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Kidney transplantation: all the things you need to know about donating

by - April 09, 2023

 What disqualifies you from donating kidney?

Kidney transplantation: all the things you need to know about donating

It happened to pop star Selena Gomez. And living transplants are also on the rise in our country. A possibility that is still too little talked about, but that can save 2 people. As told by those who have done it

There are gifts so precious that they can be given only once in a lifetime, completely changing the recipient's. That's why the organ and tissue donation awareness campaign has chosen the slogan "Let's give the best of ourselves."


And the tam tam does not stop at National Organ Donation and Transplantation Day, this year celebrated on May 27, but goes on every day. In fact, many people are unaware that, in addition to the option of signing a living person's consent to organ and tissue removal after death, one can also donate while in perfect health. This is called living donation. Let's try to understand its rules and potential.

What organs can be harvested?

"A kidney and a portion of the liver, as far as organs are concerned, " explains Alessandro Nanni Costa, director of the National Transplant Center. At Ismett in Palermo, the tenth living liver transplant in one year was just performed. "In addition, hematopoietic stem cells (contained in bone marrow, peripheral blood, and umbilical cord blood), some parts of bone (such as the head of the femur), and amniotic membrane can be donated from living people," Costa adds. The hematopoietic stem cell donor can be a family member of the recipient, due to similar genetic characteristics, or a person enrolled in the stem cell donor registries: the Italian one (Italian Bone Marrow Donor Registry) is located at the Galliera Hospital in Genoa and manages the search for compatible donors for patients in need of transplantation.

Who can donate?

"Generally, living organ donation occurs among "affectively related" people: relatives and kindred and in some cases friends." And in rare cases, authorized only for the kidney, "we also witness 'Samaritan' donations, that is, towards unknown people," clarifies the expert. In the latter case, the donated organ is used to trigger "Samaritan crossover chains," crossing incompatible donor-recipient pairs. Let's take an example: the wife of a patient in need of a kidney donates it not to her spouse, for reasons of low compatibility, but to an unknown person who, however, has greater genetic compatibility with her, to ensure a better chance of a successful transplant; in turn, a person related to that recipient makes her kidney available to the donor's husband.

How to do it.

To express your willingness to donate a living organ or tissue, simply go to the nearest regional transplant center. But there will be a green light for donation only after clinical examinations and medical examinations, interviews with a psychologist, "the careful evaluation of a medical commission independent of the specialists involved in the care of the recipient, and finally a specific authorization of the magistrate of the competent court," Costa specifies. The law, therefore, "maximally protects both the recipient and the donor, who must have optimal health conditions and in any case will not have to change lifestyle after the surgery or take drugs." Along the way, however, psychological support is guaranteed. And the results speak for themselves: when the kidney donor is a living person, "we verify a better survival of the patient," adds Nanni Costa.

What is the next goal?

"With the National Transplant Center, we have signed a memorandum of understanding for a pro-living kidney donation campaign, which was launched last year in Umbria, Marche and Puglia," says Giuseppe Vanacore, president of Aned, the National Hemodialysis Association. "We raise awareness among health professionals, patients, family members and volunteers." Agrees Flavia Petrin, president of Aido (Italian Association for Organ, Tissue and Cell Donation): "Living donations are on the rise. But they should not be considered a substitute for cadaver donation, which for some organs is the only one possible. And at the moment we are far from guaranteeing all citizens on the waiting list an adequate health response."

The numbers

15 donations of a living portion of a liver in 2017 in Italy
128.6 percent increase in donations of a living portion of a liver in 2017 compared to 2016 in our country
276 living kidney donations in 2017 in Italy. 10.7% the increase in living kidney donations in 2017 compared with 2016 in our country
36% the percentage of kidneys donated by women to their partners out of the total in 8 European countries (Austria, Belgium, Croatia, Germany, Holland, Hungary, Slovenia, Luxembourg)
2012 the year from which withdrawals of a section of lung lobe, pancreas and intestine are also allowed in Italy. As yet, no such transplants have been performed

(Sources: Eurotransplant, Cnt, Aido)

Testimonials.

Marzia Cardillo, 45, from Rome "I allowed my 8-month-old granddaughter to be reborn" "My scar, from my sternum to my navel, is the tattoo I wear with pride." On her body, Marzia Cardillo sees every day the mark that allowed her niece Sara, born with congenital biliary atrophy, to be "reborn." An aunt on her father's side, three months ago she decided to donate a portion of her liver, the left lobe, to the little girl. "The transplant, which lasted a total of 13 hours, took place Feb. 7 at Bambino Gesù Children's Hospital in Rome. The 8-month-old girl weighed 5 kilograms and was not growing regularly; she was living with a nasogastric tube, had dark skin and a swollen belly, and a catheter. She had undergone surgery in October to prevent her liver from going into cirrhosis, a chronic disease that leads to death, but the surgery was unsuccessful. The waiting list to receive the cadaver organ is very long. Her parents have a different blood type and could not donate it to her, but I have the same: knowing that Sara would not have survived otherwise, deciding to make this gesture for me was natural. I didn't even ask the question," says Marzia, 45, married with a 13-year-old daughter. "After giving consent, in December and January I underwent a series of investigations, all free of charge. Then the operation, the first in my life. I recovered slowly and recently resumed my job as a clerk; my liver is back to its original size, it is an organ that regenerates itself in a few weeks. She is now well: seeing her smile and play, gaining weight and stature is the greatest joy."

Adriana Olimpio, 48, from Lecce "I saved my husband Amedeo years of dialysis" "Positivity is our motto," says Adriana Olimpio, 48, who has been married to Amedeo Mauro, a year older, for 17 years. Both from Lecce, they have been "one flesh" for a few months, thanks in part to Adriana's kidney transplanted into the body of Amedeo, who was born with polycystic kidneys. "This is a genetic and asymptomatic condition that gradually atrophies them until they no longer function because of cysts that enlarge: I inherited it from my father, who has been on dialysis for years now," he says. Despite living a healthy life, "the day came when my husband started having high blood values. I didn't want him to become a dialysis patient, like my father-in-law: half-living, attached to a machine for hours every other day," Adriana reflects. "I immediately gave my willingness to donate one of my kidneys, but the doctors found a low compatibility, with a high risk of rejection. So I also said yes to cross-over: I could give the organ to another person who was compatible with me, and in turn a family member who was compatible with my husband would give it to him. But these 'chains' were blown 2 times, due to problems on the part of the other potential donor." Finally, doctors at the Bari Regional Transplant Center gave approval for the surgery between her and Amedeo, because in the meantime, thanks to advances in research and new drugs, the risks of rejection had been lowered. "The operation took place on January 16," she says. "After two weeks I was back at work. And now we are even stronger, united."

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