Kidney Quest – Kidneys In The News

Surgeons operate to extract the liver and kidneys from a woman at the Unfallkrankenhaus Berlin hospital in Berlin, Germany.

LONDON (Reuters) – Kidney transplants from living donors have surged worldwide over the past decade, researchers said Wednesday, adding more organs are still needed from people who have just died.

They estimated 27,000 transplants take place every year from living donors — representing 39 percent of all kidney transplants — with majority in the United States, Brazil, Iran, Mexico and Japan.

“Our study shows that living donor kidney transplant rates have steadily risen in most regions of the world increasing its global significance as a treatment option for kidney failure,” the researchers wrote in Nature’s journal, Kidney International.

Better understanding of these global rates is important as severe kidney disease requiring transplants rises worldwide due to aging populations and unhealthy diets leading to diabetes and other conditions, they said.

Researcher Lucy Horvat and her colleagues at the University of Western Ontario in Canada said understanding who donates and why in different countries can help officials find ways to increase kidney and other organ donations.

“This is the first comprehensive report of its kind and it emphasizes the growing significance of living kidney donation worldwide,” Horvat said in a telephone interview.

A kidney transplant can get a person off dialysis and back to a normal life but the shortage of deceased donors pushes more people to seek an organ donation from a friend or relative, Horvat said.

Her team analyzed data from health registries, transplant networks, published studies and national health ministries in 69 countries.

They estimated the number of living kidney donor transplants grew over the last decade, with more than half of the countries reporting at least a 50 percent increase.

The researchers said Saudi Arabia ranked highest in the world for its living kidney donation rates, with most donors unrelated to the recipients.

Iran came in third and has no waiting list, likely due to a controversial system under which patients can pay for donated kidneys.

The researchers only reported legal living donations and said the overall number is likely higher.

The World Health Organization estimates about 10 percent of all organ transplants worldwide involve unacceptable or illegal transplants.

By Carrie Whitaker • cwhitaker@enquirer.com • February 8, 2010
Last year Annie Laib was in a lot of pain. The 33-year-old doctor’s kidneys were failing and no one in her extended family, not even one of her 25 cousins, was a match for a transplant.

Annie’s twin sister, Emily, received a kidney from their cousin – the girl’s only healthy familial match – a year before and was doing well. Doctors told their family there was a 50/50 chance the kidney would last for 20 years.

The women have polycystic kidney disease, a genetic condition. Their father, grandmother and uncle have it as well but their cases are far milder than the twins’.

“Here’s poor Annie, facing a few years of dialysis and possibly her kidneys wouldn’t do so well,” said University Hospital transplant surgeon Dr. Steven Woodle.

Annie, of Newport, worried she wouldn’t get the same lease on life. But she hadn’t yet met Amy Maliborski.

Sitting in University Hospital on Friday with a new, healthy kidney inside of her, Annie Laib wept, letting loose the fear and anticipation she’d held onto for so long.

Then, happy tears, as she met her donor, a 36-year-old mother of three who heard about Annie’s plea and in a split second thought, “I could do that.”

“It’s a miracle,” said Annie’s dad, Richard, standing over the two, Annie at the edge of her hospital bed and Amy next to her in a wheelchair, grasping hands.

“Your kidney is so energetic,” Annie told Amy. “I haven’t felt this good in years.”
Amy’s story

Amy Maliborski was out of town when the plea for a donor was printed in the church bulletin at Our Lady of Lourdes Catholic Church in Westwood, the neighborhood where she lives.

She happened to think to read it online.

Coming across Annie’s name, Amy learned that this stranger was in the end stages of renal disease and needed a kidney. People with type O blood can wait four years to find a match, Woodle said.

Amy decided to call.

“I was just really at peace with it,” she said. “I thought, when else in your life do you have the opportunity to make such a big difference?”

She shared the idea with her husband, Craig, who admittedly wasn’t as gung-ho. But the assistant principal at St. Xavier High School couldn’t say no to his wife’s brave spirit.

Amy’s mother, Mary Lou Blount, was supportive and also bit her tongue.

“I was very concerned for her,” Blount said. “I knew she had to go through all this fear and courage at the same time, which I think is a very difficult thing to do.”

Amy was tested and found that she was a perfect match for Annie.

“I wasn’t afraid of the pain. I wasn’t afraid of dying,” Amy said. “But it was hard knowing if something went wrong, it was my choice.”

On Thursday she went in for surgery, refusing some medications so she could “see Craig’s face until the very last second.”

“They wheeled me back and they said, can you just hop up onto the operating table, so I did.”
Living donors

Although Woodle believes modern medicine has improved survival rates for today’s transplant donors, the reported risk of death is one in 5,000.

University Hospital prefers living donors transplants because the kidney can lasts an average of 20 years, compared to a deceased donor’s kidney, which on average lasts 10 to 11 years, Woodle said.

Forty-five percent of all kidney transplants in the United States today involve living donors. University Hospital has edged up its percentage to 64 percent, Woodle said.

“It adds years of life expectancy,” Woodle said. “That kidney will get (Annie) into middle age of life with one transplant.”

A subsequent transplant can be more difficult, making the first transplant critical, Woodle said.

According to the national Scientific Registry of Transplant Recipients, from July 2006 until January 2009 University Hospital completed 82 living donor transplants with a 100 percent survival rate after a year, 7 percentage points higher than the national average.
Going home

On the day after their surgeries, Amy Maliborski decided she wanted to meet the woman who received her organ. Annie Laib had hoped this would be the case.

The women’s mothers recognized each other. Kathleen Laib and Blount had worked together in years past as Realtors at Coldwell Banker on the West Side.

“Did you know it was us?” Kathleen Laib asked. Blount nodded her head “yes.”

Amy Maliborski was home on Saturday, about 48 hours after surgery. She’ll require a checkup in a week and should see her doctor once a year to check her kidney function and blood pressure, Woodle said. Living with one kidney gives her no better chance of kidney failure, because the things that cause kidney failure would affect both kidneys, Woodle said.

Annie will take a little more recovery time in the hospital, where they will monitor how her body receives its new organ.

The transplant means the girls are technically no longer living with polycystic kidney disease.

“It’s gone,” Annie said with a smile. “It’s too wonderful for words. She saved my life.”