Why does Niem need a new kidney?

Niem has IgA Nephropathy, a chronic kidney disease that occurs when an antibody called immunoglobulin A (IgA) lodges in the kidneys. This results in local inflammation that, over time, has impaired his kidneys' ability to filter wastes from his blood. Niem is currently in Stage 5 of the disease, which is kidney failure.

It is unclear what causes IgA Nephropathy, and there is no known cure for it. To slow down the effects of the disease, Niem is on peritoneal dialysis.

The best treatment for kidney failure is a living donor kidney.

What does it mean to be a living kidney donor?

A living kidney donor is someone who has decided to donate an organ while they are still alive. Living donors should be in good overall physical and mental health and older than 18 years of age.

If a potential donor passes a series of blood and tissue tests, as well as a psychological evaluation, they are deemed healthy and compatible for donation, and they can donate directly to Niem. Or, they can participate in paired donation, in which a donor will donate their kidney to another recipient, in exchange for a compatible kidney for the recipient they know.

Check out this Freakonomics podcast for a great story on paired donation, and the economist's algorithm that helped make it more feasible.

Is Niem on a waiting list for a kidney?

Yes, Niem is listed at Stanford Medical Center for a deceased donor kidney. This is the other option for a kidney transplant.

However, it is the less desirable one, because transplants with a living donor kidney tend to last twice as long as those with deceased donor kidneys - the average living kidney transplant lasts 26.6 years vs. the average deceased kidney transplant, which last 14.7 years.

Also, the waiting list is about 8-10 years long, and average life expectancy on peritoneal dialysis is 5-10 years. As of February 2017, Niem has been on dialysis for just over one year.

Do I need to be a specific blood type to donate?

The best match would have the same blood type as Niem's blood type of B+. However, there are certain medical procedures that can make donations from other blood types possible. There is also the possibility of a paired donation, where a living donor that is not an exact match is entered into the system to donate to someone else who they are a good match for, and in turn, their living donor candidate might be able to donate to me.

Where would the surgery take place?

At Stanford Medical Center in Palo Alto, California.

What is the timeline for kidney donation?

Testing can and should start as soon as possible. Depending on the donor and Stanford's schedule, the testing process can take anywhere from a few weeks to several months. It is important to proceed carefully, but efficiently, with all physical and psychological tests for potential living donors to be cleared.

How does insurance cover kidney transplants?

Niem’s health insurance covers the living donor’s transplant-related medical costs, including evaluation, surgery, and follow-up care.

How would my life as a donor be different with one kidney?

After recovering from the surgery, life is overall much the same with one kidney. You should have your kidney function checked at least once a year. Any loss in kidney function is usually very mild, and life span is normal. Most people with one kidney live healthy, normal lives with few problems.