The World Organ Donation day is celebrated every year on the 13th August. Each year about 150,000 to 200,000 people in our country develop Stage-V chronic kidney disease and require kidney transplant.
Kidneys for transplant may come from a person who has died (a deceased donor), or from a healthy living person, most often a family member or friend, who offers to donate a kidney (a living donor).
The usual source of deceased donor kidneys is from brain dead donors and usually this happens after road traffic accidents. Each year in India approximately 7,000 people only receive transplanted kidneys from living donors and but less than 100 receive kidneys from deceased donors.This is despite the fact that we have one of the highest road traffic accident rates. Thus there is a great gap between demand and supply of the organs.
The low organ donation rates in our country are due to lot of myths and disbeliefs that are prevalent amongst us. What is very discouraging is that here are regional imbalances in organ donation. The deceased organ donation rates have picked up considerably in the southern and western parts of our country while those in the North are amongst the lowest.
Here, I will simplifysome facts related to organ donation and answer some of the basic questions related to kidney transplant.
What are the two kinds of kidney transplants?
A living donor kidney transplant is an operation where a living person donates his or her kidney to someone whose kidneys are no longer working.
A deceased donor kidney transplant is an operation where a kidney is donated from someone who had died and transplanted into someone whose kidneys are no longer working. One transplanted kidney can do 50-85% of the work of 2 working kidneys.
Is living donor transplant and deceased donor transplant different in any way?
Yes. Living donor transplants last longer than deceased donor transplants because a living donor kidney is removed from a healthy donor in the operating room and transplanted right away. Generally, living donor transplants last 15-20 years and deceased donor transplants last 10-15 years.
Who can be a living donor?
A living donor is a volunteer who is physically healthy, does not have kidney disease and has a blood type that matches the recipient.
What if I don’t have a living donor?
Patients who do not have a living donor can wait on the national organ transplant waiting list to get a deceased donor transplant. However in our country, this wait can often be endless because of the low rate of deceased organ donors.
Which kind of transplant happens faster?
If a living donor is available, transplant happens faster, often within one year. With a deceased donor transplant, on an average most patients have to wait few years until a kidney is available from the list and the length of the wait varies greatly by blood type. Sometimes a matching kidney is never found.
What are the risks of Living Donation?
When deciding whether to donate, it is important that you understand all the possible medical, psychological, and financial risks. You can stop pursuing living donation at any point if you decide that this is not the right decision for you.
How does the transplant team keep living donors as safe as possible?
A potential donor goes through a medical and psychological evaluation to make sure that it is safe for him or her to donate. The main aim of the transplant coordinator as well as the rest of the teams is to protect the rights and health of potential living donors. This person makes sure the living donor is not being pressured into donating. The transplant team will not accept the potential living donor for surgery if there are any large risks to the donor.
What are the medical risks of the surgery?
In the short-term, there are risks of complications during surgery. Normally the doctors remove the kidney through a very small opening - a few inches in length. If complications arise, the opening may have to be made larger and recovery time will be longer. The donor might have bloating and nausea afterwards. Like other surgeries, the donor will have scars, pain, and fatigue. The risk of medical problems from donation surgery such as problems from being put to sleep, infection, fever, bleeding and blood clots is less than 5%. The risk of death from surgery is less than 1%.
Can living donors still have children after they donate?
A woman and man who donate a kidney may still have children. It is advised that a woman wait one year after donation before getting pregnant so that her body is recovered completely.
What are the psycho-social risks to living donors?
It is very important that living donors do not feel pressured into donating. Donors can stop the transplant at any time. The donor’s relationship with the kidney recipient might change because of donation. He or she might have body image changes. Also, there is no guarantee how long the donor kidney may last for the recipient. On an average, a living donor kidney lasts 15 years, but the kidney transplant may only work for a few years or not work at all. The donor may feel upset or guilty if the kidney they donated isn’t working well afterwards.
Will a living donor have health problems after donating?
Research has shown that most living donors – over 100,000 so far – remain just as healthy after donation as people who have not donated. Kidney donors are not more likely to get kidney disease after donating. For most donors the remaining kidney works fine for the rest of their lives. Some kidney donors might get high blood pressure or diabetes in the future. Less than 1% living kidney donors lose their remaining kidney.
After donors donate their kidneys, what happens to their kidney function?
After the donation, the donor’s remaining kidney takes over the work of two kidneys. Donors have similar kidney function with one kidney to what they had before surgery – enough to live a long and healthy life.
Will organ donation affect funeral and burial arrangements?
No. Removal of organs or tissues will not interfere with customary funeral of burial arrangements.
Will the decision cost anything to the donor’s family?
No. The cost required for maintaining the donor will be borne by the recipient’s family or by the hospital from the time the consent for organ donation is given.
It is time for all of us to come together and raise greater awareness about kidney donation. There is no religion that discourages organ donation. We do not need to take our organs to heaven, as we need them on earth to save precious lives. We need to remember that each deceased donor can give life to five people (two kidney patients, one liver patient,one heart patient and one patient for eyes). In this way a person can continue to be remembered and stay alive in our memories even though he may be physically no more.
It is high time that we come out of our inertia and get together and pledge to donate our organs. Please remember that we need not take our organs to Heaven as we require them on Earth to save the lives of other human beings.
(For more information regarding kidney transplant, visit Author’s website www.kidneyklinic.com)