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Advocacy Informed Consent Living Donor Research Living Donor Risks Living Kidney Donor OPTN

63.6% of Living Kidney Donors Are Overweight

An analysis of the OPTN/UNOS database from 1999-2011 reveals that 63.6% of all living kidney donors were either overweight* or obese.

(emphasis mine):

“Overweight and mildly obese kidney donors have increased through time by 12% and 20% every 5 years, respectively “

 

Obesity is associated with numerous health risks, including Type 2 Diabetes and hypertension. According to USRDS, 44% of kidney failure is due to diabetes and another 26% is because of high blood pressure.

And:

“Having a BMI greater than 35 kg/m2 has been associated with slightly longer operative times and overall more peri-opera­tive complications, such as wound complications”

 

If obesity is such a problem, especially in regards to kidney function and health, wouldn’t OPTN have some sort of policy on the matter? (emphasis mine again)

 

According to OPTN guidelines, having a BMI greater than 35 kg/m2 is considered a relative contraindication to be a living kidney donor. Despite this, transplant centers across the United States use different criteria in determining donor exclusion based on BMI. Based on a 2007 United States Transplant Center Survey, twenty percent of the transplant centers that were surveyed excluded those with BMI greater than 40 kg/m2, fifty two percent of United States kidney transplant centers excluded donors with BMI greater than 35 kg/m2, ten percent of programs excluded those with BMI over 30 kg/m2, twelve percent had no policy for exclusion, and six percent excluded based on BMI if they had other cardiovascular risks. ”

 

In short, only 60% of U.S. transplant centers follow or exceed OPTN policy.

40% of U.S. transplant centers accept higher at-risk living kidney donors than OPTN policy dictates.

 

There’s no point in having a policy if 40% of members won’t follow it. Especially if the governing organization will do nothing to enforce it. The whole thing is nothing more than theater, engineered to make the public *believe* transplant centers care about the health and well-being of kidney donors.

Unfortunately, it’s theater that’s already put over 30,000 people at risk.

 

 

*Overweight was defined as a BMI of 25 or higher.

Sachdeva, M. (2015). Weight trends in United States living kidney donors: Analysis of the UNOS database World Journal of Transplantation, 5 (3) DOI: 10.5500/wjt.v5.i3.137

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Living Kidney Donor

The Real Solution to the So-Called Kidney Shortage

Every conversation about kidney transplants always focuses on increasing living donors and shortening wait times. In other words, supply side economics.

But what about decreasing demand?

 

Today I ran across an article pertaining to minority disparities in obtaining living donor kidney transplants. While this is an important issue (disparities in obtaining any sort of transplant, which I’ve written about elsewhere), I wanted to point out this seemingly innocuous little quote:

 

“About 70 to 80 percent of kidney failure is preventable by eating well, staying fit with physical activity, avoiding salt, drinking water – simple things we know can improve our health in general.”

 

Hm, how about that.

Not “let’s pay people for body parts” or “let’s take kidneys from prisoners” or “let’s trade kidneys for health insurance”. Just a simple Take-Care-of-Yourself.

What a concept.