Two out of three kidney transplants are from deceased donors. They are in short supply
, of Kansas City, Missouri, was 25 when she was diagnosed with late-stage kidney disease. She had to start dialysis, hooking up three times a week to a machine that filtered her blood. “It wipes you out,” she says. Queasy and fatigued, Ms Bensouda struggled to care for her children and to keep working full time. To secure a place on the waiting list for a kidney transplant, she had to tackle other health problems first.
Shortening them will save more than personal misery. In Britain a kidney transplant, which lasts for 10 to 13 years on average, starts saving the National Health Service money compared with the cost of dialysis in the third year. In America a transplant saves $60,000 per year compared with remaining on dialysis.
By and large more people say they want to donate than actually volunteer to add their names to a donor registry. This has encouraged more countries to follow Spain, which has the world’s highest organ-donor rate and in 1979 became the first country to introduce a law making organ donation upon death the presumed choice of anyone who has not registered to opt out.
At what stage doctors are allowed to retrieve organs matters hugely. In less than half of European countries can the process start after the heart stops , rather than when the brain shuts down too. Across Europe, the “no-touch” time before organ retrieval can then begin varies from 5 to 20 minutes. A kidney donor typically needs two days in hospital and about a month to recover. About 20% suffer some, mostly minor, complications. In many countries some would-be donors are deterred by the cost of travel and other expenses. In the Netherlands, which has the highest rate of living organ-donors in the rich world, kidney donors get three months of paid leave to recover, as well as payment for related costs—even such needs as dog-sitting.
Such schemes are particularly beneficial for people who have had a blood transfusion or are waiting for a second transplant, because donors who suit their mix of antibodies may be extremely rare. If all living donors in America were allocated through a nationwide exchange, kidney transplants from such volunteers could double, says Jayme Locke of the University of Alabama at Birmingham.But many people, understandably, cannot bring themselves to ask others for a kidney.
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