Live donors give new life to recipients at the UCLA Kidney Transplantation Program

Donating a kidney not only presents little risk to the donor but also immediately benefits a growing pool of patients in need of a healthy organ, according to a recent study of kidney donors.

“Usually when you go for surgery, you have something wrong with you. You’re prepared to go for surgery because you want to live,” said Dr. Jeffrey Veale, director of the UCLA Kidney Transplantation Exchange Program. “If you’re a living donor, you’re going through surgery, but you’re healthy ““ there’s nothing wrong with you.”

The risk of death within 90 days of transplant surgery is low, at a rate of 3.1 deaths per 10,000 donors, the study reported.

Conducted at Johns Hopkins University, the study followed more than 80,000 American living kidney donors during a 15-year span and compared them to a control group of more than 9,000 Americans of similar health attributes who did not donate.

Kidneys from living donors last twice as long as kidneys from deceased donors because the deceased body’s physiology is harmed, and the kidney may be affected, Veale said.

Patients wait for a deceased donor for three to five years sometimes, Veale said. Meanwhile, the patients are attached to a kidney dialysis machine that flushes out waste from the body’s system, mimicking the kidney’s typical functions.

As obesity and diabetes become more prevalent in American society, more people develop end-stage kidney disease and require transplants, Veale said. Forty percent of those in need of transplants are diabetic, while the second-most common cause is high blood pressure, he added.

Today, 83,951 Americans are on the waiting list for a kidney transplant, which is 79 percent of the total number of people waiting for organs of any kind, according to the United Network for Organ Sharing. At the Ronald Reagan UCLA Medical Center, 2,104 people are waiting for a kidney.

With the increasing need for kidney transplants, any time someone can receive a living donor kidney, it means one fewer person on the deceased donor waiting list, according to Mandy Ames, spokeswoman for the United Network for Organ Sharing.

Many patients prefer a transplant over being connected to a dialysis machine because they feel it improves their health and the quality of their life, said Jennifer Martin, organ donor services director at the National Kidney Foundation, in an e-mailed statement.

When matching donors with recipients, two important criteria doctors consider are blood type and human leukocyte antigens, which play a role in the immune system, Veale said. If a patient has built up antibodies to a donor’s antigens, then the patient’s body will reject the donated organ and try to destroy it.

The kidney exchange program at the UCLA Medical Center matches up living donors and recipients in a swap program, or chain transplantation, posting a 98 percent success rate, according to Veale. In the swap program, if a donor and recipient pair have conflicting blood types, they can swap with another pair with a similar conflict. Chain transplantation begins with a donor who chooses to give a kidney to a stranger. In turn, a friend or family member of the recipient may decide to “pay it forward” and donate a kidney to another stranger.

Many recipients, donors and their families have met after the surgeries and maintain close relationships.

“They make these really special human connections,” Veale said.

Potential donors go through a medical and emotional screening process to determine their eligibility, Ames said.

People with diabetes or high blood pressure may not want to donate because they may need their kidneys, while those with cancer, hepatitis or HIV should not donate either, to avoid passing on the disease to others, Veale said.

“(Centers) just want to make sure that the donor understands the risks involved with being a living donor and make sure they’re doing it for the right reasons, and that they haven’t been pressured into donating,” Ames said of the emotional screening process.

Veale also stressed the importance of individual motivation, since the procedure, like any surgery, does involve risks.

“Since there are no medical benefits for the donor, it requires careful consideration of what the risks and benefits will be and therefore remains a very personal decision,” Veale said.

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