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Living Donor Risks Living Kidney Donor

A Couple of Notes on the Obese Kidney Donor Issue

Last May, I wrote about a press release barrage from the North Shore Long Island Jewish Health System that blatantly said American obesity was a problem because it interfered with the transplant industry’s ability to take their living donor kidneys.

In August, the NY Times wrote an article framed around one gentlemen but spattered with quote and facts from multiple New York based transplant centers, which drew no conclusions other than “dude lost weight so we took his kidney”.

I missed it until now, but at least one doctor weighed in on the topic with a “hold on, all is not well” sort of warning:

To the Editor:

Re “Transplant Centers Struggle With Donors’ Obesity” (Aug. 7): The concern for possible kidney failure in obese living kidney donors is not without justification. In 2010, Dr. Stephen Bartlett and his colleagues at University of Maryland published in the journal Transplantation their findings of follow-up of obese donors at an average of seven years after surgery. They found that kidney function in almost half had dropped to less than 60 milliliters per minute, considered Stage 3 chronic renal disease. (Stage 5 requires dialysis.)

Unfortunately, as the article reported, only 10 percent of transplant centers exclude living donors who are obese, and about half of transplant centers accept living donors who are morbidly obese, subjecting these individuals to additional risks of hypertension, kidney failure and even death.

Jim Bowman, M.D.

Rockville, Md.

 

This has been my point all along (and not just for high BMI living kidney donors). The transplant industry must stop focusing on surgical complications (and using them to justify living donation’s so-called safety), and turn their attention to the WAY long-term that every living donor experiences with one kidney or a reconstituted liver. While I understand that we are of no use to the transplant industry after our organs are removed, we certainly are valuable to our families, friends, and most of all, to ourselves. At the bare minimum, we deserve treatment equal to that given to our recipient, and that includes a ten-year, comprehensive registry. Not the patronizing “trust us, you’ll be fine” pat on the head we’ve gotten so far.

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