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Clinical Services
On any given day, patients and donor candidates at the Montefiore-Einstein Transplant Center see the Living Donor Transplant Coordinator, Patricia McDonough, discussing transplantation details with potential living donors, overseeing each potential donor's medical testing, teaching donor education classes, and answering donors' questions. While this is a typical day on the job for this wife and mother of three, what most donors don't know at first glance, is that Patricia herself is a living donor.
"My brother Vincent had chronic renal failure in 1998 and it became apparent that he would need a transplant," she begins. "At one time, I was working at the New York Regional Transplant Organ Bank, and part of my job was to go to hospitals and work with families to see if they would donate organs from those they had lost, and coordinate the organ recovery. I personally felt that the program at Montefiore Medical Center was the best, so I steered my then 39-year-old brother there."
"I'm one of five siblings and the four of us, including my brother's wife all matched as potential donors. My brother Christopher was an identical match. During this time, I was hired in the Montefiore-Einstein Transplant Center and was ironically watching another coordinator prepare my brother Christopher to donate a kidney. However, upon undergoing a CT scan, we discovered that he had three arteries for every kidney (typically it's one), so the likelihood of transplanting successfully was lower, and we don't take chances like that here."
"I was next in line."
"The team put me through the same process that every potential donor goes through without exception - the tests, the interview, and even bringing my husband in to make sure he was OK with it. You want donation to unite a family, not destroy it."
"My initial reaction was that I cried...for a long time. I went through all the, ‘What ifs' and then came down to the question, ‘What about my brother?' I finally reached a point where I wasn't afraid anymore; donors are always afraid at first, but with education and support, they can come to terms with it and say, ‘I can do this.'"
"We did the surgery January 13, 1999. Once I made the decision to do it with this team, I never felt afraid that I would die or have a complication. I worried it may not work, because the success rate, while high, is 95%. But bar none, I never thought I would have a problem in the care of this team."
"Donating an organ was the most ennobling experience of my life. Every time I think about it, it gives me a sense of ‘Wow! I'm so glad I did that!' It's a life-defining moment; you try to be a person of virtue, but all of a sudden, you get to do one right thing. At the end of my days, it is something I will always feel good about. A person gets to be brave, loving, and giving - all in one simple act. Looking at my brother, I could see he felt like a new person. In fact, he was up painting his house just weeks after the surgery!"
"He said to me, ‘I don't know how to thank you.' But the reality is, I got more out of it; he got a kidney, I got to participate in a miracle."
Here, Patricia answers some key questions she often hears at the Transplant Center:
Q: How is the experience of living donation different at the Montefiore-Einstein Transplant Center?
Pat: The experience at the Montefiore-Einstein Transplant Center is family style, where everyone knows your name. It's a personalized approach to live donation, utilizing a multidisciplinary team whose focus is always on the potential donor. Before candidates are screened to see if they match the recipient, they first meet the team, talk about the risks and benefits of donation, see a slide show, and can ask appropriate questions. The likelihood of matching the intended recipient is high if your blood type is compatible. However, the difficult part is the medical evaluation - the lab tests, EKG, CT scans, etc. Donors see three different physicians to ensure that the donation will be safe.
Q: What are the risks with donating a kidney?
Pat: Donating a kidney is called "donor nephrectomy," which is performed by transplant surgeons with specialized skills in living donation, including minimally invasive surgery.
Like all surgery, complications can occur. All patients will have some pain, which is controlled with medication after the surgery. Some patients may also experience constipation, nausea, and occasional fever. These symptoms resolve soon after the surgery. After discharge, patients are followed closely in the office.
Death from donor nephrectomy is extremely rare. The risk is estimated at 0.03% (3 out of every 10,000 surgeries). In 40 years of performing live donor transplant surgery at Montefiore Medical Center, we have not experienced a single living donor death. Our complication rate is also very low and most complications are minor and easily treated. Types of complications include infections (urine or wound, for example), hernia, bowel obstruction, bleeding, blood clots, and damage to the donor kidney preventing transplantation. We turn down many donors for reasons such as high blood pressure, in order to avoid lifelong health problems in the donor after nephrectomy.
Living donors must be followed each year to ensure they are healthy. We follow living donors beyond the minimum two-year UNOS requirement. Montefiore Medical Center is your family. You can always come back, and we will be there for you.
Q: Who can be a living donor?
Pat: Typically live donors are family members or close friends, but any healthy, adult, mature individual can be a living donor, provided they complete the evaluation and education process and are able to understand the risks. Donors should be free of duress or coercion in making their decision.
If you're considering becoming a living donor, some resourceful Web sites to visit are: www.livingdonors.org and www.livingdonorsonline.org .
Any potential candidate who is or has the following will be automatically excluded:
Q: What are the benefits of the recipient and donor?
Pat: The benefits to the recipient include the following:
The living donor also receives several benefits:
| Transplant Surgery | |
| Evaluation & Wait List | |
| Living Kidney Donation | |
| Living Donor Personal Viewpoint | |
| Highly Sensitized Patients | |
| Incompatible Blood Group |
