Q&A about kidney donation: A donor's perspective

What is living donation?

Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister (living related donation).

Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, spouse or an in-law (living unrelated donation). Thanks to improved medications, a genetic link between the donor and recipient is no longer required to ensure a successful transplant.

In some cases, living donation may even be from a stranger, which is called anonymous or non-directed donation.

What organs can come from living donors?

The organ most commonly given by a living donor is the kidney. Parts of other organs including the lung, liver and pancreas are now being transplanted from living donors.

What is the recovery period and when can the donor return to normal activities?

The length of stay in the hospital will vary depending on the individual donor's rate of recovery and the type of procedure performed (traditional vs laparoscopic kidney removal) although the usual stay is 4 to 6 days. Since the rate of recovery varies greatly among individuals, be sure to ask the transplant center for their estimate of your particular recovery time.

After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured. It is important for the donor to speak with the transplant staff about the best ways to return as quickly as possible to being physically fit.

How does living donation affect the donor?

People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney.

Physical exercise is healthy and good for you. However, it's important for someone with only one kidney to be careful and protect it from injury. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Wearing protective gear such as padded vests under clothing can help protect the kidney from injury during sports. This can help lessen the risk, but it won't take away the risk. Talk to your healthcare provider if you want to join in contact sports.

Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function (GFR) should be done every year.

Does living donation affect life expectancy?

Living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems; however, you should always talk to your transplant team about the risks involved in donation. Some studies report that living donors may have a greater chance of developing high blood pressure. It is recommended that potential donors consult with their doctor about the risks of living donation.

What can I expect emotionally after donating a kidney?

After donation, living donors often report a wide range of mixed emotions, from joy and relief to anxiety to depression. The process of getting through the evaluation and surgery can be so time-consuming that donors do not always have time to process everything they are feeling. It is normal for these emotions to come to the forefront after the donation and transplant take place.

Living donors generally rate their experience as positive. Different studies indicate that between 80-97% of donors say that in retrospect, they would have still have made the decision to donate.

However, concerns about the recipient's outcome (as well as the donor's recovery) can contribute to feelings of anxiety, and may donors report a feeling of "let down" afterwards. Feelings of depression among living donors are not uncommon, even when both donor and recipient are doing well.

While extensive data on these issues is lacking, some studies have reported the following psychological outcomes:

• Less than 1% regretted the decision
• 3 to 10% reported depression
• 10% reported "family conflicts"
• 7% reported anxiety disorders
• 16% concerned about negative financial consequences of donation
• 3 to 15% concerned about a negative impact on their health

Living donors who are struggling with these issues are encouraged to:

1. Talk to the transplant hospital's Transplant Social Worker for advice
2. Seek professional counseling or other outside help to manage difficult emotions, and
3. Talk with other living donors who can be particularly supportive if they have experienced the same feelings.

What are the long-term risks of donation?

You will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have.

Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. These risks seem to be rare, but there are currently no national statistics on the frequency of these problems.

In addition, people with one kidney may be at a greater risk of:

• high blood pressure
• Proteinuria
• Reduced kidney function

You should discuss these risks with your transplant team, and ask for center-specific statistics related to these problems.

Are there any dietary restrictions after donation?

After donation you should be able to go back to a regular, healthy lifestyle. If you are in good health, there will probably not be any specific dietary restrictions. Talk with your transplant team about your specific dietary needs.

Will I be able to obtain insurance coverage after donation?

Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.

However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.

If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.

What if I donate, and need a kidney later?

This is something potential donors should discuss with the transplant team. Talk to your transplant team about any pre-existing condition or other factors that may put you at a higher risk of developing kidney disease, and consider this carefully before making a decision about donation.

There have been some cases in which living donors needed a kidney later - not necessarily due to the donation itself. It is considered a potential risk of donation. UNOS policy give priority on the waiting list to living donors.

Can I become pregnant after I've donated kidney?

