Donation program first of its kind

Justin Costley

Charity is often expressed through the offering of assistance, money or time to others.
At Fairview-University Medical Center, it is being expressed through the sharing of kidneys.
It isn’t new for family members or friends to donate kidneys to loved ones in need. But before the University considered it, people never donated kidneys to patients they would never meet.
Beginning two years ago, the medical center crafted a set of guidelines to allow the hospital to do the nation’s first anonymous kidney donation.
Although completed a year ago, the results were published in last week’s issue of the New England Journal of Medicine.
With the help of this protocol — co-written by transplant surgeons, nurses, social workers and a representative of the University’s Center for Bioethics — six such transplants have been performed during the past year.
The policies are the first ever written for this type of kidney donation and transplantation. They include rigorous physical and psychological testing for potential donors.
The screenings are designed to ensure altruism is the only motive behind donation. It also helps protect the identities of donor and recipient before and, preferably, after the surgery.
Jeffrey Kahn, director of the University’s Center for Bioethics, said anonymity is important to protect against deals being struck or a donor showing up at a recipient’s door and asking for post-surgery payment.
“The biggest issue is that, I think we have to be concerned when an otherwise healthy person is putting themselves in harm’s way for the benefit of someone that they’ll never meet,” Kahn said. “We call those people heroes, but we think it’s above and beyond the call of duty and I think we’re a little bit skeptical when they want to do that.”
Traditionally, most kidney transplants have involved cadaver organs, but they require long waiting times searching for compatible donors.
Living donations offer better short- and long-term outcomes than cadaver kidneys and drastically reduce waiting times. A reliance on friends or relatives has caused the use of living donations to remain minimal.
This new procedure allows living kidneys to be given to patients who might otherwise have endured a three- to five-year wait on a cadaver transplant list.
Nationwide, more than 47,000 people are waiting for a kidney, and only 7,000 cadaver transplants are done annually.
Since the program began, more than 100 people across the country have expressed interest in donating to the medical center.
Dr. Arthur Matas, chief of renal transplantation at Fairview-University Medical Center, said the hope is that this protocol and procedure is evaluated, critiqued and adopted at other medical centers around the country.
He added it could become another avenue to help alleviate the shortage of organs for needy patients today.
“If other transplant centers around the country implement similar policies it would give the donors more options of centers to go to,” Matas said. “It’s another outlet. It’s unclear at this point whether or not it’s going to be a huge outlet. That remains to be seen.”
While donors, like any patient undergoing transplant surgery, are at risk, it need not affect their lifestyle.
Matas said studies have shown that patients with only one kidney can lead normal and productive lives.
Medical center transplant coordinator Cathy Garvey said the most fulfilling part of this project has been working with the donors.
“It’s so humbling working with these people,” she said. “They are such good people. All living donors are good people, but these people seem to take the extra step.”

Justin Costley covers the Medical School and welcomes comments at [email protected] He can also be reached at (612) 627-4070 x3238.