Kidney Transplantation Quotes

I encourage readers recovering from a kidney transplant to heed the advice of their medical practitioners.

I have heard that sometimes when a person has an operation to transplant someone else's heart or liver or kidney into his body, his tastes in foods change, or his favorite colors, as if the organ has brought with it some memory of its life before, as if it holds within it a whole past that must find a place within its new host. This is the way I carry Lexy inside me. Since the moment she took up residency within me, she has lent her own color to the way I see and hear and taste, so that by now I can barely distinguish between the world as it seemed before and the way it seems now. I cannot say what air tasted like before I knew her or how the city smelled as I walked its streets at night. I have only one tongue in my head and one pair of eyes, and I stopped being able to trust them a long time ago.

the dumbest kidney is smarter than the smartest doctor.

the U.S., 5,000 people die waiting for a transplant that never comes.               Supply and demand.               People need donor kidneys to survive, but only a third of all kidney transplants come from living donors and 96% of those are family members.               The demand is there, but the supply is limited, not because kidneys are not available,

If you eat a destroying angel, for the rest of the day you’ll feel fine. Later that night, or the next morning, you’ll start exhibiting cholera-like symptoms—vomiting, abdominal pain, and severe diarrhea. Then you start to feel better. At the point where you start to feel better, the damage is probably irreversible. Amanita mushrooms contain amatoxin, which binds to an enzyme that is used to read information from DNA. It hobbles the enzyme, effectively interrupting the process by which cells follow DNA’s instructions. Amatoxin causes irreversible damage to whatever cells it collects in. Since most of your body is made of cells,4 this is bad. Death is generally caused by liver or kidney failure, since those are the first sensitive organs in which the toxin accumulates. Sometimes intensive care and a liver transplant can be enough to save a patient, but a sizable percentage of those who eat Amanita mushrooms die.

let’s say he’s been killing women and trying to perform an organ transplant, why eat her kidney at all? Wouldn’t that be a waste of a harvested organ?

a kidney transplant, organ traders will continue to have a thriving business. For the average American, all of these statistics mean very little and few of us are caught

effects were horrific – Evans needed a kidney transplant and all members of the party suffered lasting damage – yet nothing in the taste alerted anyone to the perils

Is it me, or did we just stop in the median and the driver got out?" Larry asks. "He has to go peewee," Jade informs us. "Good to know I'm not demented," Larry remarks. "Merely imperiled.

Davey Boy's Dead was given a new lease on life when doctors transplanted the Dynamite Kidney into his body. That new lease on life came to a sudden and rather hilarious end when the Dynamite Kidney exploded and tore a hole in Davey Boy's side. - The Hills are Alive with the Sound of Zombies

The sick suffer alone, they undergo procedures and surgeries alone, and in the end, they die alone. Transplant is different. Transplant is all about having someone else join you in your illness. It may be in the form of an organ from a recently deceased donor, a selfless gift given by someone has never met you, or a kidney or liver from a relative, friend or acquaintance. In every case, someone is saying, in effect, “Let me join you in the recovery, your suffering, your fear of the unknown, your desire to become healthy, to get your life back. Let me bear some of your risk with you.

A heart kept on ice can be transplanted up to four hours after death. A liver, ten. A particularly good kidney will last twenty-four hours, and sometimes as long as seventy-two if doctors use the right equipment after surgery. This is known as the “cold ischemic time.” Consider it the five-second rule, but for organs.

Nothing mattered, except whether the transplant took. God, he wanted it to work. He wanted to heal Skye, make her well again, if not with his kidney, then from the very force of his longing. Tears slipped out from beneath his eyelids and ran down his cheeks. Even if he never saw her again he couldn’t bear the thought of her dying.

