Dr. Naim Issa, a Mayo Clinic transplant nephrologist, says there are some common myths regarding living kidney donations that may be holding some people back.

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"We would like people to consider living kidney donation because it saves lives. We can get people better matched kidneys through a larger pool of donors," says Dr. Issa.

He says a common misconception is that a kidney donor needs to be a first-degree relative.

"Anyone can be a living kidney donor and does not need to be relative. It can be unrelated, can be an acquaintance or can be anyone," says Dr. Issa.

Another myth is the donor kidney needs come from a person of the same race.

"A kidney is a kidney. It doesn't matter whatever race you are; you should consider living kidney donation," says Dr. Issa.

He says if you're worried that you might be too old to donate, you shouldn't. If you're healthy and over 18, you might be a match.

"In general, we typically say up to 70 years, but, in fact, there is no age limit for living kidney donation," says Dr. Issa.

Up until recently, anyone with type 2 diabetes was ruled out as a living donor. But now, based on certain health requirements, some of those candidates may be eligible.

"By expanding the criteria to allow more individuals with type 2 diabetes to be potential donors, we can close the gap between the high demand for organs and the need for kidney transplants," says Dr. Issa.

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Regardless of the cause, Dr. Bashar Aqel, a Mayo Clinic transplant hepatologist, says when the liver can no longer function, a life-saving transplant may be needed.

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The liver is the largest internal organ of the body. It is essential for metabolism, digesting food and ridding the body of toxic substances. Liver failure can happen quickly, or over time.

"Once liver disease advances, the only way we can reverse the process and give the patient their life back is by replacing the liver, " says Dr. Bashar.

When patients become a candidate for a liver transplant, they are added to a waitlist. Unfortunately, there are more people waiting for a liver than there are available organs.

"As the patient is waiting on the list, they usually are anxiously waiting for that call when a donor becomes available. And that's what we call the deceased donor liver transplantation."

Another option is a living liver transplant. It's a major surgery where a person donates two-thirds of his or her liver. Donors needs to go through an extensive evaluation to make sure they can donate safely.

"A healthy liver is able to regenerate, and you will be surprised to know that with living donor liver transplantation, both segments of the liver will grow back to almost the normal size within 90 days after transplantation."

Being a living organ donor may not be an option for everyone, but there are ways to people can sign up to be an organ donor. It can be as easy as checking a box on your driver's license.

"Donating your organs is really donating the gift of life to people who are in urgent need for organ transplantation," Dr. Bashar says.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where social distancing and other safety protocols were followed.

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ROCHESTER, Minn. — About 1 in 5 patients who are on the national waiting list for a liver transplant die or become too sick before an organ becomes available. With an ever-growing need for organs, Mayo Clinic is working to increase awareness about living liver donation for transplantation.

The number of living donor liver transplants doubled last year, now accounting for about 6% of all liver transplants nationwide, says Timucin Taner, M.D., Ph.D., a Mayo Clinic transplant surgeon and surgical director of liver transplantation. A liver transplant from a living donor is a surgical procedure where a portion of the liver from a healthy living person is removed and placed into someone whose liver no longer works properly.

Here are five things to know about being a living liver donor:

1. Thousands of people are waiting for a lifesaving liver transplant.

"About 12,000 to 13,000 people are on the liver transplant waiting list, which means about 2,500 people who are on the list each year will either die or become too sick while waiting for a liver transplant," Dr. Taner says.

2. The donated liver regenerates itself in a matter of weeks.

Liver tissue regenerates in the donor and recipient. Up to 70% of the donor liver can be removed for transplantation, and the liver regenerates in the donor and recipient to nearly full-size in about three to four weeks.

3. Outcomes are generally better for recipients who receive a liver from a living donor.

"The incidence of technical issues during surgery can be somewhat higher for the recipient because it's more difficult to transplant a partial organ. There can be increased risk of bile duct complications and arterial thromboses," says Dr. Taner. "But in living donor liver transplantation, the transplant typically occurs before the recipient becomes dangerously ill awaiting transplant, which improves the outcome."

