donor

[Bluecrababc]

I have a donor that is my cousin, perfect match. She was a drug attic over 20 years ago and totally clean since. No repercussions or and illness or drug related infections. Totally clean. She had a suicidal thought during ancient drug use. She is 60 years old and totally healthy otherwise. Can she be considered my donor? Any one heard otherwise?Thank you very much. My GFR is 15 with Type 1 diabetes for 45 years so need to act quickly. ❤️

[Darlenia]

I would simply ask her to talk to your transplant center. The transplant center will evaluate her and render a decision. In some situations, if there's an issue for some reason, the center may arrange a swap or exchange among consenting parties. Nothing ventured, nothing gained!

[PostivelyJo]

the transplant centre evaluates living donors and if they don’t feel your cousin can cope emotionally or physically they won’t proceed. But if she’s offered it sounds very promising.

Fingers crossed for both of you.

[ShyeLoverDoctor]

Disclaimer: I am not a doctor.

Out of all donor candidates, only 1 in 5 is actually heathy enough to be accepted as a donor. It’s seriously tough to find someone healthy enough and that is for their protection.

For one thing, it’s doubtful that at that age, she has enough kidney function to be a donor. GFR typically must be 85 or above. People think their health is great, but that’s because they are clueless about the reality of their kidney function. I had 59 year old and 60 year old try to be my donor. The 59 year old had a GFR of 83 and the 60 year old had a GFR of 80. The transplant center’s donor cutoff was 85 and it was a hard line. People may not take drugs, prescribed or otherwise, and exercise, and eat right, be at a “healthy weight” and still not have great kidneys.

Also transplant evaluation is shrouded in mystery. Who knows what they’re going to really think? Usually takes 4-6 months to be evaluated and that does not include the wait to get a first appointment (usually 3 months) Having pre-diabetes or diabetes or kidney stones or active cancer are instant no’s. You can take the Breeze quiz online at a transplant center’s website to check eligibility. Takes about 10 minutes.

My advice? Again, not a doctor! Get a look at her last CMP, which will include the GFR. You can actually order one by yourself without a doctor’s prescription in most states. Quest will do it, go to their website and buy it. GFR is most accurate doing a 24 Hour Urine collection, but honestly, if GFR result from the CMP doesn’t look good I would not waste your time having her tested.

Get on the cadaver list right now, as many as you can. You can be listed at more than one center it’s called multi-listing. The Mayo Clinic in Phoenix, AZ has a short wait, as does Omaha, Nebraska, as does Texas City Medical Center at Fort Worth, as do some Florida hospitals. Shortest wait list is in Toledo, Ohio. There is a website where you look at waitlist time across the US., txmltilisting.org I believe, Having a GFR under 20 makes you eligible. You must be on the transplant list to even get a living donor. I had those two donors fail, then another donor quit the testing, and another one trying for almost 2 months and still couldn’t get an appointment with the transplant center for evaluation. Her GFR was 87 the year before so I was pretty doubtful she’d pass. At that point, the transplant center I was at called me to offer a cadaver donor, and I accepted, even though a living donor kidney works better and lasts longer. I was on dialysis which will keep you alive but is a pretty miserable life. I’d been searching for living donor for a year and 8 months.

I highly recommend the online support group RSNHOPE.ORG. It’s everyone from Stage 2 to failure to transplant.

Good luck!

[Darlenia in reply to ShyeLoverDoctor]

Older people can definitely donate a kidney. In our experience, older kidneys generally go to older folks because lifespans for them are, of course, naturally shorter. So transplants generally go to people close, or less than, in age to the donor's age. It might be possible, if the cousin's health is great, that she could be put into a paired exchange where an older person gets hers while the OP gets a kidney from a younger individual. But generally, yes, it's harder for older folks to gift a kidney because of their overall health issues - kidney function, cardiac status, etc.

[modernmusic in reply to ShyeLoverDoctor]

I second everything ShyeLoverDoctor says! I know that your situation is pretty scary, but you may be capable of more than you think. I was diagnosed with ESRD in 2012 and managed to last without doing any kind of dialysis until I got my transplant 8 months ago. My eGFR slowly went from 15 in 2012 all the way down to 7 right before I got my transplant in March 2023. Early on I was fortunate enough to meet a guy who had been on dialysis and said that he got off by watching his diet and eating to your labs. Try to get bloodwork as often as they will let you and study them to figure out what you need to not eat. I had trouble particularly with potassium so I was very careful about researching the mineral content of everything I ate. It's pretty tough at first but after a while you will memorize the mineral conent of all of the most common foods and will begin to automatically know what you have to avoid, or at least eat only in very small portions or very infrequently. Anyway, yes do get on the transplant list immediately! I had them put me on a status where I was accruing time but they were not offering me kidneys. When the time finally came I had so much time (over 10 years) that they told me I was at the top of their list and they started offering kidneys within a few weeks. Things may not be as bad as they seem.

[ShyeLoverDoctor in reply to modernmusic]

Man you are so lucky! Well, yes the eating healthy was a great choice -only 8 oz per day of protein, plant protein is easier for kidneys to process than animal protein, low salt to keep BP low. But I totally tried to get a living donor before I went on dialysis, called a pre-emptive transplant, and couldn’t. Had two tested, but they both failed the tests. I went on dialysis at GFR 6 and had felt horrible those last few months. I was really mad my dr made me wait so long. So tired I could barely move, and when the constant nausea started, that was it, I insisted.

[modernmusic in reply to ShyeLoverDoctor]

So sorry to hear of your difficulties. I know how lucky I've been. Somehow, luck has been a big factor all of my life.

