Jan 15, 2023
In this talk at the TEDx Birmingham stage, Dr. Jayme Locke discusses the need for a national kidney donation exchange.
Monday mornings are usually filled with feelings of excitement and energy as we gear up for the week ahead. But for those living with kidney failure, Monday mornings can be filled with profound fatigue and a lack of mental clarity. The daily routine for these individuals involves waking up early, leaving the house and heading to the local dialysis center, where they spend the next four hours hooked up to a machine designed to clear their blood of toxins. The process is repetitive and exhausting, and for 10 out of every 100 kidney failure patients, it will end in death. The only cure for kidney failure is a kidney transplant, but the demand for kidneys far exceeds the supply.
Living kidney donation provides a solution, but even with willing donors, the process can be complicated. Many individuals in need of a kidney transplant have a willing but incompatible living kidney donor. Almost half of people who volunteer to be a living kidney donor will not match their intended recipient due to differences in blood groups and tissue types.
That's where transplant surgeons come in. They act as matchmakers, facilitating kidney exchanges between living donors and recipients who don't match. Instead of receiving a kidney from their original donor, the recipient receives a kidney from a total stranger, and in return, the original donor gives to someone else in need. It may seem complicated, but the process is similar to that used by the airline industry to keep airplanes from crashing into each other during flight.
To participate in a kidney exchange, the recipient simply needs someone willing to donate a kidney to a total stranger on their behalf. These individuals may begin as complete strangers, but with the help of a loved one willing to donate in honor of them, they can change each other's lives. Transplant surgeons like the one in the video are making rounds in hospital wards, checking on patients and making sure they are ready for surgery. It's a long and difficult process, but the end result is a new chance at life for those living with kidney failure.
It's important to note that living kidney donation is a safe and viable option for most healthy individuals. According to the National Kidney Foundation, most people can live a normal, healthy life with just one kidney. The process of becoming a living donor involves a series of tests and evaluations to ensure that the donor is healthy enough to undergo the surgery and that their remaining kidney is able to function properly.
Living kidney donation also has a positive impact on the recipient's quality of life. Transplantation from a living donor has been shown to have better outcomes in terms of survival rates and kidney function compared to transplantation from a deceased donor.
We have yet to tap into the full potential of living donor exchanges in this country. The missing piece is a centralized, selfless system in which every living donor and recipient pair participates and joins a movement to save lives. To achieve this, we must shift from an opt-in system, in which participation is only necessary when compatibility is an issue, to an opt-out system that assumes altruism and eliminates compatibility barriers. This change begins with believing in the goodness of others and igniting a movement to promote live donor kidney transplants. Let's change the conversation from donating directly to loved ones, to donating in honor of loved ones, and work together to establish a national living kidney donor exchange.
Dr. Jayme Locke is an abdominal transplant surgeon and director of the Incompatible Kidney Transplant Program at the University of Alabama at Birmingham. Dr. Locke specializes in innovative strategies for the transplantation of incompatible organs, disparities in access to and outcomes after solid organ transplantation, and transplantation of HIV-infected end-stage patients. Dr. Locke also serves as coordinator of the UAB Kidney transplant chain and has helped UAB build a nationally recognized incompatible kidney transplant program with one of the longest kidney transplant chains in the US. In addition to being a National Institute of Health funded Investigator, Dr. Locke has authored 63 articles in peer-reviewed journals. Dr. Locke is an associate editor for Transplantation, and serves as a reviewer for several other leading journals. She is a member of numerous professional organizations including the American Society of Transplant Surgeons and is a current fellow of the American College of Surgeons.
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