Kindess From A Stranger

When we look at the world we live in, we often see a lot of harsh and sad events that lead us to look at the world we live in with a negative perspective. The thing is, often enough, just when we're ready to give up on believing that man is still capable of great kindness and compassions, it never fails to pull out a surprise.

Here's a great inspirational story that reminds us of the wonders and generosity we are all capable of. In this instance, a cab driver offers to donate his kidney to a passenger whom he knows needs it.

PHOENIX — Rita Van Loenen had no idea that a trip in Thomas Chappell's taxi cab could end up being the ride that saves her life.

"There are better odds of getting struck by lightning," Van Loenen said. "A random taxi driver offering to give me his kidney and all these pieces match. There has to be something behind this. How can this be?"

Chappell, who has been driving Van Loenen to dialysis appointments, shocked the Gilbert, Ariz. woman a month ago by offering to donate his kidney. But even more shocking to her was that doctors found they had the same blood type, that they were compatible.

"He calls me all excited. If we were a closer match, we would've been siblings. I was ready to fall off the floor," Van Loenen said.

The Phoenix taxi driver said he was a man of faith and that a higher power wanted him to step in.

"By then, me and the good Lord already had a talk. He said 'Tom, you go give her one. It will work," Chappell said.

Last year, Van Loenen, an instructor in special education methods, began feeling ill and experiencing water retention in her legs. She went to see a doctor and was diagnosed with kidney disease. With kidney failure setting in, friends and family were tested but there was no match.

In February, she received her cousin's kidney but that transplant failed. One day, Van Loenen, 63, found herself telling Chappell, 56, about how her son was now going to get tested. Chappell decided to add his name to the list.

"I said 'Rita, your son's a whole lot younger than me. He's got a lot more years. I'm gonna go down and go through the process and see if it will work.' I don't think she really believed I was going to."

The gesture evoked tears of gratitude from Loenen but she was still skeptical.

"A little bit in my heart I didn't believe it. He said 'give me the number' and I have transplant number at Mayo (Clinic in Scottsdale) memorized."

The two first met more than three months ago. It wasn't an auspicious beginning.

Chappell was half an hour late picking Van Loenen up for a dialysis appointment.

"When I got there she was not happy," Chappell said. "And I can understand it now. She's sick and all these things she goes through ... The next day, it just so happens I got her again."

Since then he has — and he insists it is by happenstance — been her taxi driver three to four times a month. For the last month, Chappell has started undergoing the arduous process of donor screening, undergoing numerous tests and exams. But none of it has brought second thoughts.

"This has put a whole new kind of lift in my boots. I never knew what it felt like to give somebody life and that's what I'm doing," Chappell said.

Van Loenen said Chappell never asked for any compensation. She still can't quite believe his level of commitment.

"I've never known anybody so enthusiastic to get a body part removed," Van Loenen said.

After the transplant, which hasn't been scheduled yet, Chappell will need to tread carefully. He will have to rest between four and six weeks but his work has promised to cover his lost wages.

"I've had drivers do some pretty incredibly amazing things for no charge. But this is just over the top," said Jim Hickey, national sales and marketing director for the company that owns VIP Taxi. "We're just so proud of him."

Van Loenen said that, thanks to Chappell, she can actually make plans for the future.

"Whenever I tell my friends or my family, they just find it so incredible," Van Loenen said. "They do call him an angel. My friend says there's angels everywhere. That's the right way to capture it."

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Night Hemodialysis Just as Effective as Kidney Transplant

In the first study of its kind, it has been shown that night time home hemodialysis, which is done for 6 to 8 hours nightly, up to 7 days a week, is as effective as receiving a transplant. The long term study focused on comparing the survival rates and how this particular type of dialysis compares with both cadaver and living donor transplantation.

For the first time, it has been shown that patients who receive night home hemodialysis live just as long as those who receive kidney transplants from deceased donors.

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a total of 1,239 patients were followed for up to 12 years. Night home hemodialysis patients were compared to patients who received either a deceased donor kidney transplant or a living donor kidney transplant. The study found that the survival between night home dialysis patients and those who received kidney transplants from deceased donors was comparable, while the survival of the patients who received a transplant from a living kidney donor was better than both the other groups.

