If you’ve been following this blog and are familiar with my site, you already know that I’ve been writing a book on living kidney donation with a live-donor kidney recipient, Betsy Crais. It’s long been tentatively titled The Greatest Gift: The Insider’s Guide to Living Kidney Donation. Now that we’re down to the review process and planning for publication in 2021, we’ve made a big decision.
This book has never been just for people considering donating a kidney. We’ve always looked at our task as lending readers a hand before, during, and after the actual surgery. Similarly, there’s plenty in there for people living with end stage renal disease (kidney failure), throughout the transplant process (including dialysis) and beyond, as we touch on delicate family dynamics and relationships.
Anyone who has experienced donation or transplant–or has a loved one who has–knows that both are so much more than medical decisions and events. That’s why we wanted the title to reflect the book’s broader role. So, drum roll please, our new title is The Insider’s Guide to Living Kidney Donation: Everything You Need to Know If You Give (or Get) the Greatest Gift.
Watch this space for more news. We’ll let you know when we have a specific publication date.
My co-author, Betsy Crais, and I have been busy making revisions and updates to our book manuscript (The Greatest Gift: The Insider’s Guide to Living Kidney Donation). With the pandemic necessarily dominating the news and publishing world, this seemed like a good time to concentrate on honing our manuscript rather than sending out proposals. As we prepare the final chapters, we’re noticing some key trends since we started working on it 5+ years ago (back when we were both working full time and unable to devote much time to it):
Social media is playing a bigger and bigger role in kidney patients’ search for donors. I get requests every week to “like” a page to help someone find a donor. The National Kidney Foundation’s Big Ask/Big Give workshops, which Betsy and I have addressed in Chapel Hill and Raleigh, NC, encourage and train kidney patients and their families and friends in how to get the word out that way.
Potential donors are learning that they don’t have to be related to their recipient. Perhaps because of the social media involvement, more nonfamily members are volunteering to donate to a friend, neighbor, or colleague. Antirejection meds have come so far that, though well-matched pairs still offer the best chance of long survival, the so-called “perfect match” is far from being a requirement for a kidney transplant.
Paired donation (aka “kidney swaps”)have really taken off. Let’s say, you want to donate to Alice but you’re not a match; maybe Jane, who wanted to donate to Bill but couldn’t, can donate to Alice and you can donate to Bill. Computer formulas and kidney registeries make it all possible. In 2006, when I donated to my son, paired donation wasn’t even on our radar, and no wonder: there were only 72 such transplants in the United States that year. In 2019, there were 1,118! It doubled just in the past 5 years.
Nondirected donorsare playing a bigger role. These rare individuals (a few hundred each year in the United States) make the selfless decision to donate to someone they don’t know–and may never meet. Sometimes their donation can initiate a domino chain of kidney transplants across several transplant centers.
As we start to wrap up The Greatest Gift, I may post a few samples here from time to time.
Before my son was diagnosed with chronic kidney disease in 2004, I knew as much as most people about the subject—which is to say, almost nothing. Not sure if I even knew you can live a normal life with one kidney. Before he developed kidney failure, and I started the evaluation process for donating my kidney to him, I knew almost nothing about living donation. Now, fortunately or unfortunately, I know more than most people about these things and have made it my mission to help people learn before a crisis hits—in the hope, ideally, of preventing more such crises.
So now I find myself in a similar situation concerning liver disease and liver donation. No, thankfully, it’s not my own family this time, and I’m not considering being a living donor again in my 70s, but as always, it’s because of someone I care about. You may have read here that my friend and co-author, Betsy, needs another kidney transplant after 15 years. That was bad enough. For a while though, a few months later, there was good news when she’d found a living donor and was scheduled to have the transplant in December. Unfortunately, the good news gradually became more tentative as her health began to deteriorate and the transplant was postponed.
And now the biggest shock of all came last week when she/we learned that she also needs a liver transplant. After being stunned and saddened, I began my new education about livers and liver donation. All I knew was that, since the majority of people on the deceased-donor waiting lists need a kidney, the wait for a liver is much shorter: about a year versus 3 to 5 years (often 5-10). As for living liver donation, I knew you can donate part of your liver because it grows back but that it’s a bigger deal than donating a kidney–it’s a more serious surgery, with a longer recovery.
However, by reaching out to the Facebook donation/transplant community, reading articles, and searching online, I’ve already learned some very encouraging information. Did you know that you can donate two-thirds of your liver and it regenerates so much that within a few months, both you and your recipient have a healthy-sized liver?
