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LIVING KIDNEY DONORS: MEDICINE’S GOOD SAMARITANS
DEAR MAYO CLINIC: I’m interested in becoming a stranger-to-stranger
kidney donor. Is this possible or helpful? — Winona, Minn.
ANSWER: Yes, it is both possible and extraordinarily helpful for
healthy people to become living kidney donors. In the past decade, there
has been a tremendous increase in the number of living-donor kidney transplants
performed in the United States. In fact, the number of such transplants
done each year is almost equal to the number of transplants performed
using a kidney donated from a deceased donor. Of the 250 kidney transplants
Mayo Clinic surgeons performed last year, 205 were from living donors.
Historically, most organ donors have been family members of the recipient.
Today, friends, casual acquaintances and people such as you have been
willing to donate a kidney. This stranger-to-stranger donation is also
known as the “Good Samaritan” donation or “non-directed donation.” All
the data indicate that, for an otherwise healthy potential donor, donating
one kidney appears to have little long-term impact on his or her health.
A living-kidney donation has several advantages when compared to a donation
from a deceased person. One advantage is time. With a living donor, the
recipient does not have to wait five years or more to receive a kidney.
A second advantage is that the quality of a kidney donated by a living
donor is generally higher because there is ample time for the donor to
have a detailed exam prior to the transplant.
On average, kidneys from living donors last twice as long as those from
deceased donors. Finally, living donation offers immediate results. In
general, a kidney from a live donor is more likely to work immediately,
whereas a kidney from a deceased donor is often so stressed it doesn’t
work right away. When a transplanted kidney works sooner rather than later,
the entire experience is much easier on the patient.
— Mark Stegall, M.D., Surgical Director of Kidney and Pancreas Transplant,
Mayo Clinic, Rochester, Minn.
Additional Resources:
Living
Kidney Donors
Appointment
Information
More
Information on Kidney Transplants
DEAR MAYO CLINIC: I have severe, uncontrolled hypertension and
read about an approach called “fast medication adjustment” for long-term
blood pressure control. How does it work? — Havelock, N.C.
ANSWER: First, some background. Uncontrolled hypertension (high
blood pressure) is commonly referred to as the “silent killer” because
it can prematurely age arteries and lead to stroke, heart attack and kidney
failure. An estimated 50 million Americans have hypertension, and only
about 27 percent maintain a normal blood pressure. Patients with diabetes
or kidney disease should keep their blood pressure even lower than normal.
In conventional hypertension treatment, a patient’s blood pressure is
checked monthly and medication adjustments are made at that time. At Mayo
Clinic, patients on “fast medication adjustment” see specially trained
nurses two to three times a day over a three- to four-day period. The
nurses adjust drug dosages as necessary throughout each day. Over the
next 12 months, patients measure their blood pressure at home and confirm
that the favorable results are in fact maintained.
The rapid adjustment of drugs controls blood pressure in a significantly
shorter time — usually several days or weeks, as opposed to the months
it often takes using traditional methods. Achieving normal blood pressure
more quickly may reduce the premature artery damage that uncontrolled
blood pressure can cause. Further, the rapid approach may reduce the patient’s
inconvenience and cost since fewer trips to the doctor’s office are required
over the long term.
A reasonable goal for you is to try to achieve blood pressure control
over several weeks by working with your health-care provider. See if you
can arrange for regular visits and checkups on an accelerated schedule.
I also strongly advocate the use of home blood pressure measurements as
a follow-up step to help you and your providers better assess overall
blood pressure control.
—Vincent Canzanello, M.D., Nephrology and Hypertension, Mayo Clinic, Rochester,
Minn.
Additional Resources:
Treatment
of High Blood Pressure
Appointment
Information
More
Information on High Blood Pressure
Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite
114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2004 TRIBUNE MEDIA SERVICES, INC.
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