In March 2002, the National Academy of Sciences, a private, nonprofit society of scholars, released a high-profile report documenting the unequivocal existence of racial bias in medical care, which many thought would mark a real turning point. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care was so brutal and damning that it would seem impossible to turn away. The report, authored by a committee of mostly white medical educators, nurses, behavioral scientists, economists, health lawyers, sociologists, and policy experts, took an exhaustive plunge into more than 480 previous studies. Because of the knee-jerk tendency to assume that health disparities were the end result of differences in class, not race, they were careful to compare subjects with similar income and insurance coverage. The report found rampant, widespread racial bias, including that people of color were less likely to be given appropriate heart medications or to undergo bypass surgery or receive kidney dialysis or transplants. Several studies revealed significant racial differences in who receives appropriate cancer diagnostic tests and treatments, and people of color were also less likely to receive the most sophisticated treatments for HIV/AIDS. These inequities, the report concluded, contribute to higher death rates overall for Black people and other people of color and lower survival rates compared with whites suffering from comparable illnesses of similar severity.

The impact of second-class treatment on black people’s bodies is devastating. It is manifested not only in the black–white death gap but also in the drastic measures required when chronic disease is left unmanaged. Black patients are less likely than whites to be referred to kidney and liver transplant wait lists and are more likely to die while waiting for a transplant.68 If they are lucky enough to get a donated kidney or liver, blacks are sicker than whites at the time of transplantation and less likely to survive afterward. “Take a look at all the black amputees,” said a caller to a radio show I was speaking on, identifying the remarkable numbers of people with amputated legs you see in poor black communities as a sign of health inequities. According to a 2008 nationwide study of Medicare claims, whites in Louisiana and Mississippi have a higher rate of leg amputation than in other states, but the rate for blacks is five times higher than for whites.69 An earlier study of Medicare services found that physicians were less likely to treat their black patients with aggressive, curative therapies such as hospitalization for heart disease, coronary artery bypass surgery, coronary angioplasty, and hip-fracture repair.70 But there were two surgeries that blacks were far more likely to undergo than whites: amputation of a lower limb and removal of the testicles to treat prostate cancer. Blacks are less likely to get desirable medical interventions and more likely to get undesirable interventions that good medical care would avoid.

Another possible solution would be to think about kidney exchange in a global way. There is virtually no kidney transplantation, and little or no access to dialysis, in places such as Nigeria, Bangladesh, and Vietnam, where kidney failure is a death sentence. Presumably, many kidney patients there have willing donors, but in a country such as Nigeria, for example, where fewer than 150 transplants occurred from 2000 to 2010, that willingness doesn’t do patients any good. But suppose we were to offer them access to American hospitals, at no cost? That may sound expensive, but it wouldn’t have to be—indeed, it could be self-financing. Remember that removing an American patient from dialysis saves Medicare a quarter of a million dollars. That’s more than enough to finance two kidney transplants, as well as postsurgical care and medicines. That money could pay for an exchange between an American patient-donor pair and, say, a Nigerian pair.

National data said it wasn’t just our imagination or where we sat. I soon learned that though Blacks and Whites each made up a third of the kidney transplant waiting list at that time, Whites received every other donated kidney and Blacks received every fifth one, which meant that on average, Blacks waited nearly two years longer than Whites for a kidney transplant. As a primary care doctor at the time, not aware of the realities of nephrology, I didn’t know that two years could mean never having to be on dialysis at all. That two years could be the difference between surviving in body and spirit. Or not.

Robert had been under the care of a nephrologist for years prior to reaching end-stage kidney disease but didn’t hear about kidney transplant as an option until months after starting dialysis. Now in all fairness, few nephrologists would begin a conversation about kidney replacement options before the patient’s kidney function—their estimated glomerular filtration rate or eGFR, how fast the kidneys filter the blood—had fallen to 25 milliliters per minute, and the patient cannot be placed on the kidney transplant waiting list until kidney function reaches 20. The medical world tends to simplify the explanation of eGFR to patients as “percent function,” though 100 percent function of normal kidneys in a young person can be closer to 125 milliliters per minute, so a more accurate and easier-to-understand explanation would be that we start out with about half a cup, or 25 teaspoons, of blood flowing through our kidneys’ filters every minute. Using this analogy, nephrologists usually start talking about kidney replacement options when it has dropped to 5 teaspoons a minute, and a patient can be placed on the waiting list once his kidney function has dropped to 4 teaspoons a minute.

In December 2014, the Kidney Allocation System implemented a new rule that turned the key in the steerage lock: the waiting list date would be backdated to when the patient started dialysis rather than at the time of transplant evaluation. This was an important step toward minimizing the effect of human error on access to kidney transplantation.