4. Recovery time for living liver donors can take four to six weeks.

Potential liver donors must be in good physical health. Donors are usually under 60. People interested in donating undergo blood tests to determine if their blood and tissue types are compatible with the organ recipient.

"It's a significant operation for the donor," Dr. Taner says. "Although in the past, it required a larger incision, over the past four years, we've used a hybrid procedure that reduces the size of the incision, which translates into better pain control. The time in hospital is about four to six days, and typically it takes about four to six weeks for donors to have a full recovery."

5. You do not have to be related to a patient to donate a liver.

While living donors traditionally have been people who know the recipient, such as a family member or friend, it is not required. Mayo Clinic's William J. von Liebig Center for Transplantation and Clinical Regeneration in Rochester is now starting two additional living donor programs to improve the opportunities for patients in need of a liver transplant: the Living Liver Non-Directed Program and the Liver Paired Donation Program. Both programs have guidelines and procedures similar to Mayo's successful programs for living kidney donors.

"These programs are important in that they will help address the ongoing shortage of organs for people in need of transplants," Dr. Taner says. "Until recently, Mayo Clinic only accepted directed living donations, meaning the donated part of the liver is intended for an individual known by the donor. With the Non-Directed Program, we now accept donation from persons who don't have a recipient in mind but want to offer the gift of life to another person."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and Mayo Clinic Facts for more information about Mayo.

Media contact:

• Heather Carlson Kehren, Mayo Clinic Public Affairs, newsbureau@mayo.edu

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ROCHESTER, Minn. — It's not often that people are given the chance to give someone the gift of life, but that is exactly what being a living kidney donor offers. More than 6,400 people chose to be a living kidney donor in the U.S. in 2018, according to the United Network for Organ Sharing. Sadly, the number of people in need of a lifesaving transplant far exceeds the number of donors. More than 95,000 people are waiting for a kidney transplant.

For patients in need of a transplant, finding a living kidney donor is usually their best option, according to Mikel Prieto, M.D., a Mayo Clinic transplant surgeon.

"Patients on average wait five years for a kidney transplant from a deceased donor," Dr. Prieto says. "That long wait is especially difficult for patients who are often undergoing dialysis multiple times a week. And the longer a patient waits for a kidney, the more likely their health will continue to deteriorate."

Here are five things that you should know about being a living kidney donor:

1. You don't have to be related to someone to be a donor.

Anyone can be a living kidney donor. You can consider donating a kidney to a relative, friend, acquaintance or stranger. All potential donors undergo a thorough medical evaluation to make sure that they are suitable for donation. Living donors must be 18 or older, and be in good overall physical and mental health.

2. Want to donate to someone, but you're not a match? There is another option.

Sometimes a potential donor who wants to give to a family member or friend isn't the best match for that recipient. In those situations, paired donation is considered. Donors and recipients are matched with other donors and recipients, creating a so-called "kidney chain."

3. You don't have to know someone in need of a transplant to be a donor.

For people who want to help someone in need of a kidney but don't have a particular recipient in mind, they can elect a nondirected donation, which is also known as an altruistic or "Good Samaritan" donation. The transplant program will match their kidney based on medical and immunological compatibility.

4. Living kidney donation surgery is minimally invasive.

When donating a kidney, donors undergo laparoscopic surgery — a procedure that involves making a few small incisions instead of a larger one. This type of surgery reduces recovery time. Medical costs associated with donation are covered by the recipient's insurance. Most kidney donors return to their normal activities or job within a few weeks of donating a kidney, Dr. Prieto says. As with any surgery, there are risks, and it is important for potential donors to discuss those with their doctor.

5. Research finds living kidney donors live as long if not longer than nondonors.

To be a donor in the first place, an individual must be considered healthy. If a living kidney donor is in need of a kidney transplant later in life, the living kidney donor is given priority status to shorten the time on the transplant waiting list.

"We know that patients who receive a kidney from a living donor have better short- and long-term outcomes than those who don't. Living kidney donation gives patients with end-stage kidney disease the best opportunity to return to a full and productive life," Dr. Prieto says.

