New research shows that it is extremely difficult for a person’s body to accept a kidney from another person even if they need the transplant. So what should physicians be doing for them?

Reuters reports on kidney transplants. Kidney transplants began in the 1950s but they are not always successful.

There have been numerous cases where the surgeon operates on and/or removes the wrong kidney. But apart from that, there are many other kidney cases that are also concerning. One such instance is when the host body rejects the new kidney. Another issue is finding a donor and asking a person for such a large favor.

Dr. Hanson reported her findings in Transplantation.

She also commented on her study saying, “Patients with chronic kidney disease worry about the long-term consequences for potential donors and frequently feel unworthy of such a self-sacrificing gift. Some people don’t like to be on the receiving end and don’t like to ask favors. Our study really shows that there’s a whole host of emotional barriers, mainly guilt, that stop someone from asking for, and perhaps accepting, a kidney.”

How was the study conducted?

The author and her researchers examined 39 studies from 13 countries. The studies showed around 1,800 patients suffering from chronic kidney disease and identified themes that present barriers to finding living kidney donors. In addition to guilt, patients’ concerns about jeopardizing donor health, about causing donor inconvenience, about donor regret and about endless indebtedness went through the material.

One aspect of the studies, and one that resonated with nephrologists Hanson interviewed for a different study, was that patients with chronic kidney disease did not know how to ask relatives or friends for one of their two kidneys. It is a sensitive topic and patients often do not even know what the chances of a successful outcome are. Researchers found that if patients were better informed by their doctors first then that would be most helpful.

Dr. Roberts who is chief of the University of California, San Francisco, Medical Center Transplant Service, commented on the study.

He said, “Patients on the waiting list for a deceased donor kidney have only a one in five chance of surviving long enough to get a transplant. The chance for patients with diabetes shrinks to one in 10. Without a living donor, your chances of getting a transplant are pretty slim. Frequently the children want to donate, and the parents don’t want the children to donate, and their parents end up dying on dialysis. I think it’s really the parents’ fear of their children having a complication, not being able to work and not having health insurance.”

Despite the difficulties associate with kidney transplants and the possibility of it not working out it is still considered the best possible option for patients with failing kidneys. Kidney transplants from living donors give the best recipient survival outcomes according to the study. The study also found that shortages of deceased donor kidneys lead to lengthy wait times.

Dr. Reese, who is a transplant nephrologist, and a professor at the University of Pennsylvania’s school of Medicine, told Reuters, “Lifetime health insurance would provide a fair incentive to living kidney donors. I think that would be a good idea from a justice point of view.”

 

Gerry Oginski
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