Live donor best for transplant success

Hawke's Bay District Health Board donor liaison co-ordinator Merryn Jones says donating a kidney is low risk. Photo / Supplied

Merryn Jones wants to be busier with her "transplant pathway". The Hawke's Bay District Health Board donor liaison co-ordinator is keen for more kidneys to come forward.

"While dialysis is good and keeps you alive, a transplant will give you a better quality of life," she said.

Dialysis commits a patient daily to a machine that replaces kidney function.

"Giving a kidney is a pretty safe thing to do. Most people manage well with just one kidney - some are born that way."

No risks are taken with the donor's health - they have to have excellent physical and mental health.

"The workup process is very thorough so they get a top to toe check-up."

She said nationally there were 600 people with failed kidneys well enough to receive a new one, but they had to wait several years.

A live donor was "the best way to go" but a close tissue match was necessary. The odds of a relative being a suitable donor were about 10 to one.

"A new kidney from a live donor that has been well matched can give them another 20 years. In fact some people have kidneys that have lasted 40 years."

A suitable donor does not need to be a blood relative. Former All Black Jonah Lomu received a transplant from close friend and tissue-type match Grant Kereama who donated because it was "what you do for your mates".

Living with someone helped tissue compatibility, Ms Jones said.

"When you have a husband, a wife or family member would has lived in the same environment for a long time they have a shared immunity and are less likely to develop antibodies against each other."

She is very keen to increase the numbers of donors among Maori and Pasifika, who have a higher need but fewer family donors.

"There is a disparity in New Zealand with kidney donations. White middle-class people are happier to give to family members."

She said occasionally there were altruistic donors offering a kidney.

"People who come forward and say, I know my health is good and I would really like to give a kidney to someone - I don't care who it is'. We love those people."

Altruistic donors were highly valued for "kidney chains" where a patient has a willing, but incompatible donor. The patient receives the altruistic kidney and their incompatible donor "pays it forward" by giving their kidney to a stranger who also had a willing but incompatible donor.

"There might be three or four different people take end up getting a kidney because of one person coming forward.

"Optimally we need about 60 pairs of people on the kidney exchange to make it work - a large pool of people so we have enough to swap - but at the moment we only have about 20 couples who are waiting for extra people to come in and make it work."

It could take up to one year from the time a donor came forward to the operation "so it is best to come forward sooner rather than later and not wait until someone slips into dialysis."

-New lease on life, p9