Sanjivan - The Organ Donation Blog

I found a good write up from NYTimes on organ donation. Thanks to Jane Brody for a good eye opener.

The Solvable Problem of Organ Shortages

As of today the number of people waiting for organ donation is 98,154. This is almost thousand more people from September 2007 when the count was around 97,000. At this alarming rate, within a six months the number of people waiting for organ donation will cross 100,000. That will be a worrisome trend. Help pass the message of organ donation to your friends and relatives. On this Christmas day, nothing is great than saving a life.  Wish you all a merry Christmas and a wonderful New Year!

When an individual’s kidneys fail, three treatment options are available: hemodialysis, peritoneal dialysis and kidney transplantation. Many patients feel that a successful kidney transplant provides a better quality of life because it allows greater freedom and often is associated with increased energy levels and a less restricted diet. In making a decision about whether this is the best treatment for you, you may find it helpful to talk to people who already have had a kidney transplant. You also need to speak to your doctor, nurse and family members.

What is a kidney transplant?

A kidney transplant is an operation in which a person whose own kidneys have failed receives a new kidney to take over the work of cleaning the blood.

Are there different kinds of kidney transplants?

Yes. There are two types of kidney transplants: those that come from living donors and those that come from unrelated donors who have died (non-living donors). A living donor may be someone in your immediate or extended family or your spouse or close friend, and in some cases a stranger who wished to donate a kidney to anyone in need of a transplant.

How do I start the process of getting a kidney transplant?

Your doctor can discuss the transplant process with you or refer you to a transplant center for further evaluation.

How can I pay for my transplant?

Most private health insurance policies cover many expenses associated with kidney transplants, including medications. In addition, most kidney transplant candidates are eligible for Medicare, which will cover 80 percent of the cost of the transplant surgery. After transplantation, you will need to take medications to prevent rejection of your new kidney. Medicare Part B will cover 80 percent of the cost of these anti-rejection medications, but not the cost of other medications you may need. For most patients, this Medicare coverage will stop after 36 months. However, if you are eligible for Medicare coverage based on age or disability, the cost of your anti-rejection medications may be covered for as long as you are on medicare. The social worker or financial counselor at your transplant center should be available to answer questions about your coverage options.

What is rejection?

The most important complication that may occur after transplant is rejection of the kidney. The body’s immune system guards against attack by all foreign matter, such as bacteria. This defense system may recognize tissue transplanted from someone else as “foreign” and act to combat this “foreign invader.”

You will need to take medications every day to prevent rejection of your new kidney. Most patients need to take three types. The major one is usually cyclosporine or tacrolimus or sirolimus. In addition, you will most likely be taking some type of steroid and a third medication, such as mycophenolate mofetil, azathioprine or rapamycin. Additional treatment may be needed if a rejection episode occurs. Regular checkups at your transplant center will ensure early detection and treatment of rejection.

What are the side effects of the anti-rejection medications?

Anti-rejection medications have a large number of possible side effects because the body’s immune defenses are suppressed. Fortunately, these side effects usually are manageable for most patients. If side effects do occur, changing the dose or type of the medications will usually take care of them. Some of the most common side effects include high blood pressure, weight gain and a susceptibility to infections and tumors. You may also require additional medications to maintain blood pressure and prevent ulcers and infections.

What are the chances that a transplanted kidney will continue to function normally?

Results of transplantation are improving steadily with research advances. In the event that a transplanted kidney fails, a second transplant may be a good option for many patients.

Will I need to follow a special diet?

Kidney transplants, like other treatments for kidney failure, often require following special diet guidelines. If you were on dialysis before, you may find this new diet less restricted. The length of time you must follow the special diet varies. Your progress will be followed closely, and your doctor and dietitian will change your diet as needed.

Thanks:kidney.org

The kidneys perform many functions that are vital to good health. It is not unusual, however, to have only one kidney to do the work that two kidneys ordinarily do.
Why do people have a single kidney?

Many people are born with a single kidney. This occurs in about one out of 750 people. Being born with a single kidney is more common in males, and the left kidney is the one more often absent. The ureter (the tube that takes urine from the kidney to the bladder) on the affected side is usually abnormal or absent. An abnormality of the reproductive tract may also be seen on the same side. This occurs more often in females than in males.