These results are encouraging considering the shortage of organs. It provides a means for those waiting for a transplant to maintain good health and good quality of life. In certain situations, it may also be a good alternative to high risk patients that aren't approved for transplants and those who aren't able to get a kidney transplant.

The full article can be found here.
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Single Kidney Transplants from Young Donors Effective

In the August publication of The Clinical Journal of the American Society of Nephrology, researchers reported that transplanting a single kidney from a young deceased donor is sufficient in maintaining health in an adult with kidney failure.

In most transplant centers, the kidneys of very young deceased donors are transplanted together into one patient. According to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), a single kidney from a very young deceased donor maintains the health of an adult with kidney failure.

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The researchers' study included all 79 adults who were transplanted at the Tulane Abdominal Transplant Institute with single pediatric kidneys from deceased donors aged 10 years or less between January 1996 and June 2007. Physicians transplanted a single pediatric kidney if it was healthy enough for splitting and the recipient consented. Half of the adults received single pediatric kidneys from donors less than five years of age. The other half received single kidneys from donors aged five to 10 years.

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Patients in the two groups experienced similar rates of kidney rejection and delayed kidney function. In both groups, kidney function improved dramatically in the first year after transplant, and it continued to improve into the third year. Furthermore, patients in the two groups lived a similar length of time. The youngest donor in the study was a nine-month old female; both of her donated kidneys remain healthy more than six years post-transplantation into two different recipients.

The article is saying that based on their findings, using a single kidney from very young diseased donors are able to sustain good health in adults. Often, when the donor is of very young age, both kidneys are transplanted into adult recipients.

This report contradicts previous studies where it has been noticed that adults given single kidneys from very young donors produce more complications compared the those from adult donors.

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Wearable Artificial Kidney

The wearable artificial kidney that is being developed has been successful in preliminary trials. It looks promising with the ability to allow patients to strap on their 'portable dialysis' machines and receive dialysis 24 hours a day, 7 days a week.

While it is still going through tests, things look promising.

"Our vision of a technological breakthrough has materialized in the form of a Wearable Artificial Kidney, which provides continuous dialysis 24 hours a day, seven days a week,"

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The device—essentially a miniaturized dialysis machine, worn as a belt—weighs about 10 pounds and is powered by two nine-volt batteries. Because patients don't need to be hooked up to a full-size dialysis machine, they are free to walk, work, or sleep while undergoing continuous, gentle dialysis that more closely approximates normal kidney function.

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The Wearable Artificial Kidney is successful in preliminary tests, including two studies in dialysis patients. The new study provides important information on the technical details that made these promising results possible.

This will be a great innovation that will allow dialysis patients not only avoid having to sit around the dialysis machine during dialysis sessions, but also allow continuous filtering of the toxins from the body, resulting in better health and quality of life.
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FDA warning on Cellcept and Anemia

The Wall Street Journal has reported that the U.S. Food and Drug Administration (FDA) is is warning doctors that organ transplant drug Cellcept, may cause a type of severe anemia. Recently, the FDA has asked Roche, the maker of Cellcept, to make stricter warning labels regarding the risks involved in using Cellcept.

The U.S. Food and Drug Administration on Friday warned doctors about a certain type of anemia in patients being treated with the Roche (ROG.VX) kidney-transplant drug Cellcept.

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Last month, the FDA said it was requiring Roche and other manufacturers of certain drugs used to prevent the rejection of transplanted kidneys to warn of certain serious infections.

The drugs, including Cellcept, Myfortic by Novartis AG (NVS) and Wyeth's (WYE) Rapamune, already carry the agency's toughest boxed warning discussing their various risks.

The FDA said the drug labels must discuss an increased risk of "opportunistic infections," including activation of latent viral infections such as one caused by the BK virus.

The anemia the FDA is speaking of is PRCA or Pure Red Cell Aplasia. It is a severe form of anemia wherein the bone marrow ceases produce red blood cells because PRCA affects the production process of red blood cells within the bone marrow.

Like many other transplant medications, Cellcept carries a number of risks and produces a number of side effects. It is a very good drug in warding off rejection and is being used by close to 90% of transplant centers in the U.S.

