With so many in line, most never get the transplant they need

By Katie Scarvey

kscarvey@salisbury post.com

Like 350,000 other people in this country, Lisa Thomas is in end-stage renal disease. That means that her kidney failure is so advanced it cannot be reversed.

End-stage renal disease cannot be treated with conventional medical treatments such as drugs. Dialysis and kidney transplantation are the only options.

A shortage of donor kidneys means that only a small percentage of people who need a transplant actually receive one. The National Kidney Foundation estimates that 67,000 people die of kidney failure every year in the United States.

Those who successfully receive a kidney, whether from a living or a deceased donor, must take anti-rejection medication and be monitored by a nephrologist, or kidney specialist, for the rest of their lives. Otherwise, they can lead normal lives with one functioning kidney. The donor can also live normally with one remaining kidney.

Erika Henderson is the living donor kidney transplant coordinator for Emory University Hospital in Atlanta, which is where Lisa Thomas is treated.

Henderson explains the process that potential donors must go through.

The first step is the medical-social interview. Potential donors share information about their personal and family medical history as well as their social history. The toll-free number to set that up is 1-866-727-3250.

A set of forms must then be completed and returned. Blood is tested for compatibility. A cross-match test is also done, which puts the potential donor's blood and the recipient's blood together in an effort to determine the likelihood of rejection.

If the blood work gives the desired results, then the potential donor must undergo a 24-hour urine collection to determine kidney function.

Depending on his or her health history, a donor might have to undergo additional tests. If testing goes well, the potential donor comes to Emory University for a two-day outpatient evaluation.

That entails more bloodwork, a chest X-ray and an electrocardiogram (EKG), a CT scan and magnetic resonance angiography (MRA) of the abdomen. The donor may also have to have a cardiac stress test.

The donor then meets with the surgeon and nephrologist as well as the transplant coordinator and a social worker and financial coordinator. A psychiatric team ensures that the donor is not being pressured into doing something he or she does not want to do.

The surgeon makes the final determination as to whether the potential donor is suitable.

The surgery itself is done laparascopically and entails a 3-4 day hospital stay for the donor. Recovery time is 3-6 weeks.

Typically, there is a shorter wait for patients receiving a kidney from a live donor, Henderson says. Waiting for a kidney from a deceased donor can take up to five years, Henderson says.

For more information, go to www.emoryhealthcare.org and click the "transplant center" link, then the "kidney transplant" link.