Sunday, October 27, 2013

The Need for a Gift of Life Continues

Give the Gift of Life

From ReporterHerald.com, Loveland and Aurora, CO, by Joyce Davis

Phyllis McCormack waits for a life-saving kidney

Loveland woman hopes people will consider kidney donation while she waits on the transplant list

Wherever he goes, as often as possible, Gary McCormack is a walking advertisement for a critical need -- a new kidney for his wife, Phyllis.

"I wear a T-shirt that says 'Kidney Needed -- Save a Life,' along with a phone number to call if you want to be tested as a potential donor," he says. "We've put posters around town and messages in church bulletins -- wherever people might see it."

The McCormacks, both in their early 70s, have lived in Loveland for about 40 years. Phyllis McCormack has hereditary polycystic kidney disease in which dozens of benign cysts form on the kidney, eventually rendering them defunct. Although her doctor has been tracking it for years, he recently advised her to get on the transplant list at the University of Colorado Hospital in Denver. She's now at the lower level of stage 4 kidney failure.

The list is for a kidney from a deceased donor. "We've been told that once you're on the list, it generally takes three to five years to work your way up," says Gary McCormack. But, the optimum plan is to find a living donor... [read more about Phyllis]

Kidney Transplants
Types of kidney transplants
A deceased-donor transplant -- the most common form -- uses the kidney of someone who has recently passed away.

Living donor transplants are from a relative or close friend who is alive and donates a portion of his or her kidney

Benefits of a living donor transplant include no waiting period, convenient scheduling for surgery, simultaneous surgery, decreased risk of rejection and a kidney that typically works sooner, better and longer.

Only one donated kidney is needed to replace two failed kidneys. If a compatible living donor isn't available for a kidney transplant, your name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. The wait could be a few years.

Questions and answers
Can I live with only one kidney?

Yes. You can function with only one kidney and your remaining kidney will grow larger and function for both kidneys.

How do I become a donor?

A series of tests will determine if you are an eligible candidate. Your blood type must be known before the testing process.

How long will I be laid up after being a donor?

The hospital stay after donor surgery averages three to five days. If the donor resides outside of the Denver metropolitan area, he/she may be asked to stay in the area for approximately one week after the donor surgery.

Most people can return to work after two to three weeks, depending on their recovery from surgery and the type of job they have. A donor with a physically demanding job may have to wait a little longer.

Will donating a kidney affect my future health? Is there a risk?

Most people live a long and healthy life after donating a kidney. The remaining kidney grows bigger and simply takes over for both kidneys. There is a slightly increased risk of high blood pressure and kidney failure in a small number of donors.

How much will it cost to be a donor?

Treatment related to the donor within the first three months will not cost anything. This includes pre-operative evaluation, surgery, hospital stay, outpatient visits and medical treatment -- all paid by the recipient or his/her insurance company.

Direct costs are related to time off work, transportation and non-hospital lodging related to the evaluation and surgery.


Kidney Donation vs Payment to Donor

From CBC.ca, Canada

Kidney payment ethics questions raised

Woman who waited 9 years for kidney isn't comfortable with payments


Before Canadians consider paying for kidneys, other options for reducing waits should be carefully considered, a transplant recipient and a bioethicist say.

Helen Sklarz, 60, said the nine years she spent on dialysis were bittersweet.

"It filtered and cleansed my blood and it removed toxins so I could stay alive but it took away my quality of life," Sklarz said Friday. She received a kidney 16 months ago.

Sklarz inherited polycystic kidney disease from her father. It left her with fluid-filled cysts that were triple the normal size at times.

Dialysis meant being tethered to a machine for four hours, three weeknights a week, which Sklarz said was exhausting. Dialysis can lead to headaches and severe foot and leg cramps. Sklarz also needed angioplasty to clear clogged vessels so her dialysis access site wouldn't be blocked.