As in many instances, with kidney transplants or organ transplants as a whole, the need for weighing the good against the bad and hopefully coming up with a harmonious balance is the key.

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Fruits & Vegetables Prevent Kidney Stones

A recent study has shown that eating a healthy diet consisting of high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains coupled with low intake of salt, sweetened beverages, and red and processed meats not only prevents metabolic problems like high blood pressure and diabetes but it also prevents the formation of kidney stones.

Researchers have found another reason to eat well: a healthy diet helps prevent kidney stones. Loading up on fruits, vegetables, nuts, low-fat dairy products, and whole grains, while limiting salt, red and processed meats, and sweetened beverages is an effective way to ward off kidney stones

The article also says that such a diet contained higher levels of calcium, potassium, magnesium, oxalate, and vitamin C while having a lower amount of sodium, things that are beneficial to overall health.

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Top 50 U.S. Hospitals

U.S. News recently released the list of Top 50 U.S. Hospitals for kidney disorders. Here are the the top 25, you can click on their links to see more on the hospital. You can see the the full list here.

1 Brigham and Women's Hospital, Boston

2 New York-Presbyterian University Hospital of Columbia and Cornell

3 Mayo Clinic, Rochester, Minn.

4 Massachusetts General Hospital, Boston

5 Cleveland Clinic

6 Johns Hopkins Hospital, Baltimore

7 Ronald Reagan UCLA Medical Center, Los Angeles

8 Barnes-Jewish Hospital/Washington University, St. Louis

9 Vanderbilt University Medical Center, Nashville

10 University of California, San Francisco Medical Center

11 Duke University Medical Center, Durham, N.C.

12 UPMC-University of Pittsburgh Medical Center

13 University of Alabama Hospital at Birmingham

14 Hospital of the University of Pennsylvania, Philadelphia

15 University of Colorado Hospital, Aurora

16 University of Washington Medical Center, Seattle

17 University of Chicago Medical Center

18 University of Michigan Hospitals and Health Centers, Ann Arbor

19 Yale-New Haven Hospital, New Haven, Conn.

20 Cedars-Sinai Medical Center, Los Angeles

21 Stanford Hospital and Clinics, Stanford, Calif.

22 University of Minnesota Medical Center-Fairview, Minneapolis

23 University of Texas Southwestern Medical Center, Dallas

24 Beth Israel Deaconess Medical Center, Boston

25 Emory University Hospital, Atlanta

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Omega-3: Good for Kidney Patients

Over the years, I've learned a lot from my fellow transplantees. One of the more important things they introduced me to was fish oil and omega-3 fatty acids. They would narrate how it has helped them and how their docs recommended it. Here's another article that supports their point.

There is mounting evidence that omega-3 fatty acids from fish or fish oil supplements not only help prevent cardiovascular diseases in healthy individuals, but also reduce the incidence of cardiac events and mortality in patients with existing heart disease.

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Dietary intake of fish oil can also decrease the risk of atherosclerosis, arrhythmias, heart attack, sudden cardiac death and even health failure. Dr. Lavie adds that although there is a smaller benefit in reducing heart failure death—9 percent mortality benefit in a major recent randomized controlled trial—this is still very impressive given patients' grave prognosis.

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Based on these findings, and because the body does not produce its own essential fatty acids, the authors recommend that healthy individuals should consume 500 mg daily of omega-3 fish oil containing EPA and DHA, and people with known heart disease or heart failure aim for at least 800 to 1,000 mg daily.

"There are clear health and heart benefits associated with increasing one's intake of foods that are rich in Omega-3s, including oily fish like salmon, sardines, trout, herring, and oysters"

One of the biggest problems caused by chronic kidney dysfunction is heart disease. One reason for this is that when kidney function declines, its ability to regulate our blood pressure diminishes, resulting in high blood pressure.

Another reason is, as kidney disease worsens, cholesterol and trigyceride levels increase. Upping the risk of heart disease further.

Even after transplantation, I noticed that my doctors keep a tight watch on my lipid levels. I was told that a side effect of some anti-rejection drugs is increased lipid levels.

