DECEASED DONORS (CONTD)
Q: How can one get permission from the donor family?
A: Abroad, permission is sought via:
1. The donor putting his/her name on the national organ donor register; then their wishes have priority after death.
2. If someone is not on the organ donor register, then the wishes of the family determine whether organs are donated.
This means that deceased donor kidney donation is a gift, even though it may come from tragic circumstances
Q: Is there a difference between living donors and deceased donors?
A:
· Unlike living donation where the kidney comes directly from the donor to the recipient, kidneys from deceased donors are often injured by the death and preservation processes, so a delay in kidney function may occur.
· Occasionally, dialysis is continued until the deceased donor kidney begins to function. When dialysis is needed, deceased donor kidneys may take up to two weeks to begin functioning.
· With living donation, delay in kidney function is uncommon and function may be restored almost immediately.
Q: How good is deceased donation?
A: All kidneys from deceased donors are not the same. In fact, how well a kidney transplant works depends on both the donor and the recipient. Most deceased donors—of any kind—have less than perfect kidneys. This is what can affect the quality of kidneys from deceased donors:
1. The donor's age
2. Cause of death
3. Any event that happened when the kidney was removed, such as low blood pressure or clotting in the blood
4. Not knowing the exact condition of each deceased donor kidney; this is mainly because short-term problems can make the kidney work poorly for a while. However, after a few months, some kidneys from deceased donors are found to work better after the transplant.
5. How long the kidney has been kept out of a body in cold solution, after it has been removed from the deceased donor. This time is more of a risk when it is in the range of 18 or more hours. It happens more often when a kidney is sent from one region of the country to another because it is a good match.
Q: What are the risks involved in deceased donor kidneys?
A:
· There are a number of risks in choosing a deceased donor kidney for transplant in today's world.
· Some kidneys that seem to work well may not, some that are not used for a transplant may have worked well. It may be hard to be sure of the quality of many deceased donor kidneys.
· Yet these kidneys cannot simply be thrown away just because questions arise. Many working kidneys would be lost.
Q: Can one be harmed by a kidney transplant from a deceased donor?
A: Deceased donors and their kidneys are tested carefully.
· First, doctors look at the condition that has caused brain death. Some deceased donors have other medical conditions or diseases. Family members are asked about the life style of the donor. Deceased donors are tested for syphilis, hepatitis B and C, HIV, AIDS, and other viral infections.
· Some good donors may have infections caused by bacteria. This does not rule out taking the kidneys. But the transplant patients must be treated for these infections at the time of transplant.
· Even with all the testing, there is always a risk that a disease from the kidney may be given to the transplant patient. This risk is much less than 1 in 100.
Q: What are the barriers to deceased donations?
A: Despite its vast potential, deceased donation in Nigeria may not be successful unless the following major barriers are removed:
1. Inadequate public awareness
2. Attitude of the medical community
3. Frequently held misconceptions about religious guidelines
4. Different conceptions of brain death
5. Absence of legislation on deceased donation
Q: What are the opportunities for deceased donation in Nigeria?
A: We need legislative, religious backing and nationwide education on deceased donation of organs. It will serve as another alternate source of organs for donation. This promotes the growth of transplantation activities in the country, reduces, and eventually eliminates commercialization of organ donation which is ethically and morally wrong.
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