Published:

11/02/2011 05:16pm

You Don't Have To Be Dead To Donate

If we live in a nation “of the people, by the people, for the people,” then why are nearly 90,000 of our people having to wait several years to get a desperately needed kidney transplant?

The group I’m referring to is the 30 million member’s only club of Chronic Kidney Disease (CKD) patients. Membership is a slam dunk when you have bum kidneys; of course membership is not by choice, and status works against its constituents.

The only two options for people who’s kidneys no longer function sufficiently on their own, is to have a kidney transplant or get on dialysis. Without these treatments, members would die within a matter of weeks.

Since kidneys are hard to come by for transplant, and information is lacking, it’s no wonder that more than 350,000 of its US members are currently on dialysis.

Is that a good thing you might ask? Allow me to describe dialysis so you can make your own conclusions.
Dialysis is an external machine which is used part-time to replace kidney function waste management. The process requires the patient to be tethered to a machine in an outpatient setting for roughly four hours a day, three times a week — or exchanging fluids at home several times a day–every day.

Whichever the case, it can’t
hold a candle to the work of normal healthy kidneys, which function 24/7. Hence, dialysis can only replace 10% —to 13% function at best! This, notwithstanding the fact that dialysis can be uncomfortable, debilitating, demoralizing and extremely demanding with a high mortality rate.

So the question becomes, can dialysis provide quality of life to those it’s saving, or is it just postponing death?

Perhaps these factors are overlooked since Medicare coverage and your tax dollars, position long-term dialysis as a federal entitlement, costing billions annually.

Kidney transplants on the other hand, cost less money—a lot less. We are now learning that transplant costs (when compared to dialysis costs) save hundreds of thousands of dollars.

According to a 2003 American Journal of Transplantation article, every transplant from a living, unrelated donor saves an “expected present value” of nearly $100,000 in medical costs, when compared to dialysis payments. And this doesn’t even consider the superior “quality of life” benefits living kidney donors offer transplant recipients at the time of surgery and for years thereafter.

When compared to deceased donation, living donors can offer transplant recipients double the function in years — often adding another decade of function.

Yet proactive approaches to endorse preemptive transplant (a transplant that is performed before the need for dialysis), over dialysis continues to be shadowed by renal community campaigns, not unfittingly known as “Fistula First.”

With all these benefits, why aren’t we supporting a nation of “Transplant First”?

The real issue to address is the continued endorsement of an inferior system, when a far better option is available?

Here are the facts.

1. Patients are not encouraged to plan ahead, so they wait to get sick and are forced on dialysis.
2. Patients aren’t encouraged to find a living donor, so they remain on dialysis, waiting on the list for a deceased donor, getting weaker and sicker. (Some patients don’t even know transplant is an option!)
3. While patients are on dialysis, they often lose their health status which qualified them for transplant.
What’s even more disturbing is that those who wait for a transplant (from a deceased kidney donor), must hope that enough consented and kidney qualified organ donors die— before they do.

This life-threatening wait is underscored in the death toll of 12 deaths a day, when those in need can wait no longer.

We have an opportunity to change this anemic paradigm. All we need is a shift in thinking. If just three-tenths of one percent of the U.S. population approached organ donation differently, we could abolish the existing list.

We simply need to give up the idea