Meeting notes from last August’s ACOT meeting are now available online here. Near the very end, Attachment B, is a public comment submitted by Jane Zill, LICSW, regarding the care of living donors.
Yeah, she’s been mentioned here before.
Here’s the direct link to her statement, if you don’t want to rifle through the meeting notes.
It probably goes without saying that I agree with Ms. Zill. There is a terrible conflict of interest in the transplant industry regarding the protection and care of living donors. She’s also correct in saying that the living donor experience has been defined by the very people who stand to benefit from their sacrifice. The industry, in fact, has controlled the entire message regarding living kidney and liver donation since the beginning.
[Note: Some of us are trying to change this. Please fill out the surveyif you want to contribute]
Remarkably, I somehow missed sharing Cooper and Davis’ article with you, the one referenced by Ms. Zill, so I thought I’d do so now.
– 49.5% of kidney transplants between 2000-2008 were from living donors.
– The Medically Complex donor is defined as the presence of hypertension, obesity, or an estimated GFR< 60. From 2000-2008, 12.8% of this cohort were obese, 10.3% were hypertensive, and 4.2% had low eGFR. Donor characteristics that were associated with medical complexity included spousal relationship to the recipient, low education, older age, and non-U.S. citizenship.
– As of 2008, 60.6% of living donors were female.
– Median age of 41, up from 35 in 1988.
– 19.5% of living donors had a BMI>30 in 2008 as compared to 14.4% in 2000.
– 22.4% of new living kidney donors in the United States have some form of medical abnormality or condition that puts them squarely at risk for developing cardiovascular or renal disease. <- Think any of those prospective kidney donors were informed of this risk factor prior to donation?
And my favorite:
When 25% of some data fields are missing data, this clearly impacts the level of conclusions that may be made using the [OPTN] database.
Davis, C., & Cooper, M. (2010). The State of U.S. Living Kidney Donors Clinical Journal of the American Society of Nephrology, 5 (10), 1873-1880 DOI: 10.2215/CJN.01510210