Brother's Keeper

If you are medically and surgically cleared for donation and when a date becomes available for surgery, the following steps are completed as part of the surgical planning process:

• Meeting with Pre-admission clinic nurse
• Meeting with Anesthesiologist
• Repeat chest x-ray
• Repeat blood Work

Donor Nephrectomy (kidney removal) is a major operation

Two surgical approaches:

• Laparoscopic surgery (“keyhole” or minimally invasive surgery) – small incisions are made in the abdomen, involves air being pumped into the abdominal cavity, then a camera/different medical instruments are used to disconnect the kidney from main artery/vein (3 – 5 hour procedure)
• Open/Flank surgery - involves incision of flank muscles and dissection through the lower ribs to extract kidney (more invasive procedure)

The transplant surgeon will ultimately decide the surgical method for kidney removal when they do a final assessment

In BC, laparoscopic nephrectomy is the commonly used approach for improved pain control and shorter recovery time for patients

Your primary care provider will receive instructions for follow-up care post kidney donation, including:

• blood pressure checks
• bloodwork (can be done through outpatient lab such as LifeLabs) at 2 months, 6 months, 12 months and annually after the 1-year mark
• after donation, it is normal to see a reduction in kidney function by ~30% (compared to your baseline levels prior to surgery)

Donors are also advised to maintain healthy lifestyle (through diet and regular exercise) after surgery

Kidneys are vital organs that perform several functions:

• regulate blood pressure
• eliminate wastes from our body through filtering the blood
• helps maintain homeostasis (physiological balance) by controlling salt and water levels through fluid retention or excretion via urine
• specialized cells within kidney produce erythropoietin (EPO) hormone that stimulates production of red blood cells from the bone marrow

Kidney Failure or End Stage Renal Disease (ESRD)

• can occur because of acute illness such as a viral infection
• can develop over time from a chronic underlying cause such as diabetes, autoimmune diseases or untreated high blood pressure (hypertension)
• can be related to genetic pre-disposition such as polycystic kidney disease
• can be a secondary complication resulting from other medical conditions such as glomerulonephritis (inflammation that impacts the filtering structure of kidneys) or recurring renal infections
• in many scenarios, the underlying cause for kidney failure is unknown

Kidney failure is a progressive condition that requires treatment to help sustain life and to prevent or delay the onset of a spectrum of serious health complications

• Number of individuals who reach kidney failure and require lifesaving treatment is growing (this is due to several contributing factors)
• As of December 2023, there are 22,739 individuals receiving kidney treatment across the health authorities in BC³
• In 2023, 514 individuals were on the Transplant wait list in BC (this includes both kidneys and other vital organs) and 6 people died while they were on the wait list⁴
• As of July 2024, 586 individuals require organ transplant in BC, out of this group, 461 individuals require a kidney transplant and 8 people require donation of a kidney plus another vital organ⁴

* Check out "Resources" feature for monthly up to date statistics

Quality of Life comparisons between treatment plans for ESRD:

• Dialysis considerations:
  • hemodialysis for example can be 3x per week/4 hrs per session ( = 576 hours of dialysis per year to sustain life)
  • can result in secondary complications and multiple hospitalizations over time
  • prolonged treatment and physical toll of dialysis can often make the person feel more sick over time
  • psychosocial challenges and emotional struggles experienced by patient and their family
  • only serves as a stopgap measure

VS.

• Kidney Transplant considerations:
  • recipient takes life long immunosuppressive oral medications post surgery to prevent organ rejection
  • recipient has ongoing bloodwork to evaluate kidney function over time
  • long-term treatment with better patient outcomes, dialysis is no longer required

• Share the app with at least 2 other individuals to spread awareness about living donor kidney donation (promote province wide awareness)
• Perhaps consider getting tested for donation after a certain age (for example, for women, this maybe after they are done having children)
• Ask your family doctor to have your blood type tested and keep note of your blood type in the Notes section of your phone for quick reference
• Learn more about kidney disease and wait list estimates for kidney transplant in BC (check out “Resources” feature)