The easiest way to think about your kidneys is they're a filter for your body. So you're
drinking all this fluid in, your eating foods, and the kidneys basically clean the blood. The
blood comes in through the renal artery, it circulates through the kidney, and the kidney
acts like a filter. All the bad stuff goes into the urine and goes down to your bladder, and the
clean blood then goes back out the renal vein and circulates through your body again. One of
the saddest and most frustrating things that I see when I'm evaluating patients,
my first question is always, tell me when you first knew about your kidney disease.
And in a large proportion of patients, the story that I hear is I walked in with very
high blood pressure or a headache and they told me my kidneys had already failed. And I
know that that process was going on for years, but you don't have symptoms until the very end.
There are a couple of diseases that make you very predisposed to kidney disease. The number one
reason in the, especially in the United States, is diabetes. Diabetes is a disease that's nephrotoxic.
You're not controlling your blood sugar levels and eventually this goes on to hurt your kidneys.
There's really two options for people. They can either get a living donor transplant or
a deceased donor transplant. With a kidney transplant, we're going to give you four to
five times the function that dialysis gives you. We can talk about feeling better and
better quality of life and that's all important, but transplant is also one of the few things in
medicine that actually extends life. People live longer with a transplant. If you take
for example a typical American 50 year old, if they're healthy we expect them to live an
extra thirty years. They lived to about eighty. The same fifty year old on dialysis has a life
expectancy, an average life expectancy, of eight years. If that 50 year old gets a transplant,
immediately their life expectancy jumps to twenty years, a significant increase in life.
To be determined as a candidate for transplant whether that's from a living donor or deceased
donor, can expect the same thing. We still have to make sure that really the two major things
are accomplished. They have to be safe to have an operation and safe to receive the
immunosuppression which is the medication that your immune system needs to be able to accept
that organ for transplant. People when they come to see us, they have our extensive workup to be
able to establish those two things. The resources that are available here at the MedStar Georgetown
Transplant Institute are second to none. But we need help from others to be able to do our job,
meaning we need organs for transplant. Living donor transplant provides a huge medical benefit for the
recipient. So living donor organs tend to work faster and last longer. And so that can lead to
a longer length of life and a better quality of life for the recipient. Some recipients who have
been really sick before can feel incredibly better within days after the surgery. So and
most the time when people come back in for their follow-up appointments, if everything's going well,
kidney is working well, some of those people have a new lease on life. I mean life totally
changes for them after transplant. People that are interested in being living donors, the first
contact is the living donor connects with us. And living donation has become such a big part
of our program. We have specific individuals at the Transplant Institute that just work for
living donation. My job consists of keeping patients ready for transplant at all times,
making sure their testing is up to date, helping to allay any fears they may have towards transplant,
making sure they have proper services that they need. Eligibility for donation takes on a lot of
different phases, but sort of the big picture is things like diabetes, frequent kidney stones,
obesity, heart disease, and cancer those are kind of the big things that we say would rule out an
individual from being a donor. The good news here is that we have 40 years of data. We've
done living donor since the 1960s, and every study has shown no change in lifespan of people after
kidney donation. About a third of all transplants are living donors, and we and other centers are
doing everything we can to get people to be more open to the idea of living donation. What we often
find is that we have donors willing to donate and recipients are nervous about their donors,
as it's understandable that they are, but they're too nervous to ask or they are they don't know
how to ask. And we do what we can to try and make that process easier on them and give
them some ideas about how to ask and how to approach people. But it's really about being
as broad and aggressive as we can have recipients be to find their donors. And it's amazing who does
step up to donate. I've had a teacher donate to a student. I've had a landlord donate to
a tenant. Just a couple of weeks ago, we had someone and I said who are you donating to
and she said my auto mechanic. So I always tell people cast a broad net. Consider why they don't,
don't assume that people are going to say no because all you need is one person to say yes.