. Many people find out that they have something wrong with them for the first time when they undergo these examinations.

Donating a kidney is a generous act. But make sure you want to. Do not do it out of guilt or duty, because you'll regret it later. Do it only if you look at it as a gift you want to give.

Realize that there is a chance that the recipient will reject the kidney. It's a small chance with a live donor, but a real one. Make sure you would be okay if that happened.

The main risk of giving away a kidney is that it involves real surgery and going under anesthesia. Obviously, surgery is not uncommon, and 99+% of the time people come out of fine. But there are no guarantees, and sometimes people go under anesthesia and never come out. If you go ahead, make sure you are comfortable with the surgical team and how they will put you under.

Transplant surgery is painful. Laparoscopic surgery is definitely preferable, but I don't think every doctors does it that way even today. Recovery times vary on how the surgery is done and how quickly you tend to recover, I think the earlier estimate of 8 weeks for total recovery is reasonable.

Is having one kidney instead of two a real risk? Yes and no. There are many cases where having a second one won't help, because diseases that attack the kidney tend to have similar affects on both. However, if you are run over by a car and one kidney is damaged, having a backup is definitely a very good thing. Similarly, there are times it would be good to have backups of other organs.

Note that if you give away a kidney and you ever have trouble with your remaining kidney and need a transplant, you will immediately be placed at the very top of the transplant list. In very rare cases, a person could actually end up better off in the long term because they donated a kidney as a result, since whatever destroyed the one kidney left might have destroyed both of them had there been two.

Finally, as a recipient of a kidney, albeit not one from a live donor, I can tell you it makes a huge difference. Now, a kidney transplant is not a cure; it won't make the recipient 100% healthy. Taking anti-rejection medication can be very tough, especially in the early months after the transplant when the dosages are very high. In addition to the anti-rejection meds, most people will end up taking medications to deal with the side effects of the anti-rejection meds as well as medications to deal with the side effects of the medications dealing with the side effects of the anti-rejection meds. It can be quite difficult for some people. But for most people, I think it's a big improvement over "living" on dialysis - or dying.
posted by spira at 5:17 PM on October 14, 2007 [1 favorite]

I did, nine years ago. It lasted for 3 years in my mother, before it failed. The difference in her quality of life was immeasurable. Since I had it done laproscopically, it wasn't even a big deal. I was back at work in about 8 days. No long lasting effects that I can notice in me.
posted by Cataline at 6:05 PM on October 25, 2007 [1 favorite]