Hive Health Media

The Complicated World of Kidney Transplants

Waiting for a kidney transplant can create a hardship that affects more than just the patient and his family: for most transplant patients, there is a veritable obstacle course to traverse before—or even if—a suitable donor is found. But the journey doesn’t end once a patient finds a match.

Complications during and after a transplant surgery can complicate recovery for kidney recipients. Patients and families facing this tough, long ordeal have several critical issues to consider while they work toward finding a donor.

Tips for Ensuring a Safe Donation

Kidney transplants have advanced significantly in the last twenty years: living donors have become increasingly common for transplants, and with anti-rejection medication becoming more effective, transplant patients can find matches more easily and have more active and fulfilling lives. However, rare and tragic issues can arise throughout the transplant process.

A recent investigation involving the University of Pittsburgh Medical Center (UMPC) revealed that a transplant patient received a kidney from a living donor with Hepatitis C. Because carriers of the virus don’t always exhibit symptoms, it’s possible that initial screening did not reveal the donor’s full medical history. As a result, UMPC has voluntarily suspended their transplant program. For patients still waiting for a transplant, the field of medical centers has gotten smaller: medical centers like IU Health in Indianapolis, IN, offer alternatives to patients in the Pittsburgh area.

Building Connections to Save Lives

Pioneered in Baltimore, Md., the “daisy chain” method is steadily becoming an effective way for donors and patients to find their best matches. The process begins with an altruistic donor, a person who has no motives other than helping a patient in need of a kidney transplant. If the person to whom the donor wants to give his kidney is not a good match, the prospective recipient (or her family) can choose to donate the organ to a patient who does match the original donor.

Chains like this can include several patients and donors, such as the chain of 13 patients who received transplants in 2009. In addition to being an efficient way for hard-to-match recipients to find matches, the process has proven to be successful for cutting down on the need for simultaneous operating rooms and surgeries.

Learning About the Process

The United Network for Organ Sharing (UNOS) is the non-profit organization that manages the country’s Organ Procurement and Transplantation Network (OPTN). The organization maintains the nation’s transplant waiting list on a 24-hour, 365-day-a-year basis, and offers education to the public about the process of donation and transplant surgeries.

For families with a transplant patient waiting for a kidney, learning about the process of donation and transplant is paramount. Medical centers who perform donation and transplant surgeries also offer education and support to patients and their families. The most important aspect of receiving a kidney is preparing the patient and his family for any and all possible outcomes, and supporting the family during their time of need.

Thomas Stone is health blogger at doseofmyown.com and he focuses primarily on the benefits of exercise and nutrition for health.

6 Comments

  1. Kidney Transplant Surgery

    June 9, 2011 at 7:13 am

    In a Living Donor Kidney Transplant Surgery, the donor must be a close relative or family member only. The suitability of the donor for the donation would be determined by the Renal Transplant Team after studying the various aspects and performing a series of medical tests.

    • Robert F. Hickey, Ph.D.

      September 22, 2011 at 10:03 am

      Your statement is incorrect. There are no federal or state laws dictating living donors must be “close relative or family member only”! However, each transplant center can establish their protocols with federal regulations. In doing so, some centers refuse to accept altruistic, non-related, living donors. One example is Standford Medical Center. In my advocacy efforts I always recommend transplant candidates avoid such centers.

      • Monica

        October 3, 2011 at 12:53 am

        Mr. Hickey,
        OneLegacy in Los Angeles is the MOST UNETHICAL COMPANY my friends have ever worked for. 65% of OneLegacy’s Tissue Department either quit or were let go due to OneLegacy’s highly unethical practices. OneLegacy’s CEO made around $661,000 in 2009 alone. Then,the company laid off a lot of people late last year or early this year due to budget cuts. The jobs of these poor people who were laid off would have been saved if OneLegacy’s top management took a pay cut. A group of Onelegacy employees met with the media to divulge OneLegacy’s HIGHLY UNETHICAL practices but OneLegacy’s media department found out about this meeting and every employee in the Tissue Department was threatened with a small severance package to leave or quit their jobs if they participated in divulging OneLegacy’s evil practices and are unhappy with OneLegacy. The 65% of employees who left cannot believe the government’s oversight. The tissue department alone makes $250,000 (PER PERSON)PER TISSUE DONATION (That is skin, bones, corneas, heart valves and pericardium). This amount does NOT even include the amount made from the ORGAN DONATION (That is heart, liver, kidney and pancreas). The tissue department management insisted on getting 8 to 10 tissue donations per day. That means 8 to 10 or more people must die to make this possible. PEOPLE ARE TRULY TREATED LIKE NUMBERS HERE. Then OneLegacy throws a party for the donor families as propaganda for good public image. They treat their employees like crap although those employees still working there will not have the guts to say this out loud because they all need their jobs to pay their mortgages, bills, kids’ education, etc. . . . . The COO has threatened the tissue family coordinators on several occasions that they are all lucky to have jobs and to leave if they are unhappy. The management team is also mostly married to each other which is a violation of the company’s policy. 6 people in top management are all married to each other. In fact, they check or audit their spouse’s work. Hmmmmmmmm . . . . . . Sooooooo many cover ups. Soooooooooo MANY SECRETS at OneLegacy !!!!!!!! The tissue department manager in fact just recently (July of this year) instructed 2 coordinators to do something highly UNETHICAL and insisted that they follow his orders since both coordinators initially refused to follow his orders. Someone has to go head to head with OneLegacy. THE PEOPLE OF LOS ANGELES MUST PETITION THE TISSUE DONATION PART OF THE ORGANIZATION TO BE GIVEN TO ANOTHER NON-PROFIT TISSUE DONATION ORGANIZATION TO AVOID THE COVER UPS AND MONOPOLY SINCE OneLegacy handles both the Organ and Tissue donation in the 7 major counties of Southern California. OneLegacy COO stated that making them handle both the Organ and tissue donation creates convenience. Yes, this creates CONVENIENCE ONLY FOR ONELEGACY AND LOTS OF MONEY FOR ONELEGACY. ONELEGACY WORKS WITH FOR PROFIT TISSUE PROCESSORS where your loved one’s donated body parts are then considered as a commodity and profit. LOS ANGELES, PLEASE, FOR OUR SAKE, PETITION that a RESPONSIBLE NON-PROFIT TISSUE DONATION ORGANIZATION (EVEN ONE RUN BY A MAJOR HOSPITAL) MUST TAKE OVER TISSUE DONATION IMMEDIATELY. These millions and millions of dollars made by OneLegacy should be handled by a NON-CORRUPT, HIGHLY ETHICAL and RESPONSIBLE non-profit organization whose goal is actually to help people and save lives and not mainly to profit from the grief and loss of others. GOD BLESS!