She also had to keep a restricted diet. Even the fluid in a bunch of grapes could be too much on a hot day, she recalled.

In contrast, after the transplant, Sklarz says her life is "incredibly wonderful." She's able to renew old friendships, make new ones, enjoy long weekends away, hike, garden, travel and volunteer — activities she'd severely curtailed before receiving the kidney.

Paying kidney donors could be 'less costly, more effective'

On Thursday, researchers in Calgary published a modelling study that suggested paying $10,000 to living donors would increase the number of transplants performed among wait-listed dialysis patients by five per cent, and would be less costly and more effective than the current organ donation system.

"Our model found that a strategy of paying living donors for their kidneys not only saves money for the health-care system, but that the outcomes including quality of life for patients is improved," said study author Lianne Barnieh of the University of Calgary.

Despite the long wait, Sklarz isn't comfortable with the idea of paying for organs.

"This to me doesn't feel ethically correct," Sklarz said. "There's the potential for so many financially strapped and vulnerable populations to make a rash decision for cash."

Slarz said she'd rather governments ease wait times for people in need of organ transplants by educating Canadians to help overcome fears and encouraging people to register their consent to donate upon death, when organs can potentially save eight lives.

Paying kidney donors is socially divisive and needs to be carefully thought through, said Linda Wright, director of bioethics at Toronto's University Health Network.

"Organ donation has always been routed in voluntarism and altruism and this is changing it in a very fundamental way," Wright said of the proposal.

Iran is the only country where paying for organs is legal.


Citrus Fruits and PKD

From DNAIndia.com

Eating citrus fruits helps prevent formation of kidney cysts

A component of grapefruit and other citrus fruits like naringenin, blocks the formation of kidney cysts, a new study has revealed.

The team of scientists from Royal Holloway University, St George's, University of London and Kingston University London used a simple, single-celled amoeba to identify that naringenin regulates the PKD2 protein responsible for polycystic kidney disease and as a result, blocks formation of cysts.

Professor Robin Williams from the School of Biological Sciences at Royal Holloway said that this discovery provides an important step forward in understanding how polycystic kidney disease may be controlled.

To test how this discovery could apply in treatments, the team used a mammalian kidney cell-line, and triggered the formation of cysts in these cells. They were then able to block the formation of the cysts by adding naringenin and saw that when levels of the PKD2 protein were reduced in the kidney cells, so was the block in cyst formation, confirming that the effect was connected.

Meanwhile, Dr Mark Carew, from the School of Pharmacy and Chemistry at Kingston University, said further investigation is underway to understand the action of naringenin at the molecular level. This work will entail looking at the function of the PKD2 protein as a cell growth regulator.

The study is published in British Journal of Pharmacology.


PKD Disease 

From DNAIndia.com, by Santosh Andhale

Beware! Renal cysts can stay hidden till it's late

Polycystic kidney disease is silent, it's detected in an advanced stage.

Vilas Sawant (name changed) enjoyed a generally healthy life like most other bank employees his age. Last month, the 31-year-old suffered back pain. He consulted a number of doctors in the hope of getting some relief.

Understandably, he underwent numerous tests. A sonography revealed cysts in both the kidneys, an ailment that is described in medical terms as polycystic kidney disease (PKD or PCKD).

PKD is a common life-threatening genetic disease that is usually detected in the advanced stage. It is characterised by multiple cysts typically in both kidneys.

“We call it a silent disease as it is not detected until it has advanced. People with a history of kidney ailments in the family should go for a regular check-up, so early intervention through medication can save the kidney,” said Dr Jatin Kothari, nephrologist at PD Hinduja Hospital.

Sawant is an executive with a multinational bank and lives in Borivli. A general physician referred him to an orthopaedic specialist. He was advised some blood tests.

But it was the kidney function test that reported a high creatinine level of 4.5 milligrams per decilitre. (The normal should be below 1.) Which is when he was checked by a nephrologist and the cysts were detected. [Read more]

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