Archive for September, 2009

The Globe and Mail’s package on Lisa Sayer’s donation includes an article about the structure of stranger donations if you leave the recipient picking to the medical establishment. It’s noble to donate your kidney to “first available,” don’t get me wrong, but the emphasis on confidentiality because we all need to be afraid of each other put me off of donating this way.

Medical experts say that the relationship between recipients and donors can be fraught with tension and dashed expectations. Will the recipient be burdened by a sense of gratitude? Will the donor feel let down by the recipient if she or he doesn’t want to carry on a friendship with the person? There is also the possibility that a donor may approach the recipient for money.

An anonymous program guards against these complex psychosocial dynamics and protects both the patient and the recipient. However, if a year after surgery both sides decide they’d like to meet one another, the hospital will facilitate such an encounter and has done so in the past with no negative repercussions.

Life is filled with tension and expectations and miscellaneous weirdness. I wanted to know my recipient because I would have felt incomplete afterward, not having a mental picture of the person I helped.

I’m sure that sometimes post-kidney transplant, things get weird with family members or friends, because with family or friends, they really are doing something big for that person. I, like all stranger donors, did it for myself. It made me happy. It made me feel as though I made a small but important difference in the world. My recipient didn’t need to be grateful to me, because I already had gotten my reward.

Knowing a little bit about the person I donated my kidney to helped me understand my reward better, but he doesn’t owe me.

We don’t need to be so afraid of each other.

Canadian Lisa Sayer is a gal after my own heart. She heard about living kidney donors and thought, “Well, I could do that. How cool!”

At first, Ms. Sayer told no one but her husband, Jamie. He thought she was joking. Donating a kidney to a family member, he could understand. But to someone she didn’t know? “What if he is a jerk or a creep?” he said.

That’s funny because my only concern through donating to a stranger was, “Is he a good person?” (He is such a good person, but anyway.)

“You take something out of someone and you put it into someone else,” says Ms. Sayer, a fit, tanned blonde with aquamarine eyes and a radiant smile. “I fell in love with that idea. It became very appealing.”

There is something so profound and human about opening your body and giving a piece to someone else. Congratulations to Lisa and her recipient.

My home state is getting into the act with a paired donor chain transplant that will provide healthy kidneys to a number of Indiana residents. Hurray.

Starting with a Clovis, Calif., grocer who was grateful for his good health, kidney patients from California to New York have received transplants through a paired donor matchup. The California participants are planning to meet for dinner this weekend. Plenty to celebrate.

If you are experiencing kidney issues and are even already on dialysis, get yourself on the UNOS transplant list. This just in from the Tribune-Review:

Kidney transplantation adds an average of 10 years to a patient’s life, and a new kidney costs the federal Medicare program $50,000 less per patient than conventional dialysis.

Yet, thousands of patients started dialysis without hearing about transplant options. Some spend as long as five years on the debilitating treatments before they are placed on the nation’s transplant wait list, while others who would benefit from the surgery are not even on the list.

This is especially important because one of the factors to move to the top of the kidney list is how long you’ve been on the list. As to why patients aren’t hearing about it, I wonder if it’s the same thing that is skewing liver transplant lists toward white men.

Anyway, even if you’re oogy about the thought of getting a transplant, push to get on the list so that you have options. Talk to everyone you know about whether they’d be willing to donate to you or be a paired donation candidate. Argue, push, insist.

And check out this snappy Flash thingy that the Tribune-Review did that lays out a lot of statistics and other information about kidney transplants.

Wow. I was really looking forward to reading kidney recipient Steve Farber’s book On the List about the transplant system in the U.S. and what’s wrong with it.

And he does do a very good job of looking at the legislation, the changes being considered and the legal situation in other countries. For example, he explained that some transplant centers will not do “swaps” because they interpret the law against compensation for donors to include something like your friend getting a kidney in return.

All of that is good. But to humanize it, he brings in his transplant dilemma and that of two Guatemalan siblings who had their surgery on the same day as his.

Steve’s transplant dilemma is that his son is a perfect match and willing to donate a kidney to him but … he’d rather his son not have to do that because it will really piss off his wife. He struggles against a system that for some reason will not let him use his money and influence to get to the top of the list ahead of someone who does not have a perfect match waiting at home. This also really pisses off his wife, who pressures him to buy a kidney in Turkey.

His friend muses about the Guatemalan “peasants” and how their expectations for life are so low that it is easier for them to die than for someone like Steve. O. M. G.

Did we mention all the people Steve knows? He knows a lot of people. Did we mention he is very important? He is very important. Even the “peasants” know he is important.

Plus throughout the book, Steve paints his wife as a hysteric and a bitch. Now, maybe she is. But … dude, show some respect.

In the end, Farber favors a system that would let the government compensate people for organs at a set amount like $15,000, or through other incentives like good insurance. A lot of experts think this is the best plan.

I agree that the solution is not better donation rates from deceased people. It’s got to be living donors.

I don’t think you’d have to pay them, though that would help, too. Just let them know that they can do it and take down the barriers for stranger donations.

Do something like Virginia Postrel suggests and get every church to find one donor – no more waiting list.

Disclosure: I am an “altruistic” donor, and I am in marketing, but I think the real solution is in marketing to potential “altruistic” donors. Publicize how safe this is and how rewarding.

People have a lot of love in them. Witness the Kereamas of New Zealand.

Jonah Lomu is happy to see 9-year-old Mya Tamatea doing well after receiving a kidney transplant from donor Justine Kereama – the sister of the man who gave Lomu his life-saving kidney.

As for Mya, she’s going to Disneyland.

Hurray for Stacie Taylor, who didn’t think twice before giving one of her kidneys to her auntie, Patricia Sims.

Taylor said everything went well, and her aunt responded to the new kidney very quickly. “Her doctor joked that the kidney started working as soon as they put it in and it started (urinating) all over the place in the operating room and all over everyone. She was running circles around me. I guess, she had been sick for so long, that once the kidney was placed, she immediately felt better and was raring to go.”

My kidney did the same thing — took one look around, said, “Look at this mess!” and got to work. The surgeon said something about a racehorse.

Yes, it’s a father and son kidney transplant. The picture of this little boy is priceless.

“He’s a trooper,” [Sharon] Davis said of her grandson, an S.L. Mason Elementary School kindergartner. “I haven’t seen grown people take on as much as he has without carrying on.”

You may remember the cabbie who volunteered to give a kidney to a woman he transported to dialysis on a regular basis. The publicity over his decision to donate a kidney led his long-estranged daughter to contact him.

[Aimee] Requena turned 36 the night she spoke to her father for the first time in 30 years.

“I didn’t know what to say or where to start,” Requena said. “But it seemed natural. We just started getting in each other’s business.”

“I held a grudge, and now I’m older and I have children,” Requena said, “and I can’t set an example for them to learn to forgive if I can’t do it myself.”

She must have been one tough 6-year-old customer.