[UPDATE--KIDNEY FOUND](step) Dad's in stage 5 renal failure. Am I nuts to consider giving a kidney?

In My Humble Opinion
1

He’s my step-dad, since 1979. He’s 67 years old and hadn’t taken care of himself very well (non-insulin diabetic, three cardiac stents, angina, high blood pressure, needs knee replacement, on at least 5 medications). His kidneys are officially shot, and my parents are heading up to Mayo in Minnesota on the 7th to get started on all the stuff he needs to do to start dialysis and to get healthy for a transplant.

He has a bunch of brothers and sisters who may or may not be good surgical candidates, all in their late 50’s to 70’s. He hasn’t gotten any positive responses from any of them regarding whether they would be willing to even get tested for compatibility. Mom’s type O, but she’s two years older than him though she’s quite healthy. He’s not a great communicator, either, so the cousins who are my age and younger don’t know yet. I’m wondering if any of them would be the next best candidate after his siblings, and whether his siblings actually have been told he really needs a kidney and it’s not just a concept being toyed with right now.

Anyway, even though we’re not blood related, we have the same blood type (A+), so it just seems like something I should do, at least go through the testing to see if I could be a donor. I’m fat but healthy, (had my gallbladder out in December, surgery went fine) will be 44 this year, and am not sure what the real downside would be (after surgery and recovery), from what I understand one kidney works just fine, and if I have an issue with failure later in life, it would have been inevitable and would entail both kidneys going to shit anyway, so having one or both wouldn’t really matter if failure for me was in my future anyway. Is that correct?

Of course, donating is unconditional, but it will be difficult for me not to mention, at some point, that I’ll be pissed as hell if he doesn’t take care of the dang thing if I give it to him. I’m pretty sure he will be required to lose some weight and will take some time to get there and have to do dialysis in the meantime. He doesn’t always “get” medical stuff (like, I’m not sure he really understands that the majority of his issues could be helped and possibly reversed if he wasn’t so fat), and I fear he seems to think he can just get a transplant in the next couple months or something, when in fact he’s going to have a road to travel ahead, however it takes to drop the amount of weight his doctors specify. I don’t think we have a number of pounds yet, that may come next week while they’re at Mayo for at least 4 days. I really don’t think they’re going to want to do a transplant with him in his current condition, but if he has a donor lined up, maybe the thinking on that has changed? He hasn’t been a healthy guy for a while, and just seems like a poor surgical candidate at the moment.

I’m blurting thoughts, so if anyone has any experience with this stuff and if I’m not making sense, could you throw some coherency my way?

2

That a 67 year old obese man in very questionable health is even considered for a kidney transplant surprises me.

Re any donation you are considering remember the threads we have had on loaning friends money? It’s going to be like that. Once you give up your kidney you have zero say
so in what he does with it and the chances he’s going to be all about clean living post transplant are effective zero.

3

It’s a question of loving and caring. If you love him enough to do it…and, yeah, if it makes some moderate degree of real rational sense…then it isn’t nuts: it’s wonderful.

(If it only extended his life by six months…and shortened yours by three years…maybe not.)

It’s a decision only you can make. It’s wonderful of you to consider it!

4

It doesn’t hurt to be tested for sure. FYI, there are quite a few things that can make a transplant from you to him impossible that you might not think of. It’s not just blood types or HLA markers they check. Kidneys can be attached in different ways (as in, to the person they belong to) with the veins and arteries attaching to the kidney at different places - if you and your step dad don’t have kidneys that attach in the same way it’s a no go.

The other thing to consider is injury to your kidneys (as opposed to disease). If you play sports or ride a bike or whatever, you could have an injury to one side of your body that would take out one kidney, but the other would be fine. If you donate, that’s obviously no longer true.

Regarding your stepdad’s brothers and sisters and nieces and nephews - I’m not sure your aunts and uncles would be allowed to donate if they’re in their 60s (although I’m not positive about the cut off age).

Good luck. I hope your dad is able to rally.

5

Your heart is in the right place but I think your emotions are clouding rational judgement. 67 is too old. At that age, you should just play the cards you were dealt in life. (Or at least, not be putting others life at risk.)

