The following interview with a donor by the name of Barbara Thomas contains valuable information from the perspective of someone who has successfully undergone the process of donating a kidney.

As Barbara mentions in the video, the health insurance of the recipient (assuming they are insured) should cover almost all of the costs associated with the transplant (Barbara did have to pay out of pocket for things like transportation to and from the hospital).

Modern advancements in medicine and surgical procedures have fortunately made it so that experiences like Barbara’s have become much more common. Today, it is safer than ever to donate a kidney and quite possibly save someone’s life by doing so.

We strongly encourage you to watch the above video for detailed information about the experience of living kidney donation.

At just 9 years old, Emily Clark had already battled kidney cancer twice and had one kidney removed. Emily’s mother, Claire, was gearing up to donate one of her own kidneys to her daughter when doctors noticed that Emily’s kidney function had improved from 18% to 35%, practically overnight.

Emily’s parents attribute this miraculous turn of events to her having a guardian angel watching over their eldest daughter.

Read the full article here.

The patient, Nancy Kammerer, was undergoing a routine kidney transplant when surgeons accidentally cut a part of her pancreas, which subsequently required that the damaged organ be removed.

At 56-years old, Nancy is now a diabetic who will have a life-long dependency on insulin. This new aggravated condition forced her to leave her occupation at Wells Fargo. In the malpractice lawsuit, Kammerer also alleged that the surgeons were negligent because they used a medical record in her patient file that was inaccurate.

Although the hospital denied any liability in the incident (which occurred in 2008), this recent large settlement may be an indication that they feared the courts might have a different point of view.

Kidney transplantation, like any major surgery, can be very dangerous. The risk factor is one disadvantage of a kidney transplant that you may want to consider if you are a candidate for the surgery. However, unfortunate incidents like this one that Ms Kammerer experienced are in the minority of cases.

Corticosteroid therapy is the most frequent cause of post-transplantation hyperglycemia. Steroids may increase production of glucose from gluconeogenesis, impair peripheral use of glucose, and cause elevation of glucogen levels by a direct anti-insulin effect at the cellular level. An undetermined threshold dose of corticosteroid may be required to provoke diabetes in susceptible individuals. Some studies have shown post-tranpslant diabetes to be related to steroid does, increased patient age, black race, a positive family history of diabetes, increased body weight, and human leukocyte antigen A28. These findings have not been consistent.

Typically, the onset of steroid diabetes is mild, without associated ketoacidosis; it may resolve on withdrawal or reduction of the steroid dose. Both cyclosporine and tacrolimus contribute to glucose intolerance by inhibiting insulin secretion by pancreatic beta cells and by inducing peripheral insulin resistance. Animal studies have revealed a decrease in islet cell insulin content as well as a severe degranulation and hydropic degeneration of islet cells after treatment with cyclosporine. Human studies have shown both improved glucose tolerance curves and insulin output after conversion from cyclosporine to azathioprine and prednisone. Cyclosporine dose reduction may improve glucose intolerance.

From the video:
Did you know that the typical wait time to receive a kidney transplant from a diseased donor in Ohio is between three to five years?

If you are to receive a living donor kidney, the following will be arranged and completed prior to transplant:

• tissue typing from both yourself and the potential donor
• full donor workup or medical evaluation
• periodic physical examinations by the local nephrologist or transplant center
• blood tests and X-rays (other types of tests may also be required)

If you are receiving a transplant from a cadaver, the following will be completed before your name is placed on a waiting list:

• you are tissue-typed and the results are placed in a computer with other names on the waiting list
• a tube of blood serum must be sent regularly from the dialysis center to the tissue-typing laboratory for sensitivity screening
• periodic physical examinations, X-trays and blood tests are ordered

Also, the hospital or dialysis center must be assured of your whereabouts by receiving the telephone numbers and addresses so that you can be reached in the event a kidney becomes available.

