Question: I have had diabetes for many years. I was too busy to check my blood sugars except occasionally. I had one kidney removed after an auto accident. Now doctor says there is a touch of diabetes on my kidney. I am scared. My neighbor is hooked to a kidney machine. Why doesn’t everybody get a transplant and get it done with? I went to the motor vehicle bureau the other day and they asked me if I want to donate my organs after death. They did not know I have only one kidney. I said no. My daughter says she loves me and will give a kidney to me. I hate to have my daughter lose a kidney. Is there any other option? Will I be able to keep my job after receiving a kidney donation? — Sam, of Wapakoneta
Thank you for your question. I am sorry you are having kidney problems.
The most common cause of kidney failure, with a person needing dialysis or transplant, is diabetes mellitus. The next most common is hypertension. There are, of course, others.
Kidney transplant is far more preferable than dialysis. There are about 100,000 people on the kidney transplant waiting list here in the United States. In Ohio, we have about 3,800 people. About 18,000 kidney transplants are done in the United States each year with about 13,000 of those being cadaver donors and about 5,000 living donors. As a result, waiting time on the transplant list can range between two to five years.
Living donor is preferred to cadaver donor. In this case, the waiting time will depend on when the evaluations and necessary testing are completed for both the donor and the recipient. This can range between three to six months in general.
You can get on the kidney transplant list by being referred to a transplant center by your kidney doctor. The evaluation and work up will be done by the transplant center and are usually extensive and similar between transplant centers with minor variation. If everything goes well, you will then be placed on the transplant list. You can be listed in more than one center to improve your odds.
These are some of the reasons one may not be considered a candidate for kidney transplant:
• Heart disease that cannot be corrected. The heart will be evaluated to see if it is healthy enough to withstand the stress of surgery.
• Lung disease. Some people with bad lung disease for any reason may be considered poor candidates, as it may be difficult to get them off the breathing machine after surgery.
• Weight. The transplant center may want you to be at a certain weight before surgery to minimize possible complications after surgery. They will ask you to lose a certain amount of weight if you are not within their goal.
• Financial. The insurance companies sometimes may not cover the total cost of the transplant, and the transplant center may want a guarantee of payment for the uncovered portion.
• Cancer. If one has cancer, it would have been treated and in complete remission. Depending on the type of cancer, one may have to wait a certain number of years after remission to be considered for kidney transplant.
• Social support. They may want you to have good social or family support after transplant to care for you, especially the first few weeks after transplant.
• Transport. They may want you to have reliable transport for other transplant visits which sometimes may be more than once a week for several weeks, especially if you live far away.
• Other diseases. When you suffer from other diseases, they may say you have too many comorbidities for surgery. They just lump everything together.
• Psychological. They will evaluate you to be sure you are in sound mind.
In general, people can return to work about eight to 12 weeks after transplant, but this can vary depending on other things.
Thank you for your inquiry and best of luck.
Jonah O. Ukiwe, M.D., FACP, FASN, Kidney & Hypertension, 750 W. High St., Lima