But it didn’t go far enough. It didn’t go far enough because most people start dialysis when their eGFR is somewhere between 5 and 10. The difference between an eGFR of 20 and 10 alone can be several years for many patients. Years that could be spent accruing time on the kidney transplant waiting list. Sometimes so many years that a patient could potentially get a preemptive transplant—a transplant without ever having to go on dialysis.

In 1999, a bunch of researchers published a study of about 1,600 adults examined in order to come up with equations to estimate kidney function. Just plug in the patient’s creatinine, age (because adults tend to lose muscle mass as we get older), and gender (because men tend to have more muscle mass than women), and voila!—an estimate of kidney function. Most laboratories can do this for us now. A rising creatinine level in the blood means the kidneys are not able to pee creatinine out as well as they used to, so the person’s estimated kidney function is lower. But wait—if the patient is Black, the study determined that you have to multiply by 1.2 to get a more accurate estimate. This finding was attributed to Blacks in the study having higher muscle mass than Whites and, therefore, higher amounts of creatinine in their bodies. Laboratories report the eGFR, and just below it, the eGFR if Black. Of course one of the problems with generalizations is that they aren’t always true. In medicine, in particular, they make us lazy and we often accept them without question—especially when they are in line with our underlying assumptions and beliefs. Like the belief that Black and African are inherently different from White and European at a DNA level, a belief that dates back to the days when American researchers were measuring Black-White differences in skull size to prove Black inferiority and justify slavery. But I wonder how often health-care providers make the mental adjustment that the “race adjustment” is really a proxy for muscle mass rather than just focusing on the race of the person in front of them when they are assessing lab results. I wonder if the person in front of them were a White male bodybuilder how many would tell him the race-adjusted estimate of kidney function, or a skinny Black woman the non-race-adjusted estimate. Then too I wonder how many health-care practitioners realize that equations derived from the original study of 1,600 people only included about 200 Blacks—and no American Samoans, no Hispanics, no Asians. These groups have very different body frames, but all are simply “not Black” in our equations. The implication, then, is that only Black people are different. This shortcut has the potential for a significant negative impact on Black patients who happen to not have a high muscle mass. Patients like Book of Eli. When the non-race-adjusted eGFR is 20 (when a person can be placed on the waiting list), the race-adjusted value is closer to 25. Just as the difference between eGFRs of 20 and 10 can be several years for many patients, so can the difference between 25 and 20. Years of accruing time on the kidney transplant waiting list when thirteen people on the waiting list die every day waiting for a kidney.

It wasn’t until cyclosporine was discovered in 1976 that the balance between preventing rejection and avoiding infection greatly improved. That plus simultaneous efforts to figure out how to better match donors to recipients and the discovery of newer, better drugs over time has created the current reality in which more than two-thirds of all kidney transplants are still working after five years, while little more than a third of dialysis patients are still alive in that same time span. Some kidney transplants last twenty, thirty, forty, even fifty years.

The hope is that our efforts will make eventually as far away as possible. Because once eventually comes, all that is left to do is to try to replace the kidneys with a transplant or dialysis, because we can’t live without Her.

I learned to see transplant for what it is—a treatment for kidney failure.

The toxic effects of acetaminophen are accelerated by alcohol use. Chronic acetaminophen use and chronic alcohol abuse have been separately linked to kidney and liver disease, according to Dr. Martin Zand, medical director of the kidney and pancreas transplant programs at the University of Rochester Medical Center in New York. If you want to give your liver a break, avoid acetaminophen.

She’d gone into kidney failure when I was in high school. Never got to the transplant list, though, because her best friend, Dorothy, stepped in and gave her one of hers. Mom was lucky. She never even had to do dialysis.

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Organ donation is the stuff of which dreams are made,” he began. “Literally. In a given year, there may be 4,000 people waiting for 2,000 donated hearts, and 4,000 people waiting for 1,000 donated lungs. Livers? Probably 18,000 people will wait, 6,000 will get, and another 2,000 will die waiting. And the numbers are even higher when we talk about kidneys—60,000 people waiting, 15,000 getting, 4,000 dying while they wait. By the way, the survival rate for these transplants is impressive, often up in the 85 percent range.