6

Beyond this that he is OK with letting his relatives and others offer up their organs to him in his condition, and at his age is kind of astounding. If I was in his condition and his age there’s no way I would be letting my relatives and loved ones remotely consider doing something like this.

7

Your heart is in the right place, but he is not a good candidate for a donation, and it would decrease your life expectancy. If he is a good father he would refuse this gift. From any living donor, but especially from one with his whole life in front of him.

8

Believe me, this is all stuff that’s going through my head, too. Keep it coming, for and against.

What’s confusing to me is that Mayo has not been telling him anything about the possibility that he can’t receive a transplant. They’ve just been planning his appointment for next week’s testing like everything will be going forward. Maybe that’s SOP until all the testing is done and it’s really ruled out. Seems unfairly hopeful to me.

I’m not exactly chomping at the bit to do this, but feel it’s the right thing to do, at least do the testing, which doesn’t seem to be a total picnic in itself. Even if I do the surgery, I won’t be able to take the time off work until after July, unless I’m able to take FMLA for it. If I can, then there are financial concerns, and I may need some ransom.

I think he’s been under the impression he can somehow avoid dialysis all together. He’s actually said he’s dead set against it for the last couple of years, but now that he’s in stage 5 he’s rethinking that stance. Even if he gets a donor lined up, me or someone else or a cadaver, he’s going to have to do dialysis for a few months at least.

9

His age isn’t a contra-indication. But he may be iffy on many other criteria.

From: UpToDate.com

10

I have stage 4 Renal Failure. For now, I am careful (but not as careful as I should be) with diet.

When I first broke the (then stage 3) news to my kid sister (we are both in our 60’s), she offered to donate on the spot.
I refused - it is nasty surgery, and dialysis will probably be enough to get me to the point that something else will kill me.

The Nephrologist’s office is covered with posters laying out the stages and corresponding treatments. All have, as bottom bullet for stage 4, “Prepare for KRT”, where KRT = “Kidney Replacement Therapy”.
As Wiki explains, despite the name, it does not necessarily mean “transplant” - it means finding a way to replace the functionality of the kidney.

See: Renal Replacement Therapy

Until he is told specifically that he is on the transplant list, stand down.

To recap:
I would not allow you to donate
He may not be found eligible for transplant - for either straight physical reasons or a combination of factors - including a long history of not being willing to care for himself.

IMO: I would not donate to a person with that kind of track record. Does he still drink cola? That stuff has phosphoric acid for “tanginess”. Phosphorus is a huge no-no. Simply switching to lemon-lime replaces it with citric acid. I’ve found a root beer which uses citric acid and actually tastes good - I’m back in business!

11

Even if you decide not to donate to him, there are thousands on the list waiting. Me, included.

From this side of the screen, it’s extremely difficult to ask someone to give up a part of their body. I am going to be starting dialysis within the next month, and still have not really asked friends or family (the only genetic relative I have, TheKid, probably has the same disease).

The testing he will have is very thorough, and he will not be informed whether he is a good candidate until it’s all done. I was added to The List unofficially until I had some other issues resolved. They may put him on it, but it’s not first come, first served. They do look at who will benefit the most - if he and I were equally matched for a kidney, I would probably receive it due to my age and overall health.

You do what is right for you.

12

I’ve been there a couple of times. I had a treatable condition and I’m in pretty good shape for now, but I’ve lost half my kidney function, so I’ll probably be back there again some day. This is just my opinion, I’m not going to pass judgement on someone else, but as I approach the age of 60 I have no intention of taking someone’s kidney. Donating a kidney to someone young who hasn’t had the opportunity to live life without dialysis makes sense to me, but even though you have two you don’t know when you might need that other one, so it’s never a risk free decision. I wish your step-dad the best of luck, and just considering this speaks well of your character.

13

He appears to be in really poor health, even considering his age. In particular, diabetes and cardiac disease are considered severe complicating factors. Also remember that he’d have to be on immunosuppressant medications for the rest of his life to deal with rejection of the new kidney. Patient compliance is critical for this to succeed - and even then rejections do happen.

