Thursday, 1 December 2016

Living donor not at higher risk of kidney failure: Study

By Carolyn Khew. The Straits Times, 30 Nov 2016

A kidney donor may have only one kidney after a transplant but it continues to function well, with four in 10 regaining 75 per cent of their pre-donation kidney function after five years.

In fact, donors lead healthy lives and are not at a higher risk of kidney failure or dying compared to the general population, according to a new study conducted by researchers from Singapore General Hospital (SGH) and Duke-NUS Medical School - believed to be the largest of its kind in South-east Asia.

The study looked at about 180 living kidney donors at SGH from 1976 to 2012. These patients had an average follow-up period of 11 years during which doctors looked at their blood pressure, urine test and kidney function during medical check-ups. It was also noted that kidney function in donors also stabilised after about a decade.

Which is why authors of the study are hoping that their findings will persuade more to consider being a living donor.

"The kidney function is actually not declining. We've removed your kidney but the kidney function tends to gradually increase... It's a very gradual, slow process and then it tends to stabilise. After stabilising, there will not be a dip," said Duke-NUS Programme in Health Services' Professor Tazeen H. Jafar, who was involved in the study.

Singapore is among the top five countries in the world with the highest incidence rates of kidney failure. In the last reported figures from the Renal Registry, 1,730 people suffered from kidney failure in 2014.

Kidney transplant from a live donor remains the best option for patients with end-stage kidney failure. Patients who undergo a transplant tend to have higher survival rates than those who undergo dialysis.

However, the latest figures from the National Organ Transplant Unit, Ministry of Health, show that while the waiting list for kidney transplants was 310 for the first half of this year, the number of kidney transplants from living donors stood at 16 as of the same period.

As for deceased donor kidney transplants, there were only 19.

Researchers cited a 2012 study which found the fear of surgical risks and poorer health after donation as the main reasons for respondents not considering being a living kidney donor. The risks for surgery, however, are minimal.

Dr Terence Kee, director of the renal transplant programme at SGH, said the risk of complications arising from surgical procedures for kidney transplants ranges from 1 per cent to 5 per cent.

Internationally, the statistic for the risk of death from a donor surgery is one in 3,000 which is considered to be very low, as low as going for an appendix operation, he added.

Researchers say one in 2,000 people is born with one kidney - a condition known as renal agenesis, and yet they lead a normal life and have a normal lifespan.

Dr Tan Ru Yu, associate consultant from SGH's department of renal medicine and lead author of the study, said end-stage kidney failure patients wait close to 10 years for a cadaveric kidney donor transplant.

"But the best option for them is a transplant from a living donor as outcomes are better. We hope the findings of our study will encourage more people to consider being a living donor, more so if the patient is their loved one," she added.

He loses 30kg so he can donate kidney to sister
By Carolyn Khew. The Straits Times, 30 Nov 2016

Ms Sheralyn Tay first found out in 2001 that her kidneys were failing but she never thought she would one day need a kidney transplant.

She took medication and continued with her activities as usual.

But in 2005, her health took a turn for the worse and her doctor told her that she needed a new kidney.

"I started feeling really unwell... and I was getting really tired," said Ms Tay, 35, who runs her own writing consultancy firm. She also noticed crystals forming on her skin.

She later found out that it was because of the build-up of waste products like uric acid in her body.

When her younger brother, Mr Alphonsus Tay, 32, volunteered to donate one of his kidneys after hearing about his sister's condition, it offered her a lifeline.

"I was already prepared to donate my kidney when I saw her health deteriorating," said Mr Tay, who runs his own marketing consultancy firm. "She's my sister. I have two kidneys, so I wanted to give one to her."

After nearly a year of evaluation, doctors certified in 2005 that he was fit to go ahead with the procedure. He was overweight, so he had to lose about 30kg before he could donate his kidney. Today marks the 11th anniversary of the transplant.

Ms Tay said she is now enjoying life without dialysis. In 2005, she had to quit her job as a journalist so that she could go for dialysis three times a week.

Looking back on the experience, she said: "You're exhausted, you have a headache, you're dizzy and you feel like throwing up. It's terrible. It was like you're breathing, but you're not really living.

"Since the transplant, I've just gone on and lived my life. When they say it's a gift of life, it's not an understatement."

Mr Tay said he hopes that his example will encourage more people to step forward as kidney donors.

Although he now has only one kidney, he said he does not feel any different compared with before the surgery.

The only thing that has changed, he said, is that he now takes better care of his health.

He said: "I owe it to my sister to take better care of myself. You have to because it's a way of making sure the recipient won't regret the decision to receive your kidney."

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