Pregnancy after donation is possible but is usually not recommended for at least six months after the donation surgery. Living donors should talk to their ob/gyn and transplant team before getting pregnant about pregnancy and make sure that they have good pre-natal care.

Generally, living kidney donors do well with pregnancy after their donation. However, some studies have shown small increases in some risks like gestational diabetes, pregnancy-induced hypertension, protein in the urine and pre-eclampsia. Living donors should inform their ob/gyn about their donation to allow monitoring for these potential complications.

दाता स्वीकारकर्ता के बिना कुछ भी नहीं

दाता को महान पुण्य करने वाले व्यक्ति के रूप में माना जाता है और स्वीकारकर्ता को विनम्रता का पात्र, जबकि ऐसा नहीं होना चाहिए।
दाता स्वीकारकर्ता के बिना कुछ भी नहीं होता। चाहे वो अंगदान ही क्यों न हो। 
भारतीय पौराणिक कथाओं में भी कई ऐसे उदाहरण है जिसमे भगवान खुद एक स्वीकारकर्ता के रूप में दिखे है। वामन अवतार में भगवान विष्णु ने दानव राजा बाली से दान स्वीकार करने के लिए एक बौने का रूप ले लिया था। नतीजन, दाता राजा बाली राक्षसी रूप से उठकर दैवीय रूप में आ गए थे। भगवान महान दाता भी है और स्वीकारकर्ता भी है। वह सब कुछ देता है। वह सब कुछ स्वीकार भी करता है, प्रार्थना भी और डांट भी। एक योग्य व्यक्ति द्वारा एक पुरस्कार की स्वीकृति दाता के लिए एक विशेषाधिकार है और सम्मान के रूप में माना जाता है।

इसलिए न दाता को दान के लिए एहसानमंद होना चाहिए और न ही स्वीकारकर्ता को खुद को ऋणी समझना चाहिए।

मानवता ही हर धर्म की नींव है और अंगदान मानवता का एक रूप

व्यापक संदर्भ में, सभी धर्म एक आम चरित्र को बताते हैं और वो है मानवता । दान, चाहे किसी भी रूप में हो, हमारी प्राथमिकताओ या नैतिक मूल्यों के बारे में नहीं है, अपितु यह करुणा, साहस और भाईचारे का प्रचार करने, देने से जो परम आनंद और संतुष्टि मिलती हैं, उसके, एक बेहतर दुनिया का निर्माण करने और मानव जाति की मदद करने के बारे में है।

 लोग अंगदान के विषय में अज्ञात क्यों रहना चाहते  है, ये मुझे नहीं पता, लेकिन जहा तक मुझे लगता है, इसका एक बहूत बड़ा कारण डर है । क्या आप गलत कर रहे हैं? क्या आपका निर्णय सही  है? क्या होगा यदि आपका निर्णय गलत निकला और बाद में आप उसे सही नहीं कर सके? क्या आपका धर्म इसकी इजाज़त देता है?

 इतना सब सोचने के बजाय हमे यह सोचना चाहिए की शायद सही समय पर उठाया गया छोटा कदम भविष्य की बड़ी समस्याओं से बचा सकता है। हम यह दिखावा नहीं कर सकते की हम कुछ जानते नहीं थे। हमने सब कहावतो, पुराणो और दार्शनिकों में पढ़ा है, सुना है, हमारे पूर्वजो और समाज से सुना है की दान करना सही है, फिर भी कभी कभी हमें खुद जानने की आवश्यकता होती है। जानना सोचते रहने से बेहतर है, जागना सोने से बेहतर है और कुछ करने की हिम्मत करना, कुछ न करने से कहीं बेहतर है.

