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Answers to some of your frequently asked questions
Dialysis is a treatment that performs some of the functions carried out by healthy kidneys. For most patients, dialysis means being hooked up to a machine 3 times a week for 4 hours each time. Many people are unable to work while on dialysis due to its debilitating side effects including low blood pressure, nausea, vomiting, and muscle cramps. According to WebMD.com the survival rate for patients on dialysis for one year is 77%. At five years the survival rate drops to 28% and just 10% of patients survive ten years on dialysis. Dialysis generally comes with a restricted diet. A kidney transplant recipient, in contrast, does not usually have any major restrictions following the transplant, though of course a healthy, well-balanced diet is always recommended. Dialysis does not bring kidney function back to normal, but only to approximately 10- 15% of normal; it is better than dying of End-Stage Renal Disease but remains a painful, debilitating, and time-consuming course of treatment. While dialysis keeps a patient alive, a kidney transplant will give them back their life. In addition, the life expectancy for someone who receives a transplant is much longer than compared with someone on dialysis.
Every potential living donor is put through battery of tests, such as blood, urine, EKG, CT scans, as well as psychological evaluations to ensure the long term health of the donor and increase the chance of successful donation and transplantation. Depending on the hospital, testing usually takes one to two days at the hospital that will perform the transplant.
Each hospital has its own restrictions on whom they will accept as a donor. Generally, hospitals will accept a donor up to age 70. The lower age limit is 18; minors are not allowed to be living donors.
There are four blood types: A, B, AB, and O. Generally speaking, each blood type matches with their own, with the exception of type O, which can match with any blood type. In addition, every person has a genetic “fingerprint” defined by his/her HLA. These are different antigens within the blood that make the blood either more compatible or less compatible with someone else’s blood even when it is the same blood type. However, the RH factor in one’s blood (for example: Type A positive or Type B negative) is not involved in matching a donor with a recipient. Blood relatives are generally the best match, though often the testing reveals that the underlying issues affecting the patient affect other family members as well.
A donor must be in general good health. Someone with a history of kidney disease, diabetes, high blood pressure, or kidney stones may be disqualified. A family history of any of the above does not automatically disqualify someone from being a donor. There can be exceptions as well, so even someone with a prior history of any of the above should speak with the hospital’s transplant coordinator to fully assess if they are a candidate for donation.
Today, over 95% of donations are done through a process called laparoscopic nephrectomy. Since this technique uses smaller incisions than an open nephrectomy, donors benefit greatly from reduced post-operative pain, speedier recovery time, and less scarring. The operation lasts 3 to 4 hours and requires general anesthesia.
Once a donor has recuperated from the surgery, he or she can expect to lead a completely normal life. There is no need to take any special medications, follow any dietary restrictions, or limit one’s physical activities. However, a kidney donor is cautioned regarding high impact recreational activities and contact sports to prevent injury to the remaining kidney. Drinking water is recommended to everyone as a good habit to keep one’s kidney(s) hydrated. Regular checkups with your doctor are strongly recommended as well.
It is against the law to give money or gifts in exchange for a kidney. However, ancillary expenses such as loss of wages, travel expenses, food, etc. can be covered by Renewal. The recipient’s insurance will cover all the costs associated with the actual procedure. Many states provide tax benefits for any expenses incurred (up to a certain amount) due to the transplant.
On average, kidney donors spend two-three days in the hospital and can return to their normal activities within two to four weeks. During this time it is expected that the donor will feel some pain and discomfort, as well as less energy. Donors are restricted from lifting heavy items for up to six weeks.
Kidney donation requires major surgery under general anesthesia. Nonetheless, it is one of the safest surgical procedures and it carries little to no long term risks and repercussions. However, as is the case with any surgical procedure, the particular procedure itself does carry some risk. The risk of death to the donor is roughly .03% (or 3 in 10,000). By comparison, the infant mortality rate (according to the US Census Bureau) is .59% (or 59 out of 10,000). It is perfectly safe to live with one kidney. However, with one remaining kidney, a donor can be at risk for developing high blood pressure, proteinuria, and reduced kidney function. For this reason a donor is strongly encouraged to maintain regular yearly checkups to ensure that their remaining kidney is functioning properly and to prevent minor issues from becoming serious. Before any donor is accepted, a Renewal staff member as well as a medical professional will explain the procedure and risks in greater detail with the donor. It is important to note that most kidney diseases affect both kidneys and having a second kidney would not have prevented the disease. Should a donor later need a kidney he/she is given priority on the national waiting list.
Absolutely. In fact, no posek today forbids live kidney donation, and many, though stopping short of declaring it obligatory, encourage donation and consider it to be an extraordinary mitzvah. See Rabbinic Endorsements