The Hindu : Karnataka / Bangalore News : Kidney donors face the blues

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Friday, Oct 12, 2007
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Karnataka

Karnataka - Bangalore

Kidney donors face the blues

Alladi Jayasri

Study makes a strong case for screening of donors

Study shows that some of the donors were unfit to donate a kidney
Post nephrectomy, nine donors had developed anaemia

BANGALORE: In early 2001, 53 donors (25 men and 28 women) of Pallipalayam in Erode district of Tamil Nadu did what many others in the village had done before: they came down to Bangalore and “sold” a kidney, believing that it would get them out of the debt-trap.

In August 2001, transplant surgeons C.N. Lakshmi Kanth and Philip G. Thomas of St. John’s Medical College and Hospital embarked on what could be the first ever study of paid kidney donors on parameters of health, social and economic implications. Their conclusions have nailed the argument of the lobby that wants the Transplantation of Human Organs Act 1994 amended to liberalise unrelated renal transplants.

The study also made out a strong case in favour of stringent screening of prospective donors, and continuous follow-up of the health status, post donation, Dr. Kanth, who is currently with the Grand Rapids Medical Education Research Centre, Michigan State University, USA, told The Hindu.

Findings

The most shocking finding of the study was that let alone being counselled on informed consent and risks involved, some of these donors were unfit to donate a kidney. This meant that the hospitals were not even considering the safety of their patients who would receive these kidneys.

Two male donors had a history of sexually transmitted diseases (STD), four had jaundice and 18 men were smokers, while 16 men and one woman consumed alcohol. Four men came from families where others had donated kidneys, two men and four women had a family history of diabetes. Fifteen men and 18 women had symptoms of psychological problems, which manifested post-surgery.

Post nephrectomy (removal of kidney), nine donors had developed anaemia; five had abnormal kidney functions with high presence of serum creatinine, and reduced levels of creatinine clearance. Their body weight, fat percentage, fat-free muscle mass and other factors were below that of normal persons in their age group, which makes them susceptible to kidney diseases.

A few of them had developed hypertension, tenderness in the abdominal area and the operation site, and a case of incisional hernia. None of the donors had sought medical attention after the opeartion.

Dr. Kanth said the study had established that the financial incentives for donating a kidney had not changed the donors’ social or economic status.

Though there was no major increase in morbidity, a high level of psychologically negative feelings persisted among most donors.

Those who advocate a shift towards promotion of related and cadaveric renal transplants, rather than liberalising unrelated transplants point out that all donors need follow-up and treatment.

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