If a Cadaver Kidney Becomes Available

You will be notified when a potential kidney becomes available. Once notified, you should stay close to a phone to receive information on the time of hospital admission. Arrangements for traveling to the hospital should be made and you will probably be told not to eat or drink anything in preparation for the surgery. You may need to be dialyzed before the surgery depending upon when you were last dialyzed, your blood chemistries and your general medical condition.

“That was it for me,” Morgan explained. “Now I take my insulin every day. My blood sugar doesn’t get over 120.”

People that suffer from Type 2 diabetes (the most common type) are particularly at risk for kidney failure. This type of diabetes inhibits the body’s natural ability to properly produce insulin. Insulin is a vital hormone that is necessary to get glucose into cells so that it may be used as energy. If this process is obstructed, the glucose may build up in the bloodstream which may lead to eye, nerve, and kidney damage. If this problem is neglected, there may be serious consequences such as loss of limbs, stroke, or heart disease.

Along with frequent doctor visits, there are many ways for people with Type 2 diabetes to minimize their risk of experiencing kidney failure. For instance, eating fish twice a week is believed to significantly reduce the risk of kidney disease for diabetics. Poor diet is one of the biggest risk factors.

Tracy Morgan is expected to recover quickly, and will probably only have to be absent from a couple episodes of 30 Rock, his current hit television show. Upon returning, Morgan will be welcomed by his fellow cast members such as Alec Baldwin, Tina Fey, and fellow kidney transplant recipient Grizz Chapman.

These Medicare benefits consist of two types of insurance: Part A, or hospital insurance, and Part B, or medical insurance. Almost everyone who is eligible for Medicare is covered by hospital insurance without paying any monthly premium. Hospital insurance covers medically necessary inpatient hospital care and, under certain conditions, medically necessary post-hospital inpatient care in a skilled nursing facility, and home health care provided by a home health agency. The hospital insurance part of Medicare, for example, helps pay for an inpatient stay in an approved surgery. Hospital insurance has an annual deductible, and Medicare payments for services are made directly to the participating facility providing services.

When a person becomes entitled to Medicare hospital insurance because of chronic kidney failure, they are also enrolled for medical insurance or Part B of Medicare. Although they do not have to take this part of Medicare, most of the services and supplies required by chronic kidney failure are covered only by the medical insurance and not by the hospital insurance. The monthly premium for medical insurance protection covers physicians’ services; outpatient hospital services; outpatient maintenance dialysis treatments in an approved dialysis facility; durable medical equipment for use in the home, such as dialysis machine; and almost all items necessary for home dialysis, as well as many other health services and supplies. In addition to monthly premium payments, medical insurance also carries a small annual deductible payment and a 20 percent co-insurance liability.

Note: There is no minimum age required to receive Medicare benefits under the kidney disease provisions, as long as all other eligibility requirements are met.

How to Find Out if You’re Eligible for Medicare Benefits

The law states that you must be a Social Security or Railroad Retirement beneficiary or be “fully or currently” insured in order to be eligible for the kidney disease provisions of Medicare. You are currently insured it you have at least six quarters of coverage during the full 13-quarter period ending with the calendar quarter in which dialysis or a transplant occurs. A patient is fully insured when they have one quarter of coverage under the Social Security program for each year elapsing after 1950 (or after the year the patient attains age 21, if later) to the year in which dialysis or transplant occurs. In no case is more than 40 quarters of coverage required. The spouse or dependent child of an insured individual is also eligible. For more information on eligibility, contact your local Social Security office. A social worker is best suited to assist you in determining whether or not you are eligible for Medicare benefits.

