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Living donors, families of those who die unexpectedly, are key to organ transplantation

Park Country Club Golf Course Superintendent Scott Dodson has much to be thankful for when it comes to receiving a kidney from a living donor, but leaders of two Western New York transplant hospitals say those in need of a kidney can do almost as well when receiving a kidney from someone who has recently died.

"The sooner somebody gets a kidney transplant – any kidney transplant – the better off they will be in the long run," said Dr. Liise Kayler, who three years ago became program director of the Regional Center of Excellence for Transplantation and Kidney Care at Erie County Medical Center. "They will live longer and have a better quality of life. They'll have more energy. They'll have more time to spend with their family, because dialysis is inconvenient and takes a lot of time. They'll be able to travel more easily and they won't have as many dietary and fluid restrictions."

Kayler estimated that about 1,500 patients in the eight-county Buffalo Niagara Region have end-stage renal disease.

About 600 people are on the ECMC transplant evaluation and waiting lists; 138 kidney transplant surgeries were performed last year, up from 128 the previous year and and 102 in 2015.

All but 15 of the transplants last year came from deceased donors.

Residents in the region have shown a growing generosity in recent years, Kayler said, though the need, and ECMC's capacity to perform more surgeries, outstrips organ supply.

Another challenge: Kidney disease can show few symptoms until jaundice and fatigue appear in the later stages. By that point, lifestyle choices that helped bring on the disease – smoking, poor nutrition, lack of exercise, for instance – also may have contributed to heart disease, breathing conditions and other health challenges that need to be addressed as kidney recipients clamor for surgery.

"Our main barrier is getting people prepared for transplant," Kayler said. "That takes quite a bit of time and that's important because we want the transplant to be successful."

A stroke of fortune for both kidney transplant recipient and donor

To be sure, genetics play a role in many cases of kidney disease. In any case, Kayler said, "the most important thing is to see a primary care physician" who can order blood tests that can diagnose patients earlier, giving them better options for kidney care. They also can make recommendations about diet, and provide medications that control high blood pressure, diabetes and other conditions that can put stress on kidneys, she said.

Medical staff in the Strong Memorial Hospital transplant program, on the University of Rochester Medical Center campus, perform 60 to 80 kidney transplants each year. Roughly half involve living donors, a higher percentage than most transplant centers, said Dr. Mark Orloff, professor of surgery and vice chair of department of surgery.

Kidneys from living donors tend to be of a higher quality, the donor can generally be identified more quickly, and surgery scheduled more easily, sometimes before dialysis is needed, Orloff said.

"The longer somebody spends on dialysis in general before transplantation, the shorter the survival of both the patient and the transplant. It's not tremendously shortened but it is shorter."

Kayler and Orloff both stressed that a transplant recipient's health insurance almost always covers the cost of donor testing, surgery and follow-up care, although the donor may need to cover some costs including transportation, lost work time and, if necessary, out-of-town lodging. The Kidney Foundation of Western New York is among nonprofits that can pick up at least a portion of those costs.

Giving also comes with benefits a bit harder to quantify – but much more gratifying.

"When you've donated a kidney, it's such a significant, huge gift that you feel good about yourself the rest of your life," Kayler said. "A lot of people want that. Sometimes I joke that the recipient sometimes feels guilty but the donor always feels great."

TRANSPLANTATION STATISTICS

– The median wait time for an individual’s first kidney transplant is 3.6 years and can vary depending on health, compatibility and availability of organs.

– More than 3,000 new patients are added to the U.S. kidney waiting list each month.

– 13 people die each day while waiting for a life-saving kidney transplant.

BECOME A DONOR

Those in WNY can reach out to Erie County Medical Center at 898-5001 or 888-894-9444.

Acceptable organ donors can range in age from newborns to 65 years or more. Living donors in New York State must be at least 16.

Donor organs are matched to waiting recipients by a computer registry called the National Organ Procurement and Transplantation.

IDENTIFY YOURSELF AS AN ORGAN DONOR

Visit the Donate Life America website at donatelife.net.

New York State residents can do so at donatelife.ny.gov/register.

Declare your intentions on your driver's license.

Sign a donor card.

Signing a donor card, registry or driver's license is a good first step in designating your wishes about donation, but letting your family or other loved one's know about your decision is vitally important. That's because family members are often asked to give consent for a loved one's donation, so it's important that they know your wishes.

Source: National Kidney Foundation

email: sscanlon@buffnews.com

Twitter: @BNrefresh

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