I also learned that the donation surgery is easier than it used to be and that some centers have started to use minimally invasive laparoscopic surgery as is done for kidney donors. That means a much smaller incision, far less pain and blood loss—and a quicker recovery. That should make it a little easier to think about asking people to consider donating.
That’s all good news, not just for Betsy and her friends and family, but for all patients and their families and friends. Betsy certainly has a lot to deal with and is facing many difficult decisions and waiting periods. But she’s an amazingly positive person and is learning all she can and asking questions so she’ll be as informed as possible. As we always say, information is power—never more so than in matters of health.
I’ve long thought that living donors are a special breed. Whether we live in Iowa or North Carolina, the United States or India, Australia or France, I fully believe we have more in common than what separates us. As I discovered so vividly at the Living Donor Rally at the Bean in Chicago last year, we have an extraordinary bond. We “get” one another on a level that transcends age, gender, race, country, or politics.
I was particularly reminded of that recently when I received an email from a living donor in Australia. Kaye Price, an enterprising living donor advocate, with whom I’d had just a couple of exchanges, was writing to check on my safety in the path of Hurricane Dorian. I was touched by her concern, but the funny thing is that I didn’t feel that she was a stranger. Like me, she’d turned her experience as a living donor (to her sister-in-law) into a mission. She founded a free app, DonorPlus (available through Google Play and the App Store), with another entrepreneur/living donor advocate, Patricia Hunt. Much like this website and my book with Betsy Crais, The Greatest Gift, their app “informs, supports, and empowers living donors.”
Although certain procedural specifics obviously vary by country, the basics are remarkably universal. DonorPlus guides the potential donor through the decision making and the preliminary interviews. It’s definitely applicable to potential donors in many countries. The website, DonorPlus.org, features donors’ stories and even a large selection of donor merchandise.
The app is in the early
stages, but they’ll soon be releasing a more advanced version that includes an
expense tracker and planning tools. In addition to practical information for
potential donors, the app will connect people with previous donors to make a
direct connection. Kaye and Patricia have big plans for it and would love to
get input from people all over the world. They have succeeded in attracting
investors in Australia and will be traveling to the States soon to meet with major
donor groups and medical centers.
I hope we can connect while they’re here. Meeting fellow living donors and supporters always feels like meeting old friends.
This week Betsy Crais and I spoke at another terrific Living Donor Champion workshop. I’ve written about the one we did in the spring at UNC Transplant Center plus the National Kidney Foundation’s Big Ask, Big Give in June at Rex Hospital in Raleigh, NC.
It’s funny that I’m starting to feel so comfortable at these valuable events. As I told the group, I used to be intimidated by the very heavy subject of kidney transplant and donation and doubted that I could possibly add to the discussion–until I realized that just sharing my own story and my perspective was valuable. How could I have forgotten how comforting it feels to talk to someone who’s been through the experience for people who are overwhelmed, confused, and no doubt frightened? Now that I have a few years of research in connection with our book on the subject plus submersion in the kidney support community as we expand our advocacy efforts, I feel even more equipped to talk about all this.
We met a family there from Raleigh—the husband was in need of a kidney, and his 20-something daughter had just surprised him with the news that she was testing to be his donor. I could feel their excitement and knew that this step has a huge impact on the entire family. I told them about my website, of course, and urged their daughter to contact me if she has any questions or just wants to talk about it. [If she’s made her way to this post, I hope she knows I meant it!]
Wishing all the attendees
good luck on this very special, intense journey!
Funny how things take on a life of their own. Less than 3 years ago when I was interviewed at length on “Your Health” radio show and asked to tell my story about donating a kidney to my son in 2006, I was a bit uncomfortable with their description of me as an advocatefor living organ donation. Yes, I was passionate about the subject, never passed up an opportunity to talk about it, and was writing a book on living kidney donation, with a live-donor-kidney recipient (Betsy Crais). I’d also written a couple of op-ed pieces, but “advocate” sounded much more significant (and certainly impressive) than whatever I was doing in my own little ways.
But then I ventured out a bit and spoke at a rotary club and a couple of patient workshops. I started writing blog posts sharing my story. I began to use Twitter and Facebook to talk more generally about the 30 million Americans with chronic kidney disease and the dire need for donors—live and dead. So when two local TV news stations interviewed Betsy and me last year about our book in progress and referred to us as advocates, that time the label felt right.