• better understand the causes of kidney diseases and kidney failure
• develop new strategies for the treatment and prevention of kidney diseases and kidney failure
• improve dialysis therapies
• increase success rates for kidney transplantation
• find alternative treatment methods for kidney failure

Important Research Accomplishments

As a direct result of intensive research and technological advances, the treatment of kidney failure has changed and expanded. Many advances have made it possible for people with kidney failure to live longer and with fewer complications. Some of these research developments include:

• the use of recombinant erythropoietin to treat the anemia of chronic kidney failure. Erythropoietin has reduced the need for transfusions and has improved the exercise endurance and feeling of well-being of many people who suffer from kidney failure
• a better understanding of the immunology of transplantation that has led to the ongoing development of new medications and tissue typing techniques to prevent the rejection of transplanted kidneys
• the effective use of calitriol, the active form of Vitamin D, for the treatment of a common form of bone disease that occurs with kidney failure
  the identification of another form of bone disease in hemodialysis patients called amyloid bone disease and the development of methods to detect and diminish the accumulation of amyloid in bones and joints
• a major reduction in the occurrence of aluminum bone disease through the use of preventive interventions
  the continued improvement of continuous ambulatory peritoneal dialysis (CAPD) so that the risk of infection has been significantly mitigated

Recent Research Developments

There have been several recent research developments that have led to new ways of preventing kidney failure and treating people with kidney failure.

Recent research has demonstrated that the progression of diabetic kidney disease, a major cause of kidney failure, may be slowed by the use of blood pressure lowering medications called angiotensin-converting enzyme (ACE) inhibitors and by very good control of the blood sugar. In addition, the use of new tests for the early detection of kidney disease in diabetic patients permits earlier intervention with prevenentive measures.

The development of new and more effective antihypertensive medications now offers more treatment options for people with hypertension, which remains a major cause of kidney failure.

The continued development of high-flux dialysis membranes and new biocompatible membranes has improved the efficiency and safety of hemodialysis. The development of new CAPD systems has dramatically reduced the incidence of peritonitis the most common complication of CAPD.

Improvements in the use of immunosuppresive medications in preventing the rejection of transplantations and in tissue-type matching have increased the success rate of kidney transplantation.

General Screening
From the perspective of infectious disease and their consequences, evaluation should include eliciting a history of antibiotic allergies, valvular repairs or replacements, a dental assessment, a preoperative urine culture, and a chest radiograph to exclude active pneumonic processes and identify evidence of prior granulomatous or infectious disorders. A purified protein derivative (tuberculin) skin test with appropriate controls should be applied; however, suboptimal reactivity of skin testing in renal failure patients may lead to false-negative results. Isoniazid (INH) prophylaxis may be indicated with an abnormal chest x-ray result representing old tuberculosis despite a negative skin test. Precise recommendations for dosage an duration of therapy should adhere to the Centers for Disease Control guidelines on INH prophylaxis. Additional preoperative assessment should include a history of sexually transmitted diseases such as syphilis, HSV infection, viral hepatitis, and HIV infection.

Immunizations
Pretransplant candidates lacking standard pediatric or adult immunizations, splenectomized patients, and renal failure patients may benefit from pretransplant vaccinations with influenza, pneumococcal, and hepatitis B, diphtheria-pertussis-tetanus, inactivated polio, and measles-mumps-rubella (MMR) vaccines. Suboptimal efficacy of vaccinations in patients with renal failure must be recognized due to the effects of uremia on the immune system, however. Live vaccines should be avoided in immunocompromised patients (e.g., a renal transplant candidate with an underlying condition requiring immunosuppresive medications) and in patients who have undergone solid organ transplantation. Of particular pretransplant concern are pediatric renal failure patients with incomplete primary immunizations of live viral vaccines such as MMR. The general recommendation of avoiding live, attenuated viral vaccines in allograft recipients precludes the completion of the immunization series, thereby exposing the child to the risk of measles. Consequently, pretransplant immunization offers the opportunity to prevent the post-transplantation risks of live, attenuated viral vaccines. In this respect, measles, MMR and varicella vaccines should, ideally, be administered several months before transplantation. Pretransplant vaccination with a live, attenuated CMV vaccine has been reported to result in a reduction in the severity of CMV disease and improved graft survival in seronegative recipients of a CMV-positive allograft, the group considered to be at highest risk for CMV disease. Administration of this vaccine, however, has not been implemented.