Omega-3 fatty acids provide good protection from cardiovascular disease. Research has shown that it helps lower cholesterol levels and trigycerides. Another thing worth noting is that omega-3 reduces inflammation that is present in people with kidney disease.

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Keep Your Hands Off Our Kidneys

In another step towards deterring transplant tourism, the UK government has placed a ban on private organ transplants, essentially closing the door for foreigners to receive cadaver organ donations in the UK.

The British government said Friday that it plans to ban private organ transplants from dead donors to allay fears that prospective recipients can buy their way to the front of the line.

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organs donated within the state-run National Health Service should stay within the public health system.

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While I found no evidence of wrongdoing in the way organs are allocated to patients, there is a perception that private payments may unfairly influence access to transplant, so they must be banned

The UK is the latest nation to take an extreme stance on its organ donation policy. In a sense, the battlegrounds on how donated organs are being allocated are slowly being drawn up, with different countries taking different sides on the issue of who gets to live and who does't.

The UK has taken a “what's ours is ours” policy, disallowing foreigners to access of UK donated organs, while Singapore announced late last year that it is allowing compensation for kidney transplants, passing legislation that declared reimbursement for kidney donation was acceptable as long as it is not "an undue inducement, nor amounting to organ trading"

Then you have those in the gray area, such as in the case of the Philippines, where organ transplants is regulated by the government. In their case, not only does the government ban foreigners from receiving organs from Filipino citizens, it has also disallowed any sort of organ donation between two individuals unless they are related.

Whichever way you look at it, governments are trying to make decisions on behalf of their citizens believing that what they think is for the betterment of their constituents. But is this really so?
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When it Comes to Kidney Donors: Younger is Better

When I was on the waiting list and looking for a donor, I remember by doc at that time telling me a few things about what to look for. Things like the donor's height, size and age. These seem to be trivial, but when he explained why to me, it made real good sense.

Reading an article that mentioned how kidney transplants from older donors did not fare as well as those from younger donors reminded me of why you should find a donor who is just as old or younger than you are.

Kidneys from older donors often do not survive long after transplantation because of certain structural dysfunctions that can occur as the kidney ages

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The findings indicate that the number of functioning glomeruli - the filtering units of the kidney - drops significantly with age, leading to a self-perpetuating injury in the rest of the kidney

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To understand the aging-related changes in the kidney that account for the shortened survival of older organs, Dr. Tan and her colleagues analyzed the structures of kidneys from 20 aging (ages above 55 years) and 23 youthful (ages less than 40 years) deceased donors. They also looked specifically at the glomeruli of a subset of 13 aging and 12 youthful deceased donors that were taken prior to transplantation. The investigators found a 32% depression of the glomerular filtration rate, a measure of the kidneys' ability to filter and remove waste products, in the aging vs youthful groups. In addition, the number of functioning glomeruli was profoundly depressed in older kidneys compared with younger kidneys.

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Baking Soda: Not Just for Regular Everyday Use

Here is a very interesting story on how sodium bicarbonate, which is more commonly known as baking soda seems to have the ability to preserve kidney function. Here are some things that the sciencedaily.com article has to say.

The study included 134 patients with advanced CKD and low bicarbonate levels, also called metabolic acidosis. One group received a small daily dose of sodium bicarbonate in tablet form, in addition to their usual care. For this group, the rate of decline in kidney function was greatly reduced—about two-thirds slower than in patients. "In fact, in patients taking sodium bicarbonate, the rate of decline in kidney function was similar to the normal age-related decline

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Rapid progression of kidney disease occurred in just nine percent of patients taking sodium bicarbonate, compared to 45 percent of the other group. Patients taking sodium bicarbonate were also less likely to develop end-stage renal disease (ESRD) requiring dialysis.
Patients taking sodium bicarbonate also had improvement in several measures of nutrition. Although their sodium levels went up, this didn't lead to any problems with increased blood pressure.

I wonder how much of an effect it really has. It definitely has some merit as I have spoken to a number of transplant patients who used sodium bicarbonate when their native kidneys were failing and they did say that their kidneys did last quite a bit longer than what their doctors expected.
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