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Organ Donation Awareness Week

Friday, 3 April 2009

This week is Organ Donation Awareness Week. The annual campaign aims to highlight to the general public the plight of people with organ failure and the ongoing need for organ donation for transplantation to encourage more people to make an informed decision to carry an organ donor card and to donate their organs in the event of their untimely death.

Today we are going to be talking about Organ Donation Awareness Week, and also looking particularly at living transplants, where a living donor donates an organ. We will be speaking to Dr. George Mellotte, Consultant Nephrologist and the President of the Irish Nephrology Society. We will also be speaking to Padraig and Andrew Gilligan, two brothers from Sligo. Andrew donated a kidney to Padraig in February this year.


This week is Organ Donation Awareness Week

Our guest Dr. George Mellotte is a Consultant Nephrologist and the President of the Irish Nephrology Society. A Nephrologist is a physician who has been trained in the diagnosis and management of kidney disease
Padraig and Andrew Gilligan are two brothers from Sligo. Andrew donated a kidney to Padraig in February this year.

What is Organ Donation Awareness Week?
Organ Donor Awareness Week which is organised by the Irish Kidney Association and supported by the Irish Donor Network will take place from 28th March until 4th April 2009.
What are the aims of Organ Donation Awareness Week?
The annual life saving awareness campaign aims to highlight to the general public the plight of people with organ failure and the ongoing need for organ donation for transplantation to encourage more people to make an informed decision to carry an organ donor card and to donate their organs in the event of their untimely death.

What will be happening during the week?
Throughout the Week, Irish Kidney Association volunteers will be out on the streets and in shopping centres throughout the country selling 'forget me not flower' emblems (the symbol of transplantation), brooches, car magnets and organ donor keyrings. Proceeds will go to the Irish Kidney Association's support programme for patients on dialysis and those patients fortunate enough to have a kidney transplant. The support programme includes the running of a renal support centre in Beaumont Hospital and holiday centres in Kerry and Tramore, as well as patient aid and counseling services, patient training and rehabilitative work placement, health promotion and the provision of kidney patient information and education.

How do I get an Organ Donor Card?
LoCall 1890 543639 or Freetext the word DONOR to 50050

Living Donors
Who can live kidney donation help, and who is eligible to donate?
Live kidney donation can be an alternative transplant treatment for patients in end stage renal failure.
The potential donor and transplant may be genetically or emotionally related
Donation can only take place where there is minimal risk to the donor and a high likelihood of a successful outcome for the recipient.

Are many transplants in Ireland from living donors?
Currently only around 5%, but we are aiming to raise this. In America for example 40% of kidney transplants are from living donors. There is a concerted push from the government for additional resources for living transplants. Living donor transplants are more cost effective, the organ lasts longer, there is less chance of rejection or complications and less need for drugs than with a dead (cadaveric) donor

Are there any problems with using a living donor?
It has been slightly controversial in the past due to worry that a healthy person is putting their health at risk with an unnecessary operation. There is a very slightly higher risk of hypertension in someone who has donated an organ, but in general any health risks are very minimal. There is also concern that a person might feel obligated to donate an organ to a family member who is ill. However there is a procedure whereby each donor is carefully vetted to make sure each donor is making the decision of their own free will and for the right reasons.

What is the procedure?
Once a patient is deemed fit for transplantation the option of live donation can be discussed with the patient and family. Family members wishing to be considered should first check their blood group, obtain a letter of referral from the patients nephrologist, and then contact the hospital for an appointment.
Initially the potential donor will meet with the transplant co-ordinator to discuss the process. The purpose of the evaluation and the investigations involved are discussed. The potential donor needs to be fully informed of the risks and benefits of the donation, and the different stages involved. A blood test is also taken to check the tissue type of the donor and to eliminate the possibility of unacceptable antigens that the recipient may have developed antibodies against.

A full assessment of the donor will be undertaken to determine suitability to donate, to include medical, immunological and psychological evaluation.

How can this affect the donor?
The decision to donate a kidney to another person is a major one and can generate a significant amount of stress to the donor, recipient and their family. Prospective donors need sufficient time to reflect on their decision to donate. Support from other family members is very important.

What are the statistics of live kidney donation in Ireland?
There were 10 living kidney transplants in 2008, i.e. where a kidney is donated by a living person, and the projections for this year are that up to 30 such procedures will take place.

Background on kidney disease:
What do the kidneys do?
The kidneys have a number of important functions:
. Filter waste products and toxins
. Regulate body fluid balance
. Control levels of salts such as sodium and potassium in the bloodstream
. Produce vitamin D
. Produce the hormones erythropoietin and calcitriol.
Fortunately, we only need one healthy kidney for normal kidney (renal) function. If both kidneys fail, however, renal failure occurs and dialysis or transplantation is necessary.

What causes kidney disease?
Kidney disease can be caused by a large number of conditions including:
. Diabetes
. Congenital and genetic disorders such as polycystic kidney disease (causes cysts on the kidneys)
. Hypertension (high blood pressure)
. Impaired blood supply to the kidney
. Kidney infections e.g. pyelonephritis
. Tumours
. Obstruction in the urinary tract e.g. kidney stones or prostatic enlargement
. Medicines and drugs

What are the symptoms?
Symptoms of chronic renal failure include:
Nausea and vomiting
Tiredness due to anaemia (low blood count)
Shortness of breath
Skin irritation
Pins and needles (paraesthesia) due to damage of peripheral nerves (peripheral neuropathy).

What treatments are available?
Treatment of renal disease depends the cause. Blood pressure will need to be controlled and dietary restrictions may be necessary in certain cases. In end stage renal failure, dialysis or kidney transplantation may be necessary.

What are the complications of kidney disease?
Serious kidney disease may lead to impairment or failure of the kidneys ability to filter waste products from the blood and excrete them in the urine. This process controls the body's water and salt balance and helps to maintain a stable blood pressure. If it fails, renal failure results. Kidney failure can be sudden (acute) or develop more slowly (chronic). In acute renal failure, kidney function usually returns to normal once the underlying cause has been treated.

Acute renal failure commonly results from a serious injury or major illness. It occurs in major bleeding or burns where a decrease in blood volume and blood pressure cause a decreased blood supply to the kidney. Acute renal failure can also occur after a severe myocardial infarction (heart attack), pancreatitis, mismatched blood transfusion, acute glomerulonephritis and urinary tract obstruction.

Chronic renal failure occurs in a number of conditions affecting the kidney including polycystic renal disease, diabetes, chronic obstruction and glomerulonephritis. In end stage chronic renal failure, dialysis or kidney transplantation is necessary.

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