This is an article from New England Journal of Medicine and it is published by Hassan N. Ibrahim, M.D., Robert Foley, M.B., B.S., LiPing Tan, M.D., Tyson Rogers, M.S., Robert F. Bailey, L.P.N., Hongfei Guo, Ph.D., Cynthia R. Gross, Ph.D., and Arthur J. Matas, M.D. in January 2009.
The article says the long-term renal consequences of kidney donation by a living donor are attracting increased appropriate interest. The overall evidence suggests that living kidney donors have survival similar to that of nondonors and that their risk of end-stage renal disease (ESRD) is not increased. Previous studies have included relatively small numbers of donors and a brief follow-up period.
According to other Internet sources, End-stage kidney disease (ESRD) is when the kidneys are no longer able to work at a level needed for day-to-day life. The most common causes of ESRD in the U.S. are diabetes and high blood pressure. These conditions can affect your kidneys. ESRD almost always comes after chronic kidney disease. The kidneys may slowly stop working over 10 - 20 years before end-stage disease results.
Back to the research article, they ascertained the vital status and lifetime risk of ESRD in 3698 kidney donors who donated kidneys during the period from 1963 through 2007; from 2003 through 2007. They also measured the glomerular filtration rate (GFR) and urinary albumin excretion and assessed the prevalence of hypertension, general health status, and quality of life in 255 donors.
Note that glomerular filtration rate (GFR) is a test used to check how well the kidneys are working. Specifically, it estimates how much blood passes through the tiny filters in the kidneys, called glomeruli, each minute.
The survival of kidney donors was similar to that of controls who were matched for age, sex, and race or ethnic group. ESRD developed in 11 donors, a rate of 180 cases per million persons per year, as compared with a rate of 268 per million per year in the general population. At a mean (± means standard deviation) of 12.2±9.2 years after donation, 85.5% of the subgroup of 255 donors had a GFR of 60 ml per minute per 1.73 m2 of body-surface area or higher, 32.1% had hypertension, and 12.7% had albuminuria. Older age and higher body-mass index, but not a longer time since donation, were associated with both a GFR that was lower than 60 ml per minute per 1.73 m2 and hypertension. Most donors had quality-of-life scores that were better than population norms, and the prevalence of coexisting conditions was similar to that among controls from the National Health and Nutrition Examination Survey (NHANES) who were matched for age, sex, race or ethnic group, and body-mass index.
As a conclusion, survival and the risk of ESRD in carefully screened kidney donors appear to be similar to those in the general population. Most donors who were studied had a preserved GFR, normal albumin excretion, and an excellent quality of life.
Saturday, November 17, 2012
Thursday, November 8, 2012
A New Push to Let H.I.V. Patients Accept Organs That Are Infected
In September 2008, the world's first organ transplants from a HIV-positive donor to HIV-positive recipient took place in Cape Town, South Africa.
Two kidney transplants were carried out at Cape Town's Groote Schuur hospital. The surgeon, who carried out the operations, Dr. Elmi Muller, said the operations had been highly successful and both male recipients of the kidneys had been discharged from hospital and were doing well.
Before then, the organs of HIV-positive donors were simply discarded, and HIV-positive patients were not eligible for organ transplants.
A consultant nephrologist said that while giving HIV-negative organs was better for patients, most HIV-positive patients were open to accepting an HIV-positive kidneys.
But receiving an HIV-infected organ is not without risks for the patient. In receiving donated organs, they can receive a new strain of HIV.
If the strain is a drug-resistant strain, the recipient could also develop resistance to life-prolonging anti-retroviral drugs.
In South Africa, HIV drug resistance is still ralatively low.
South Africa has the highest number of HIV-positive people in the world, meaning a large proportion of organ donors are HIV-positive.
An estimated 5.7 million, out of a total 48 million South Africans, are infected with HIV.
Even though organ transplants from an HIV-positive donor to HIV-positive recipients is still in clinical trials and has obstacles such as drug-resistant strain, it is a great news for South Africans and other HIV-positive people in the world.
Two kidney transplants were carried out at Cape Town's Groote Schuur hospital. The surgeon, who carried out the operations, Dr. Elmi Muller, said the operations had been highly successful and both male recipients of the kidneys had been discharged from hospital and were doing well.
Before then, the organs of HIV-positive donors were simply discarded, and HIV-positive patients were not eligible for organ transplants.
A consultant nephrologist said that while giving HIV-negative organs was better for patients, most HIV-positive patients were open to accepting an HIV-positive kidneys.
But receiving an HIV-infected organ is not without risks for the patient. In receiving donated organs, they can receive a new strain of HIV.
If the strain is a drug-resistant strain, the recipient could also develop resistance to life-prolonging anti-retroviral drugs.
In South Africa, HIV drug resistance is still ralatively low.
South Africa has the highest number of HIV-positive people in the world, meaning a large proportion of organ donors are HIV-positive.
An estimated 5.7 million, out of a total 48 million South Africans, are infected with HIV.
Even though organ transplants from an HIV-positive donor to HIV-positive recipients is still in clinical trials and has obstacles such as drug-resistant strain, it is a great news for South Africans and other HIV-positive people in the world.
5 Taiwan patients face AIDS risks after organ transplantation
Do you think a person who is AIDS virus carrier can donate his or her organs?
In August 29, 2011, there was a case related to this question in Taiwan.
The 37-year-old organ donor suffered a serious head injury due to a fall and was sent to emergency room. After he was confirmed to be brain dead, his family contacted the hopital to arrange the transplant of his organs.
A medical team removed his heart, liver, lung, and both of kidneys, then doctors checked the results of HIV tests on the organs. However, the transplant team members misheard a lab staff member saying that the HIV test result were "non-reactive" while in fact they were "reactive" and proceeded to perform four transplant procedures.
This mistake was found after the transplants had been completed and the transplant team collected the paperwork.
Five transplant patients were facing an anxious few months to find out if they have been infected with the AIDS virus. Later, each recieved an organ from the man found to have been as HIV carrier.
The hospital issued a news release saying that the mistake was due to its transplant team not following standard operating procedures or checking test results on computer before performing the operations.
They said their medical team have started relevant treatment and care including emergency anti-HIV medication for the recipients and will give the most appropriate medical care for the recipients in the future and take all responsibility.
The medical staff involved in the transplants had also started a course of anti-HIV medication.
Every hospital should draw a lesson from this incident and be more careful.
In August 29, 2011, there was a case related to this question in Taiwan.
The 37-year-old organ donor suffered a serious head injury due to a fall and was sent to emergency room. After he was confirmed to be brain dead, his family contacted the hopital to arrange the transplant of his organs.
A medical team removed his heart, liver, lung, and both of kidneys, then doctors checked the results of HIV tests on the organs. However, the transplant team members misheard a lab staff member saying that the HIV test result were "non-reactive" while in fact they were "reactive" and proceeded to perform four transplant procedures.
This mistake was found after the transplants had been completed and the transplant team collected the paperwork.
Five transplant patients were facing an anxious few months to find out if they have been infected with the AIDS virus. Later, each recieved an organ from the man found to have been as HIV carrier.
The hospital issued a news release saying that the mistake was due to its transplant team not following standard operating procedures or checking test results on computer before performing the operations.
They said their medical team have started relevant treatment and care including emergency anti-HIV medication for the recipients and will give the most appropriate medical care for the recipients in the future and take all responsibility.
The medical staff involved in the transplants had also started a course of anti-HIV medication.
Every hospital should draw a lesson from this incident and be more careful.
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