Should we all be kidney donors?

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Should we all be kidney donors?

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This needs more thought still.

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References

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Great points by Salil Saxena on Open Bagel Forum:

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So there may be some truth to the idea of the general population being kidney donors in a utilitarian sense. Some background info:

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  • On average, kidney transplant can lengthen one’s life to 10-15 years or usually around double or triple compared to dialysis. It all depends on one’s comorbidities, access to health care, living vs deceased donor etc. For perspective, on average, there is a 50% chance of mortality in the first 5 years when starting dialysis (Hemodialysis but there are also other forms of dialysis as well).
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  • not everyone is a candidate for kidney transplant (active or recent cancer, severe mental illness, severe obesity)
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  • not everyone is a candidate to be a kidney donor (current renal function, expected years to live – person may develop kidney failure and need a transplant in the future if they donate their kidney)
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  • there are risks to be a kidney recipient: chronic medications, chronically immunocompromised (easily get infections and die from them), transplant rejection w/ failure of the organ, multiple renal surgeries if kidney is rejected or after the transplant has finished its life span 10-15 years)
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  • there are risks to be a kidney donor: surgical complications, infections from surgery – but often rare
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Overall though, most of those w/ kidney transplants live longer and have higher quality of life (don’t need to stay in dialysis unit 3/7 days and waste their life in that room 4 hours each day).

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I would make the argument that maybe in the short-term donating a kidney will help increase overall length of life and quality for most in a utilitarian sense. On the other hand, money/time/resources are better spent on preventative medicine where one does not develop end stage renal disease or if it does, we can develop organs from our own pluripotent cells where there is no need for a donor, chronic meds, and chronic immunosuppression.

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By the way, there are some renal docs that don’t provide the option for kidney transplant because they lose that patient to a kidney transplant doctor and thus lose money (much of the money a renal doctor can make is from dialysis).

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