Selasa, 29 November 2011

Making sure kidney donors fare as well as promised

More and more donate a kidney to a relative, friend, even a stranger, and now a move to actually make sure that donors same success that was promised.
Surgeons stress rarely brings serious complications for the donor. What is less certain is the risk of long-term health effects, partly because transplant centers may lose track of donors after their return home.

"Who takes care of the donor after surgery Really?, No," said McLear kidney donor Krystal, 32, of Indian Head, Maryland, which sits on a committee that the network of the U.S. organ transplant system manages.
The United Network for Organ Sharing, the discussion of new policies to change the situation. One of the proposals: a checklist for assessing self-financing and explanation of the risk _ and a commitment to the health of donors and social stability, a better monitor for two years. Centers should monitor things like the condition of the kidneys, and if the dealer has a hard life or health insurance after.
And "reassuring data. A 2009 study at the University of Minnesota, for example, the track record of almost 3,700 people who donated a kidney out four decades. He concluded that donors have lived a normal life and are more likely than the general population suffer from kidney failure later in life, probably partly because they are very healthy start.
But there were more than 109 000 living kidney donors at national level in the past two decades, and today a little "different. The donors are older. Some transplant centers to accept donors who have hijacked long because they are overweight or have high blood pressure. More African-Americans, who are more prone to kidney disease, are becoming living donors, and there is less information about the results. Even if people had the picture of health when they served in later life obesity, hypertension and diabetes increase the risk of kidney disease.
"We are changing," said Dr. Connie Davis of the University of Washington in Seattle, who heads the committee of UNOS living donor. "We really need to look again at things in real time to say, okay, in this current climate is our risk?"
More than 90,000 people on the national waiting list for a kidney, and the wait can stretch for years. There are fewer than 17 000 kidney transplants a year. But more than 6,000 of them each year are due to living donors.
Surgery always involves risks, but the donor's death are extremely rare. UNOS data show that since 2000, there were 13 deaths from donors within 30 days after donating a kidney that is not a cause, of course, nothing. Davis said that no more than 5 percent of donors have complications such as bleeding or blood clots.
What can we say? Transplant centers are required to verify a minimum, but an analysis of UNOS is to lose sight of many donors. Just one year after the donation, I do not know if two-thirds still alive or dead, let alone had their kidneys tested.
"There is this perception that donors can not be followed. This is not necessarily the case," said McLear, who emphasized that doctors kidneys and blood pressure control remains low.
McLear traveled to Michigan in 2008 to donate a kidney to his cousin in 26 years, and is glad his cousin _ is thriving. But McLear had trouble finding what they expect their health after surgery. And one week after the donation, a dangerous inflammation of the pancreas, a rare complication. She was admitted to the hospital for seven days more and more work for 12 weeks, nearly twice as long as he had expected.
The new proposal: the transplant centers must be at least 90 percent of living donor kidney them for two years _ not only when they are still alive and have their kidneys checked, but if they hospitalization, he developed other health problems, had no loss of income or insurance because of their donation.
Separate proposals to the first standard informed consent document explaining the risks to uncover and try to variations in how the centers of a fitness test to eliminate donor.
The proposals are open for public comment until December, for a final decision next year. Among the problems are and if the cooperation of the donor transplant centers have the staff and money to keep.
The National Kidney Foundation has long called for such surveillance, and some transplant centers that specialize in gifts of life have been trying.
New York, Mount Sinai Medical Center, for example, has a living donor, two years ago, which provides power and other post-donation counseling in addition to health checks.
Georgetown University Hospital in Washington, Dr. Jennifer Verbesey recently saw a woman who was clinically well after donating a kidney to his son, but had a depression after surgery.
"For many people, there are many ethical and emotional after a transplant," says Verbesey. "If you tell me that 99 percent of people will not have a problem, I always make sure I'm here to be the only person who could find."

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