यहाँ मैं विभिन्न धर्मों में अंग दान या सामान्य रूप में दान के बारे में क्या मान्यताएं रखते है, ये साँझा  कर रही  हूँ: -

हिन्दू धर्म

हिंदू धर्म में मृत्यु के बाद जीवन और पुनर्जन्म एक दृढ़ विश्वास है। जीवन, जन्म और आत्मा के पुनर्जन्म का निरंतर चक्र है तथा यह प्रक्रिया अनंत काल तक चलती रहती है, अतः भौतिक शरीर नगण्य है। इस कांसेप्ट को हिंदू धर्म में अंग दान और प्रत्यारोपण की अवधारणा पर सकारात्मक दृष्टिकोण के रूप में देखा जा सकता है।

जैन धर्म

जैन धर्म में, दया और दान को प्रमुख गुण माना जाता है। अंग दान व्यापक रूप से जैन समुदाय के नेताओं और भिक्षुओं द्वारा समर्थित किया गया है। एक रिपोर्ट के अनुसार मुंबई में, नेत्र दान सहित सभी अंग दान (85-90%) जैन और गुजरातियों द्वारा किये जाते है. Gujarat में जैन धर्म के लोगो की आबादी ज्यादा होने की वजह से  नेत्र दान में  काफी सफलता मिली है.

बुद्ध धर्म

बौद्ध धर्म के अनुसार, दुसरो को नया जीवन देने की खातिर अपने शरीर का कोई अंग दान करना एक महान योग्यता है। भगवान बुद्ध ने भी एक खरगोश के रूप में अपने पिछले जन्म में आग में कूद कर एक भूखे ग्रामीण को पोषण देने के लिए खुद का बलिदान कर दिया था. दान करने का फैसला, बौद्ध धर्म के अनुसार, अंगदाता के द्वारा ही किया जाना है। यह स्पष्ट नहीं है की मस्तिष्क मृत्यु (brain death) बौद्ध धर्म के अनुसार मौत का एक रूप है या नहीं है, क्योंकि मरा हुआ व्यक्तिं स्वयं का निर्णय नहीं कर सकता है. लेकिन ऐसे केस में भी बोध धर्म अंगदान को एक नेक कार्य मानता है.

रोमन कैथोलिक चिकित्सक नैतिकता

कैथोलिक चिकित्सा नैतिकता में  Pope Pius XII ने कहा है की मृत्यु को चिकित्सा विशेषज्ञों द्वारा निर्धारित किया जाता है. चुकीं  "यह चर्च की क्षमता के भीतर नहीं आता" , इसलिए चर्च इस मुद्दे पर चिकित्सा समुदाय के दृष्टिकोण का समर्थन करने के लिए बाध्य है। हाल ही में, विज्ञान के बिशप अकादमी ने कैथोलिक सिद्धांत को सही ठहराया है।

इसलाम

अधिकतर इस्लामी धार्मिक नेताओं ने जीवन को बचाने के क्रम में अंगदान- जीवन के दौरान (बशर्त है की उससे दाता को कोई नुक्सान न हो) और मृत्युपरान्त, को स्वीकार किया हैं। हालांकि, अधिकांश धार्मिक नेता मस्तिष्क मृत्यु को मौत नहीं मानते क्योकि मौत की घोषणा के लिए एक पूर्व शर्त के रूप में दिल की धड़कन समेत जीवन के सभी लक्षण की समाप्ति अनिवार्य है, इसलिए इस्लाम में अंगदान की इजाज़त है.

जूदाईस्म

यहूदी चिकित्सा नैतिकता, अंगदान के लिए एक अद्वितीय दृष्टिकोण रखता है। यह किडनी प्रत्यारोपण,  आंशिक जिगर पालि (वयस्क / बाल) प्रत्यारोपण, ब्लड डोनेशन को प्रोत्साहित करता है, लेकिन इसमें दो बुनियादी शर्ते है- पहली ये की इससे दाता की जान का खतरा न हो और दूसरी इससे किसी और की जान बच रही हो.