In other cases, one kidney may need to be surgically removed, leaving a single remaining kidney. A kidney may need to be removed because of an anatomic abnormality such as obstruction, or because of a tumor, or from a severe traumatic injury after an accident. One kidney may be donated to a loved one with kidney failure.

How is a single kidney different?

The single normal kidney will grow faster and get larger than a normally paired kidney. For this reason, the single kidney is larger and heavier than normal, and it is, therefore, more vulnerable to injury. It is important to be aware of the increased risk for injury with certain heavy contact sports, so that careful decisions may be made regarding participation in various physical activities. The American Academy of Pediatrics, American Academy of Family Physicians and the Medical Society of Sports Medicine have suggested that people with one kidney avoid sports that involve higher risks of heavy contact or collision. This includes boxing, field hockey, football, ice hockey, Lacrosse, martial arts, rodeo, soccer and wrestling. Anyone with a single kidney who decides to participate in these sports should be extra careful and wear protective padding. He or she should understand that the consequences of losing a single kidney are very serious.

Are there long-term problems for people with a single kidney?

In general, most people with a single normal kidney have few or no problems, particularly in the first few years. However, some longer-term problems have been recognized. Most doctors believe that people with a single kidney, particularly from birth or during early childhood, should be followed more closely than people with two normal kidneys. Children who have had a kidney surgically removed may have a slightly increased chance of developing abnormal amounts of protein in the urine and some abnormality in kidney function by 25 years later. Similar abnormalities have been found in individuals born with a single kidney. In addition, there is greater chance of developing high blood pressure. The decrease in kidney function is usually mild, and life span is normal.

Are dietary changes needed?

In general, special diets are not needed by individuals who have one healthy kidney. Speak to your doctor or a registered dietitian if you have questions about the basic ingredients of a healthy diet.

How often should someone with one kidney see a doctor?

A urinalysis (urine test) and blood pressure check should be done yearly, and kidney function should be checked every few years, or more often if an abnormal urinalysis or blood pressure is found.

What special precautions are recommended for transplant patients?

Because the transplanted kidney is usually placed into the pelvis, these kidneys are in a location providing less protection and, therefore, are more easily injured. Consequently, the same recommendations of avoiding heavy contact and collision sports apply to the people who have had a kidney transplant.

Careful testing has shown that the transplanted kidney can increase its function as in other situations resulting in a single kidney, reaching a level of function that is about 40 percent greater than a normal level for a single kidney.

Thanks:kidney.org

AML is a fast-growing cancer of the blood and bone marrow. In AML, the bone marrow makes many unformed cells called blasts. Blasts normally develop into white blood cells that fight infection. However, the blasts are abnormal in AML. They do not develop and cannot fight infections. The number of abnormal cells (or leukemia cells) grows quickly. They crowd out the normal red blood cells, white blood cells and platelets the body needs.

Symptoms and Diagnosis
AML is the most common type of leukemia. More than 11,900 new cases occur in the United States each year, mostly in older adults. The average age of a person with AML is 65 years. Fewer than 10% of people with AML are children. The symptoms of AML are caused by low numbers of healthy blood cells and high numbers of leukemia cells. A person with AML may feel generally unwell and run-down. He or she may also have other, less common symptoms. AML is diagnosed when blood and bone marrow samples show a large number of leukemia cells. AML has eight subtypes, labeled M0 through M7. The subtypes are based on the type of blood cells affected.

Treatment Options
AML can get worse quickly, so doctors usually begin treatment right away. To plan treatment, doctors look at a patient’s risk factors (also called prognostic factors). Risk factors are patient and disease traits that clinical studies have linked to better or worse outcomes from treatment. For a patient with AML, the treatment plan may include:

• Chemotherapy - drugs that destroy cancer cells or stop them from growing.
• A bone marrow or cord blood transplant.
• All-trans retinoic acid (ATRA) if he or she has the subtype of AML known as promyelocytic leukemia.
• Gemtuzumab ozogamicin (Mylotarg) - a type of monoclonal antibody. Monoclonal antibodies are proteins designed to attach to leukemia cells and help the immune system destroy them.