  2. 1GiftofLife

    May 31, 2011 at 1:46 pm

    I agree with both Robert F. Hickey comments above. I agree with livingdonor101 that living donors should receive much better follow-up post-transplant. However, from what I’ve seen volunteering with hundreds of kidney patients,transplant programs do a lousy job of educating patients on how to solicit a living donors, as do many nephrologists. This is unfortunate because most patients trust the system, and do not know about the conflict of interest that keep them on dialysis. Dialysis patients should not be cash cows for the providers. This story illustrates potentially grave consequences for the patient, as well as the unfortunate for the transplant surgeon and nurse, who probably wanted to do the right thing — but didn’t! Unfortunately, marginal donor organs are being foisted by UNOS on the unsuspecting public, including kidney patients and their trusting loved ones. It’s called extended criteria donation programs. While some people are willing to take the risk of an extended criteria organ, e.g., a deceased donor with moderately elevated blood pressure, most patients are not aware of the risks.

  3. livingdonor101

    May 30, 2011 at 11:52 am

    Not surprisingly, this entire article focuses on the treatment of the recipient. What the transplant industry conveniently forgets is that living donors are people too. Yet 50 years after the first living donor transplant, there is NO long-term data on living donors’ health and well-being, there is NO standardized evaluation, selection, or treatment for living donors. And asd Hickey pointed out above, there is NO oversight or protections given to living donors or living donor programs.

    4.4 living kidney donors die every year in the US within 12 months of surgery. Many others experience serious debilitating complications: hernia, pancreatits, adrenal dysfunction, chylous ascites, intestinal swelling and sensitivity, intestinal blockage, etc.

    40% of liver donors experience complications post-surgery.

    20-30% of living donors experience depression, anxiety, anger and PTSD yet not a single transplant center offers aftercare or support services.

    UNOS and OPTN profit from transplants; they have no interest in ensuring that living donors are cared for, short or long-term. Stories abound from living donors regarding bills for complications related to the donation, and abandonment by their transplant center. The fact that transplant programs ‘educate’ thier would-be recipients on how to solicit a living donor is a clear indication of where their priorities lie.

  4. Robert F. Hickey, Ph.D.

    May 29, 2011 at 1:33 pm

    First, the so-called nonprofit, private gov’t contractor, United Network for Organ Sharing (UNOS) has no authority over living donor transplants. In fact, it is prohibited from doing so under the provisions of the National Organ Transplant Act (NOTA) 1984. That is not to say that UNOS is not trying to get NOTA modified to allow it to take such control. If it does happen the presently unfair, unethical, and corrupt US transplant system will cause the deaths of even more patients.
    Second, no one gets an oragn donated to them if they need a transplant. The 58 ‘nonprofit’ Organ Procurement Organizations (OPO) across the country are permitted by NOTA to charge a “REASONABLE” processing fee for each organ. The average fee for a kidney is $45,000.00. The price for other organs goes up from that point. These fees are euphemistically referred to as ‘Organ Procurement Fees’. They generate bilions of dollars annually to the OPO. As an example, LifeLink a Tampa OPO had total revenue as reported for 2008 on their IRS 990 nonprofit tax return of $70 million. The top 2 executives for this supposed nonprofit had salaries of $602,000.00 and $597,000.00 with 10 other managers paid over $200,000.00.
    OneLegacy in LA pays its CEO more than &650,000.00 on $68 million in revenue from Organ Procurement Fees. A recent audit by HHS Inspector General revealed that executives of OneLegacy sp[ent more than $341,000.00 on Rose Bowl parties including more than $100,000.00 on a New Year’s Eve party. The UNOS CEO is paid more than $500,000.00 annually on $35 million in revenue. TMany of these OPO also own tens of millions in realestate holdings including UNOS with its $20 million headquarters building in Richmond.
    Yes, patients and their families have a long and needlessly difficult struggle on the path to organ transplantation. Most of it caused by an unethically corrupt system.

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