Mayo Clinic has several transplant physicians who can talk about living kidney donation, including:

• Mikel Prieto, M.D., a kidney transplant surgeon at Mayo Clinic in Rochester
• Caroline Jadlowiec, M.D., a kidney transplant surgeon at Mayo Clinic in Arizona
• Hasan Khamash, M.D., a transplant nephrologist at Mayo Clinic in Arizona
• Katherine Oshel, M.D., a transplant nephrologist at Mayo Clinic in Florida

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

Media contact:

• Heather Carlson Kehren, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

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Paired donation, also known as "paired exchange," may be an option when a donor and intended recipient have incompatible blood types, or when the recipient has unacceptable antibodies against the donor's tissue antigens. In paired donation, two or more organ recipient pairs trade donors, so that the recipients get organs that are compatible with their blood type. A nondirected living donor also can participate in paired donation to match incompatible pairs.

On the next Mayo Clinic Radio program, Dr. Carrie Schinstock, a Mayo Clinic nephrologist, and Kay Kosberg, a Mayo Clinic nurse who coordinates the paired kidney donation program across Mayo Clinic's Arizona, Florida and Rochester campuses, will discuss the paired kidney donation program at Mayo Clinic. Also on the program, Dr. Amir Khan, a Mayo Clinic ophthalmologist, will explain what causes eye floaters. And Dr. Pashtoon Kasi, a Mayo Clinic medical oncologist, will explain changes in colorectal cancer screening guidelines to prevent the disease in younger adults.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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Paired donation, also known as "paired exchange," may be an option when a donor and intended recipient have incompatible blood types, or when the recipient has unacceptable antibodies against the donor's tissue antigens. In paired donation, two or more organ recipient pairs trade donors, so that the recipients get organs that are compatible with their blood type. A nondirected living donor also can participate in paired donation to match incompatible pairs.

On the next Mayo Clinic Radio program, Dr. Carrie Schinstock, a Mayo Clinic nephrologist, and Kay Kosberg, a Mayo Clinic nurse who coordinates the paired kidney donation program across Mayo Clinic's Arizona, Florida and Rochester campuses, will discuss the paired kidney donation program at Mayo Clinic. Also on the program, Dr. Amir Khan, a Mayo Clinic ophthalmologist, will explain what causes eye floaters. And Dr. Pashtoon Kasi, a Mayo Clinic medical oncologist, will explain changes in colorectal cancer screening guidelines to prevent the disease in younger adults.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Paired kidney donation / eye floaters / colorectal cancer in younger adults appeared first on Mayo Clinic News Network.

When Mary Redepenning found out her sister Barbara needed a kidney, Mary wanted to be the donor. But traveling to Portland, Oregon, was a significant obstacle. Learning Mayo Clinic could perform a remote donation made all the difference.

One of eight children, Mary Redepenning is close with her siblings, especially her four sisters. So when she found out her oldest sister, Barbara, who lives in Portland, Oregon, would need a kidney transplant, Mary began the process to find out if she could be Barbara's kidney donor. Her three other sisters were tested, too. Mary and one of her sisters were both a match. Mary wanted to be the donor.

"How could I not do this for my sister?" she asks. "It was the right thing do."

Making her choice even clearer was the option for Mary to donate a kidney to her sister without traveling to Portland. From her home in Atwater, Minnesota, Mary drove to Mayo Clinic's Rochester campus in April for the surgery to remove one of her kidneys for Barbara's transplant. The organ then was transported to Oregon. Mary says being able to donate remotely is what made the gift to her sister possible.

"Flying out to Portland several times for testing and then for the surgery would have been expensive and stressful. It just wasn't a good option," Mary says. "I wanted to have my kidney harvested near where I live."

Once Mary learned Mayo Clinic could do the remote donation, the decision to move forward came quickly, and soon Barbara had a new kidney.

Lowering barriers

Mayo Clinic and Legacy Good Samaritan Medical Center in Portland — the hospital where Barbara was having the transplant — are members of the National Kidney Registry. That meant Mary and Barbara could participate in remote kidney donation. Theirs would be the first conducted by Mayo Clinic for a transplant to be performed outside of Mayo's three campuses.

Having remote donation available is a significant step forward, according to Kay Kosberg, a living donor care coordinator at Mayo Clinic's William J. von Liebig Center for Transplantation and Clinical Regeneration.