If transplant is still considered viable, maybe cadaver donation would be an option? That would at least carry less moral baggage for him, in the event the transplant fails for whatever reason.

Many people are scared by dialysis but get used to it. It is possible to live a reasonably healthy life on dialysis.

14

Trying to get up the energy to call him. I know it will be a draining call, but needs to be done soon. I really kinda want to see him on dialysis for a while, and lose a bunch of weight, before I really commit, if I don’t rethink and change my mind anyway. I might go through the testing and still change my mind, I don’t want him to think this is some easy thing. I would want to lose some weight of my own before I undergo elective organ loss surgery, and I’m extremely hard to intubate (like, I have to be awake for it, and wear a medic alert bracelet because of it), so that in itself makes me nervous.

At any rate, as far as I’m concerned, this is months away at the very least. He needs to know that. And I think I’ll also make sure he’s looking for a cadaver donation first. It’s funny, I was just looking at old threads I’ve started, and I found one from 2011 on being ticked at him about all this.

Thanks, guys, for giving me some insight.

15

He’ll still have to fully qualify for surgery even if he has a donor ready. My donation is being held up right now because the recipient has to get some minor dental work done before his team will let him have the surgery. They can be pretty picky.

16

Stop the agonizing. Talk to his doctor and get yourself tested to see if you would be a suitable donor.

If you are, you may resume agonizing.

17

OK, he’s 67, hasn’t taken care of himself, has diabetes and cardiac problems, doesn’t always “get” medical stuff… and you think you might get pissed if he doesn’t take care of a kidney you might donate him in the future.

This doesn’t look good to me.

Post-transplant he HAS TO comply with his medical regimine without fail or he’s going to lose the new kidney. Heck I know someone who is totally compliant, does take care of himself, doesn’t have diabetes or a cardiac problem, and is 20 years younger than him who STILL lost his first transplant and is now on kidney #3 (which apparently is still humming along fine after about 12-15 years, so yay). By the way - that guy once mentioned to me that while getting a (working) transplant is better than dialysis you will forever be a patient afterward with a crapload of medications and follow up appointments forever post-transplant. You don’t go back to normal, you exchange one stack of medical problems for another stack of medical problems which, you hope, have fewer nasty side effects and more benefits.

Even if he qualifies for a transplant, even if you are a match, I’m not terribly hopeful he’d suddenly reform for anything but the short term, and you’ll have to deal with the emotional crap you’ll have from having given a kidney that you perceive isn’t being properly cared for.

I’d say don’t donate, but that’s strictly my opinion. I’m sure others will differ. If you come to a different decision I’m cool with that, too, but hey, my opinion is that this isn’t a good thing for YOU.

18

It’s up to you. However, I wouldn’t donate to someone who was repeatedly warned that he was endangering his health, and still refused to make lifestyle changes. It’s one thing to treat your own body like crap; it’s quite another to treat someone else’s body like crap.

19

I had a talk with Dad last night. I didn’t tell him no, but it’s not a yes yet, either. I told him I need more information, it’s certainly not going to happen for several months, and we don’t even know for sure he’s a candidate.

So, one step at a time, let’s get through his testing next week first, then talk about it again.

Something else he said, about being really set against dialysis, is making me pull back a bit. He really seems to think he can avoid dialysis if he can get a donor right away, and doesn’t even seem to see it as a short-term solution for a year or even a few months. I will not be strong-armed into this, it feels like blackmail. I don’t think he meant it that way, he’s no wordsmith, but if he’s not going to even consider dialysis short-term, I won’t be strong-armed into it before I’m ready, either. I already don’t feel guilty however things work out, but I am kinda hoping next week will rule out donation and therefore further conversation down this road, he’s not going to like what I have to say. (There was a lot more to the conversation including a couple other things I would have liked to argue about that would have made him feel even worse, so I left them alone, plus I’m trying not to get too bloggy.)

:frowning:

20

This says it all - people don’t feel “strong-armed” and “blackmailed” for no reason. You already know the answer.