[ShyeLoverDoctor in reply to modernmusic]

Actually I do consider myself lucky. I got a transplant after only 11 months and 3 weeks on dialysis. Many wait for years, My doctor was amazed. I am very grateful to the donor and their family. Part of what makes me hang in there is a feeling of obligation not to “waste” that precious organ. I owe it to them. Other people have it far, far worse than me. But yes I have suffered a lot, thanks for recognizing that.

[DexterLab]

I agree with much of what ShyeLoverDoctor said. The transplant center will run your cousin through a battery of tests to evaluate her prospects of thriving on only one kidney. If there is any doubt, they will say no. The idea is to have two healthy people after the transplant.

I disagree about the age of the donor. My donor was 60 and he passed with flying colors. You do need to get on the list for deceased donors and to think about where to ask for a living donor if your cousin doesn't work out. Good luck.

[ShyeLoverDoctor in reply to DexterLab]

Fair enough, It’s possible to find an older person healthy enough, I just think it’s unlikely. Theoretically there’s no age limit to donate. One of my transplant centers has 65 as the cutoff.

[Bassetmommer]

I also agree that the age for donor depends on the medical center. I would try and see what they say. Even so, go through the process of getting on a list.

[Tolmezzo]

Technically absolutely yes. At least in Italy. Before become eligible for being a donor there's a standard procedure to deeply check healthy and phycological mental freedom of donor. The transplant team must grant donor to remain healthy afterwards ad that choice to make donation is totally free from any conditionings. Rgs

[hope1419]

Bluecrababc, Before I say anything else, a question popped in my mind for you. How do you know your cousin is a perfect match? Has your transplant center evaluated her? Or are you basing this just on the blood type? If it is the second case, it is important to know that blood type compatibility is only the first step. She needs to complete the whole evaluation through your transplant center. Only they can determine 2 things. 1st, if she is healthy enough to donate. (By the way, age is not necessarily a thing, as long as she is healthy enough. I knew a guy who donated at 65). 2nd. The center can tell you how trully compatible she is with you after the crossmatch tests.

If the transplant center has already approved your cousin as your donor, you don't have to worry about. They wouldn't so it unless it is safe for her to donate, and for you to receive her kidney.

On another topic, my GFR was between 10 and 13 previous to the transplant, but I wasn't diabetic. I think you still have tome to find a good donor if your cousin doesn't work out. Make sure you are in good stand in the UNOS transplant list and stay as healthy as you can. Getting transplanted pre-dyalisis and from a living donor is the best case senario. Good luck with your transplant. Hopefully your cousin will work well because not many people are trully selfless to donate an organ. I am forever thankful beyond words to my Angel who donated mine, and we weren't even family. Now we are!

[ShyeLoverDoctor in reply to hope1419]

By the way, I found four total strangers step forward to donate. We all had something in common since we belonged to the same religious synagogue. First I put a listing in our monthly newsletter. .One went through all the testing and was rejected. Then I gave a 6 minute speech at once service. After they heard the speech, two volunteered. One was an 11 year old girl, and one was in her 70s and had four kidney stones. I put a paid ad in a religious magazine, and another woman saw the ad and was trying to enter the process - center not returning her calls, etc - when I got the offer for a cadaver kidney.

[LavenderRabbit]

Only your transplant center can tell you. My husband gave a kidney for me, he was 67 at the time.

[Yankcg70]

Please talk to your Dr. They can give you the ups and downs of both sides. Also do get on the cadaver donor list. In this day and age they can last just as ling as a linving donor. I am 34 years out on my deceased donor transplant and no issues ever and no longer take immunosuppresants either. Good luck

[hope1419 in reply to Yankcg70]

Yankcg70, Now I am very curious about how you ended up no longer taking antirejection meds. How compatible was your donor? How did your doctor decide you didn't need antirejection meds? I have always been told that we are in them for life. I do not know why, but my transplant team decided I didn't need prednisone; and God, I was thankful. I started at 7 mg x2 a day of Tacrolimus and 1000 mg of Mycophenolate x2 a day. Med dosage has been adjustes up and down according to my labs. Right now I am almost 8 months after transplant, and I am at 4mg x2 a day of Tacrolimus and 500 mg of Mycophenolate x2 a day. All this to ask you how did you go out of antirejection meds? Did you ask? How old were you? How often do thwy monitor you?

[Yankcg70 in reply to hope1419]

I had my transplant in 1989. I was on cyclo, prednisone and immuran. They took me off the prednisone in 2003. My dr then retired and i had a new dr who i am still with. In 2013 i talked with him about lowering doses or stopping more. I have always ran around a .7 for my creatinine with no rejection episodes so we stopped the cyclo. When 2014 came around i had to have rotator cuff surgery and had to be off the imuran for 2 weeks prior. After that my numbers stayed perfect so we never started it again. Everything has been good since. For me the reasoning was what good is getting this transplant at 18 yrs old only to end up dead in 30 years because of all the side effects of the immunosuppressents? I had labs done every 2 months for a year and after that back to normal 2 times a year. I have not seen my transplant team in decades. To be quite honest...they are just the surgeons. After about 3 years i would only see their pa's or a resident anyway and it was a 3 hour drive one way for a 15 min appt. Plus my nephrologist does the exact same labs and if anything is wrong he can treat me just as well as the surgeon can.

[ShyeLoverDoctor in reply to Yankcg70]

I am really happpy for you! How awesome.

[LeslieK]

If she’s a perfect match then she must have started some bloodwork.

Perfect match Kidney- I say go for it! Get all the testing for you both to be approved and see what the transplant team board decides.

I didn’t do dialysis or get a transplant till I was at a GFR of 3. You have time but the hospital will move things along quickly with a potential living donor.