उम्मीद है यह ज्ञान आपको अंगदान (जीवित या मरणोपरांत ) का फैसला करने में मदद करेगा. धन्यवाद
मानवता ही हर धर्म की नींव है और अंगदान मानवता का एक रूप.

Donate. Save lives.

Religion or no religion.... Humanity exists

In  broader terms, all religions points out to one common character - Humanity. Donation, in any form, is not about your preferences or moral values, but its about Compassion and courage to help human kind, to propagate brotherhood, to enjoy the gratitude of giving and build a better world.

I don't know why we put things off, but if I had to guess, I'd have to say it has a lot to do with fear. Sometimes the fear is just of making a decision, because what if you're wrong? What if you're making a mistake you can't undo? 

 A stitch in time saves nine. We can't pretend we hadn't been told. We've all heard the proverbs, heard the philosophers, heard our grandparents and society. Still sometimes we have to see for ourselves. That knowing is better than wondering, that waking is better than sleeping, and even the biggest failure, even the worst, beat the hell out of never trying.

Learn. Understand. Donate. Save lives.

Here i am sharing what different religions have to say about organ donation, or donation in general:-

Hinduism

Life after death is a strong belief of Hinduism and is an ongoing process of rebirth. It is a perpetual circle of birth and rebirth of the soul, so the physical body is insignificant. This could be seen as reflecting positively on the concept of organ donation and transplantation in Hinduism.

Jainism

In Jainism, compassion and charity are considered to major virtues. Organ donation has been widely supported by the Jain community leaders and monks. It has been reported that in Mumbai, 85-90% of all organ donations including eye donations, are by Jains and Gujaratis (a significant fraction of them are Jain in Mumbai).Gujarat has had considerable success with the eye donation program due to a significant population of the Jain community, which considers eye donation as a sublime form of charity.

Buddhism

According to Buddhism, it is a great Merit to donate ones own flesh for the sake of another. The lord Buddha is also believed to be sacrificed himself by jumping into a fire in order to nourish a lost and starved villager in woods, in a previous life as a rabbit.

The choice of making the donation has to be made by the donor himself according to Buddhism. It's not clear brain death is a form of death according to Buddhism. But if it considered as death, in which case one cannot make decision of ones self, it's a good deed for one who died and also for the ones involved in decision making and contributing.

Roman Catholic medical ethics

In Catholic medical ethics, Pope Pius XII stated that death is determined by medical experts and it "does not fall within the competence of the Church." Advocates of brain death criteria have claimed that this implies that the church is bound to support the view of the medical community on this issue. More recently, the Pontifical Academy of Science has upheld Catholic doctrine.

Islam

The majority of Islamic religious leaders accept organ donation during life (provided it does not harm the donor) and after death in order to save life. Most religious leaders do not accept brain death as a criterion and consider cessation of all signs of life including heart beat as a precondition for declaring death.

Despite this position by Islamic religious leaders, Muslims are oftentimes uncertain about whether or not Islamic tradition considers organ donation to be forbidden. This uncertainty stems from ambiguity caused by conflicting opinions among some Islamic leaders regarding this issue. Moreover, a lack of support along with a generally negative attitude toward organ donation and transplantation has been reflected in surveys of diverse Islamic populations.

Judaism

Jewish medical ethics takes a unique approach. It encourages live organ donation, such as kidney transplant, partial liver lobe (Adult/Child) transplant and the like, when two basic conditions are met, firstly, that the operation does not (significantly) endanger the life of the donor, and secondly, that the recipient's life will be saved through this donation. However, opinions are divided on the issue of organ donations which will permanently end the donor's heart beating, in a case when the donor is brain dead.

Meanwhile, proponents of the brain death criterion, such as Halachic Organ Donor Society have been active in advocating organ donations and transplants either at brain death or even at cessation of heart beat, where donation of corneas and skin is still medically possible.

I hope this helps while you are in dilemma of donating( living or dead) or not donating. God bless.