Daily Press

Life expectancy unaffected by donation

- — Eve Glazier, M.D., MBA; and Elizabeth Ko, M.D. Send questions to askthe doctors@mednet.ucla.edu

I was surprised to find out that a co-worker gave his nephew a kidney several years ago. He never mentions it and I don’t want to invade his privacy, but I would like to know more. What does it take for someone to donate a kidney? Is it safe?

Dear Reader: Your co-worker is a living donor — the donation of an organ by someone who is alive.

The kidney is the most frequently transplant­ed organ from a living donor. While less common, it is also possible to donate a lobe of the liver, all or part of a lung, a portion of the pancreas or intestines. The majority of the 6,000 organs provided by living donors each year come from relatives, loved ones or close friends. A small number come from a donor who has chosen to help a stranger in great need. Whatever the circumstan­ces, becoming a living donor is a weighty decision that requires serious thought.

Depending on the transplant center, the prospectiv­e donor must be at least 18 or 21 years old. They must also be mentally competent to make the decision to donate and be in good health. Conditions that can interfere with becoming a living organ donor include diabetes, cancer, uncontroll­ed high blood pressure, hepatitis, HIV or an active infection. All of this is ascertaine­d during the evaluation that is required of all potential donors. This begins with blood tests and tissue typing to see if a potential donor is a good match. If so, the person undergoes additional testing, including heart and lung exams, a colonoscop­y, and liver and kidney function tests.

Not surprising­ly, given the enormity of such a decision, a mental health assessment is an important part of the screening process. The transplant center also makes sure the donor has the financial, medical and personal support required when someone undergoes major surgery.

The transplant itself is done under general anesthesia and takes three to four hours. Most kidney transplant­s are now done laparoscop­ically, which means small incisions and a faster recovery time.

The timing of a return to work and a regular routine varies, but typically takes three to six weeks.

Short-term risks to the donor include those involved in any surgery. These include infection, pain, blood clots and an adverse reaction to anesthesia. Long-term risks include the natural decline in kidney function that accompanie­s aging and developing a disease that itself impedes kidney function. This includes Type 2 diabetes, high blood pressure and obesity. A donor loses 25% to 35% of their kidney function. To compensate, the remaining kidney increases in size.

The data show that donating a kidney does not affect the donor’s life expectancy. People on the kidney transplant list wait an average of three to five years for an organ. Tragically, some don’t survive the wait. In donating a kidney to his nephew, your co-worker has made a courageous and generous choice.

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