And now the National Kidney Foundation has made it official, inviting me to join its nearly 200 Kidney Advocacy Committee members nationwide. The NKF advocates can
bring the patient/family voice to NKF’s legislative priorities
serve on panels and in conferences hosted by various government agencies….
I am honored and deeply humbled to join the ranks of “donation advocates.” There’s work to be done.
So glad that ABC News (WTVD) did a piece on Betsy Crais’s need for a second transplant (see the video), as I described in a post about my book’s co-author last month.
Betsy initially thought she had four possible kidney donors in her immediate family. A few weeks ago she received a call from the transplant center saying that one by one, all of them had been eliminated. Potential donors have to be in excellent health and can be disqualified not only if they have a condition that could potentially harm the recipient–but also if donating might jeopardize their own health.
Fortunately, Betsy has never been one to be discouraged for long. She took a deep breath and sat down to send off an email to friends, family, and colleagues, letting them know about her kidney failure after 15 years of a successful transplant. Within minutes of hitting SEND, Betsy was heartened to receive not only messages of concern and support but even several inquiries about how to be tested to be a donor.
Because the transplant center will consider and test only one candidate at a time, Betsy and her family now have to wait impatiently for word from the transplant coordinators. Although Betsy is on the waiting list for a deceased donor, that wait is often several years long. A transplant from a live donor might be just months away, typically has a better chance of success, and can last up to twice as long. Naturally, Betsy is fervently hoping for a live donor.
In the meantime, she had an access port surgically created in her arm in readiness for dialysis. Betsy’s condition is stable, so there’s a chance she may never need it–if a donor is approved in time, she could have a preemptive kidney transplant (that is, before she needs dialysis).
I really hoped I would never need to write this post.
If you’ve checked out my story or many of my blog posts, you know that Betsy Crais, the co-author of my book in progress* and a dear friend, is a kidney recipient from a live donor. Betsy had her transplant 15 years ago and had been doing really well until the last several months.
I am so sad to say that Betsy’s kidney function has declined to the point that she now needs another transplant. I’ve always said that Betsy was the poster child for living a full and productive life with a kidney transplant: not only does she work full time as a university professor and researcher, shunning retirement, but she’s active on grant review panels, committees, and national organizations–on top of being a devoted wife and mother and a lovely person (not to mention a co-author and a donation advocate, of course).
Because Betsy, like her mother and two of her sisters, has polycystic kidney disease (PKD), her two adult children are at risk of developing it themselves. They can’t be considered as donors until they’re well into their thirties, when the disease typically manifests itself. Betsy had fervently hoped to avoid dialysis, but in the absence of a living donor for now, she is having an access port put in soon and expects to start dialysis this summer.
If you know anyone who has ever remotely considered donating their kidney (or maybe the idea of doing it yourself is what brought you to this site), please contact me (firstname.lastname@example.org). I’ll provide the contact info for the donor nurse coordinator at UNC Hospitals. Betsy is blood type A, but as you may already know, these days it’s not essential to have a matching blood type (see the FAQs). There are lots of options now.
Thanks for anything you can do to help spread the word!
*The Greatest Gift: The Insider’s Guide to Living Kidney Donation.
What are living donor champions? They are friends and family members of someone who needs a transplant who learn how to effectively spread the word to potential donors. Let’s say you know someone who needs a kidney, but they’re uncomfortable for any number of reasons about coming out and asking someone they know–much less someone they don’t know–to donate one of their kidneys.
Back in 2004 when we first learned that my son would need a transplant, the idea of asking someone if they would donate their kidney was beyond awkward. (People who have trouble asking for a ride to the airport don’t even know where to begin to ask for a bodily organ!) Though social media existed then, it was mostly a social thing for teens and 20-somethings–hardly a vehicle for something like life-saving/life-changing requests. Fast forward to 2019: Facebook, Twitter, and other platforms have changed the whole donation landscape, which dovetails perfectly with living donor champion efforts.
Betsy Crais, my co-author (The Greatest Gift: The Insider’s Guide to Living Kidney Donation), and I are going to speak at a few such programs over the coming months. We’ll start with one this weekend at the University of North Carolina’s kidney transplant center. That’s only fitting, because it’s where I donated a kidney to my son, and where Betsy received hers from a UNC colleague. We’re going to tell our stories and take questions from attendees.
I’m so looking forward to it. Watch for a post on the event!