"I think more donors would step forward if they knew they could stay in their own cities."

Kay Kosberg

"The financial piece can make it difficult for the donor. It can be a big barrier to have to take time off from work, travel and find someone to take care of their family," Kosberg says. "The National Kidney Registry facilitates getting the kidney from point A to point B. That's the pearl to this — having the donor stay local."

With an average wait time for a kidney from either a living or deceased donor at two years, Kosberg says the option of remote donation also could have the benefit of making more organs available to people in need of a transplant.

"There are 100,000 people nationwide waiting for a donor," Kosberg says. "I think more donors would step forward if they knew they could stay in their own cities."

Success all around

A month before the surgery, Mary had three days of testing at Mayo Clinic. The test results cleared the way for the surgery, and on April 17, Mary underwent the procedure to remove one of her kidneys.

"I can't say enough about the Mayo staff and the quality of the surgeons. My kidney nurse coordinator was amazing. She followed me through every step of the way," Mary says. "My surgeon, Mikel Prieto, M.D., has such a pleasant disposition. He was never in a hurry to get through an appointment. Everyone always put the focus on me and how I was doing, explaining the procedures, explaining and going over every aspect of testing that was done."

After Dr. Prieto performed the surgery to remove the kidney, Mary says he took a picture of it and texted it to her husband, who then sent it to Barbara.

"I felt such gratitude and awe that she would do this," Barbara says.

"I'm back to 100 percent. If I could, I would do this again in a heartbeat."

Mary Redepenning

Mary was discharged from the hospital two days after surgery. She says she was well-prepared because she was given so much information about what to expect, and her recovery was easy.

"I'm back to 100 percent. If I could, I would do this again in a heartbeat," Mary says. "I'm singing the praises of Mayo. It's an amazing facility."

In June, both sisters traveled to Sacramento, California, for Barbara's daughter's wedding — an event that Barbara wasn't sure she'd be able to attend prior to finding a donor.

"Everyone said I looked 10 years younger than I had prior to the transplant," Barbara says. "For me to be healthy enough to participate was just a really big deal."

HELPFUL LINKS

• Read more about living-donor transplants.
• Consider becoming an organ donor.
• Explore the Mayo Clinic Transplant Center.
• Connect with others talking about transplants on Mayo Clinic Connect.
• Request an appointment.

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"Some people just come forward as a potential donor wanting to help a needy patient that’s on the waiting list," says Dr. Charles Rosen, director of Mayo Clinic's Transplant Center. "Another thing that happens is a donor and recipient pair come forward, where it’s not a match for one reason or another, and they may exchange kidneys with another donor-recipient pair."

April is National Donate Life Month. Dennis Douda shares more of Dr. Rosen's thoughts.

Watch: The Mayo Clinic Minute

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"You know, 1 out of 5 to 1 out of 4 of the people that I meet with will never get a liver," says Dr. Rosen.

He says it's a hard reality. And even more patients with failing livers would die, if not for living donors.

"We can take up to 70 percent of the liver but not more," says Dr. Rosen. "It grows back very quickly in both the donor and the recipient."

Occasionally, parts of the lung and intestine are supplied by living donors. Four out of 5 people on the transplant waiting list need a kidney. Dr. Rosen says kidneys from living donors function better, last longer and can eliminate lengthy waits.

"Which may be five to seven years in many parts of the country, during which time a patient has to be on dialysis, which may be three to four hours a session, three to four times per week," says Dr. Rosen.

Living donors must be at least 18, in good mental and physical health with no alcohol or substance abuse problems. While family members often provide the best tissue match, 1 in 4 living donors are not biologically related.

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ANSWER: The first step is to contact the transplant center where the donation would take place. They will perform a thorough medical evaluation to see if you can safely donate a kidney. Recovery from kidney donation surgery usually takes two to three weeks. But you will have some activity restrictions for up to six weeks.

Your kidneys are two bean-shaped organs, each about the size of a fist, in the back of your abdomen on either side of your spine. Kidneys remove extra fluid and waste from your body and help control blood pressure. When a person’s kidneys no longer work — a condition called chronic kidney failure — a kidney transplant usually is the best treatment option. A transplant often allows people to return to a fully active life.

