I'm considering donating a kidney.

I'm posting this mainly because I am wanting to hear all of the reasons NOT to do this. The reasons to do it are pretty compelling to me.

No, it's not a kidney for a relative or friend. And if it was just one stranger I would be risking my life to help (because ALL surgery carries risks), it'd be pretty easy to not do it. But I read recently some very interesting things about the National Kidney Registry and what they're doing.

A lot of times a person who needs a kidney has a relative or friend who would be willing to donate, but they aren't a match with each other. The registry has allowed for "paired exchanges", where donor A gives a kidney to recipient B, and donor B gives a kidney to recipient A. More complicated exchanges have occurred, including a recent 21 recipient/21 donor exchange in 2010.

When a person donates without a named recipient in mind, though, they start "donor chains". The original donor donates to recipient A, then donor A donates to recipient B. Donor B donates to recipient C.... etc. Since the surgeries don't have to be done at the same time and don't rely on one specific donor pair to "complete" the swap, the chain is theoretically infinite The National Kidney Registry estimates that 36 lives could be saved a year because of one person who decided to do a non-directed donation. Also, the likelihood that a single donor would be a match to start a chain of transplants is higher than the likelihood of a recipient/potential donor pair matching into an exchange since they're only dealing with one tissue type that has to match.

Not many people would risk their lives to save just one stranger. But to help save 36 of them, or more?

The reasons I've thought of *not* to do it:

1) Uh, it's like, a friggin' kidney! Those things are kinda vital! I've been trying to do some research on outcomes for kidney donors. I haven't seen any studies that show a decreased lifespan for those who survive the procedure (they seem to suggest the opposite, actually, but selection bias may be a factor because donors have to be healthy in the first place), and the mortality rate from the surgery is 3 in 10,000. There is a small increased risk for pre-ecclampsia in kidney donors who later become pregnant (and since I don't have kids, that's something I'll have to think about), but it's not an extreme risk and none of my relatives have ever dealt with it during pregnancy. If a living donor ever needs an organ transplant later on, most of the time they are given preference on the waiting lists because of their previous donation.

2) Insurance, pre-existing conditions, and finance. I currently have health insurance through my employer and my job is secure. I've had coverage for more than a year, so if I have to change insurance companies they can't subject me to a pre-existing condition exclusion. I also already have life and long term disability insurance, so I won't have to requalify anytime soon. Most insurance companies do not see having donated a kidney as a severe enough condition to refuse coverage, so hopefully if one denied me I could find another that would accept me should I lose my current insurance. The donor registry provides a temporary insurance policy to "Good Samaritan" donors so that if there are any complications treating them won't come out of my pocket. My work offers paid short term disability leave that organ donors qualify for so the time out of work wouldn't come out of my pocket -- plus for covering any time off they will get a tax deduction from the state.

3) The possibility someone I know might need a kidney later and me not be able to donate. This so far is the biggest reason I can think of not to do it. But .... if I do this, it will help clear the backlog and make more kidneys available, meaning that person would have a better chance to get a match. If more people see how well the new registry is doing to help save not just one life but many, they might donate as well and make even more of a difference. Who knows, the chain I start could still be going and the person I love might later be a part of it.

Is there anything I'm missing here as far as risks and things to think about? I'm not asking anyone to make a decision for me (unlike that silly professor that was on the news recently). I'm just trying to make sure that I've thought this decision through before making the choice and starting the process to qualify (and it's possible they may find a reason I can't donate anyway). And more heads are better than one.

Is there any money in it? :blush:

:hi:

... That *is* a consideration, I might be missing out on a financial opportunity later down the road... heh.

I'm already in the National Marrow Donor Registry -- and the donation procedure is so simple nowadays that it's pretty much like donating blood (two needles rather than one, tho, so guess it's more like plasma donation). Most marrow transplants are actually transplants of blood-borne stem cells now. The donor gets two tubes in them and their blood is filtered to harvest the stem cells. A couple of hours and it's done. Easy-peasy.

do you have to do dialysis after, for the rest of your life?

At all?

Most kidney disease affects both kidneys, so if I were to develop it later on in life it's more likely that I'd be in the same boat as I would have been if I hadn't donated. No data has yet indicated that a person is more likely to have kidney problems later, and many people are born with only one kidney.... but no data has said conclusively that there is no additional risk either.

I have a good friend who got a kidney due to the generosity of someone like you...or I should say, someone that you might become.

His kidney was part of the "paired exchange" you mentioned.

He recently got to meet his donor, and it was amazing!

I see NO reason for you not to do it, but I'm standing on the other side of this, having seen my friend get off his 10-year dialysis because of the generosity of a then-stranger.

Dialysis is no fun at all, and not everybody can stay on dialysis indefinitely. It has a lot of risks. It keeps people alive until they can find a donor, but it's not an alternative to transplants by any stretch of the imagination.

It's also horrifically expensive. Even though organ transplants are some of the most expensive surgeries done today, it actually costs the health care system more for a person to be on dialysis than it would for them to get a transplant. I was pretty surprised when I read that little factoid.

If it's as low of a risk as it seems to be to donate, and if no other compelling reasons not to donate come up for me, I think I'll end up doing it, or at least trying to see if I qualify medically. From what I've read I do, but they do lots of other tests to make sure you're in good enough of health to do it... and those tests may indicate something I don't know that would make me ineligible. I just wanted to see if anyone here had thoughts about why it'd be a bad idea (other than medical ones, I will be talking to my doctor about it first before doing any of the pre-tests to see what he thinks) that I hadn't considered already.

Even if I don't donate, I do have to say I think the Registry is *extremely* cool. It's opened up a whole new world for people who thought they'd have to rely on the anatomical gift wait list and sit on dialysis until someone died who was a match, or die themselves because they didn't have a family member who was a match. I mean, really ... 21 transplants? How great is that?? ;)