In 1980, Stanford University internist and epidemiologist James Fries recognized that modern medicine was not extending the human lifespan, and yet survival curves were changing. More people were living vitally until eighty-five or ninety, and then dying quickly, like the wonderful one-hoss shay in Oliver Wendell Holmes’s poem, which ran perfectly for a hundred years and then fell apart all at once.2 Fries called this phenomenon “compression of morbidity.”3 In 1900, because most deaths were premature, the human survival “curve” was a diagonal line; now it is more of a rectangle—especially if you have no risk factors (Figure 7.1). In 2040 there will be ten times as many eighty-five-year-olds as there were in 1990. This is not because the normal human lifespan is any longer than it was, but because fewer people will die before eighty. After eighty the lifespan will reflect little increase. Medical advances like antibiotics, new cancer treatments, and kidney transplants all serve to decrease premature death. But they do not alter the fact that the bodies of most of us, like the one-hoss shay, have not evolved to live past one hundred.

Also the hotel has free parking for guests, which, in San Francisco, is the equivalent of a hotel giving out free kidney transplants.

He’s doing it for Joy,” he said, talking to the screen. “Did he tell you that? His mother had a kidney transplant when he was a kid. Always dreamed of paying it forward. At least that’s what he said when Zander asked him if he wanted to run the labs. Glad it worked out.

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It’s a car, darling, not a fucking kidney transplant. It’s just money, go.

The first transplant recipients did not die because their new kidneys failed, but rather because their bodies would not be fooled. Though the new kidney cells looked and acted in every respect like the old ones, they did not belong. Transplant surgeons must now give the recipient immunosuppressant drugs for the rest of the patient’s life

This is why I love the field of transplant. Since I began taking care of sick people, I have noticed that one of the hardest things about getting sick, really sick, is that you are separated from the people you love. Even when families are dedicated to the patient, illness separates the well from the sick. The sick suffer alone, they undergo procedures and surgeries alone, and in the end, they die alone. Transplant is different. Transplant is all about having someone else join you in your illness. It may be in the form of an organ from a recently deceased donor, a selfless gift given by someone who has never met you, or a kidney or liver from a relative, friend, or acquaintance. In every case, someone is saying, in effect, “Let me join you in your recovery, your suffering, your fear of the unknown, your desire to become healthy, to get your life back. Let me bear some of your risk with you.

Again, everything needs to be perfect. It doesn’t matter how tired or distracted you are, how many things might be going on with other patients or with your boss or your lab or in your personal life. It needs to be perfect. Otherwise, the patient will pay a huge price, the donor won’t have given the gift of life, and you will be woken in the middle of the night by a shrill pager letting you know you’ve screwed up, it is your fault, and now you have to deal with it. That’s a kidney transplant. No big deal, but one of the best things we do in health care.

From World War II onward, the picture shifted radically. Sulfa, penicillin, and then numerous other antibiotics became available for treating infections. Drugs to control blood pressure and treat hormonal imbalances were discovered. Breakthroughs in everything from heart surgery to artificial respirators to kidney transplantation became commonplace. Doctors became heroes, and the hospital transformed from a symbol of sickness and despondency to a place of hope and cure.

In Israel, living kidney donors are now offered forty days’ pay at their current wage, even if they don’t miss that many days of work, and they are promised priority on the deceased-donor waiting list, in case they should ever need a transplant themselves.)

Rather, I was fascinated with how going through the process of becoming Robert's kidney donor gave me a glimpse of the kidney transplant system that being a primary care doctor did not provide. Though at the time I was working on research projects on the effects of language barriers on health outcomes, my experience with Robert inspired me to change my research focus to what made some people more likely to get a kidney transplant than others. Donating my own kidney was my solution for Robert. I saw research as the way to help other people like him.

Best Laparoscopic and Laser Urologist, Renal Transplant Surgeon Dr Shyam Varma has extensive long term experience in diagnosing and treating Kidney Stones, Prostate Enlargement, Prostate Cancer, Kidney Cancer, Bladder Cancer and Incontinence, male infertility and Erectile Dysfunction – Impotence