A kidney for a transplant may come from a deceased donor or from a living donor. Kidneys from living donors usually last longer and work better than those from deceased donors. Living kidney donations are possible because although you have two kidneys, your body can work well with only one.

Many people who consider donating a kidney are family members or friends of someone who needs a kidney transplant. But some people who want to be kidney donors do not have a certain person in mind to receive the kidney. This is called non-directed donation. All potential kidney donors go through the same evaluation process to make sure they can donate safely.

The evaluation starts with an interview or questionnaire to gather information about your background and medical history. You will also talk with a member of the transplant team about the donation process and what to expect.

If the transplant team decides you may be able to be a kidney donor, typically the next step is to have blood tests. If the results of those tests are acceptable, you go through a number of other medical appointments.

The appointments usually include a physical exam, more blood tests, urine tests and imaging studies. You also need tests to check how well your kidneys work. You may need tests to screen for cancer and other existing medical problems, too.

If the results of your evaluation show that you can be a donor, and if you decide it is right for you, then you have surgery to remove one of your kidneys. The surgery takes about one to four hours. At most transplant centers, the procedure is done using laparoscopic surgery. That means instead of one large incision, the surgeon makes several smaller incisions. The surgical instruments are inserted into two of those incisions, and the kidney is removed through another incision.

After kidney donation surgery, most people stay in the hospital for one or two nights. You may have some pain and discomfort after surgery. It can often be managed well with pain medications. Most people can go back to work two to three weeks after surgery. But it may be up to six weeks if you have a job that involves heavy lifting or other manual labor.

Complications after kidney donation surgery are very rare. There is a small risk of infection, bleeding and blood clots. A small group of patients may develop an incisional hernia — a bulge under the skin that requires a second procedure to repair. The transplant team will talk with you in detail about the possible risks of kidney donation.

Donating a kidney for a transplant is a wonderful act of generosity. Many people are waiting for a kidney transplant. If you are interested in becoming a kidney donor, contact your transplant center, or go online to the United Network for Organ Sharing at www.unos.org for more information. — Mikel Prieto, M.D. , Mayo Clinic Transplant Center, Mayo Clinic, Rochester, Minn.

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A year ago, the Robert Maddox family from Boyce, La., would never have imagined attending the 50th Anniversary of Kidney Transplantation celebration event at Mayo Clinic this month. A year ago, their 9-year-old son Robert, who goes by the nickname "Boo," was struggling to survive, and a transplant seemed impossible.

After a devastating bout of H1N1 (swine flu) in 2009 when he was just 5 years old, Boo spent nearly 500 days in Children’s Hospital of New Orleans. After multiple surgeries, numerous transfusions, and months of uncertainty, he recovered and survived despite the odds. But he was left with renal failure, dangerously high pulmonary pressure, and susceptibility for recurring infections. Doctors told the family that he would never be a candidate for a transplant, and was destined for a life of dialysis and complications from the high pressure and infections.

Determined to find hope, Robert and Renee Maddox brought their son to Mayo Clinic last winter and met with the kidney transplant team.

“I talked to his Dad,” says Mikel Prieto, M.D., surgical director of kidney transplantation, “and I said, ‘I think maybe we can fix this.'"

Dr. Prieto and the team at Mayo Clinic remedied the cause of the high blood pressure by removing the fistula that had connected artery and vein to allow for easy dialysis treatments. The engorged vessel had placed increased pressure on Boo's lungs and caused high pulmonary hypertension. They also removed a blockage in one of Boo's veins.

Suddenly, Boo was a candidate for a kidney transplant. Both Renee and Robert eagerly volunteered; but ultimately, it was Renee who donated her kidney and on July 29, Boo underwent what Dr. Prieto estimates may have been his 70th surgery.

“The support we’ve received from our friends, family and community has been amazing,” says Robert Maddox.  “That support, along with our faith in God, has sustained all of us. We are so happy that Boo is back to being a kid, and want to thank all the wonderful doctors, nurses, and staff at Mayo for the love and compassion they have shown our family. This is what makes Mayo what it is. God bless you all.”

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