Kidney donors 'should be paid' for time out of work

Transplant group hopes move would help bring down New Zealand's growing waiting lists. REBECCA WALSH reports.

People who take time off work to donate a kidney for transplant should get Government compensation, says the New Zealand Kidney Foundation.

It hopes payment will encourage more to do so.

Waiting lists are growing because of a lack of organs and the increasing incidence of kidney failure - the result of ageing, an increase in diabetes and a more ethnically diverse population.

The foundation says more than 1300 people are on dialysis. Many would benefit from an organ transplant.

But in 2000 there were just 106 kidney transplants, 31 from live patients.

Most live transplants come from family members, but foundation director Guy Johnson says it can be exceptionally difficult for some because they cannot afford five or six weeks off work.

"Employers are under no obligation to pay anything," he said.

"We are lobbying the Government to look at some way to see if a minimum wage could be paid in the time they are off work."

Dunedin man Simon Crosby, 37, hopes to have a kidney transplant this year but says he and his brother Shane, who is the donor, are worried about how they will cope financially.

They have young families to support and mortgages to pay.

"I think it needs to be assistance-based on each individual case," Mr Crosby says.

"When you get someone who is prepared to give someone a better chance of life it's a great thing. The Government should be there to assist you. If it was an accident-related thing, ACC would pay out."

Mr Johnson says removing such barriers to kidney donation would save the country money in the long term - kidney dialysis costs between $25,000 and $30,000 a year and a kidney transplant about $40,000.

Next week marks Kidney Awareness Week, which will focus on live donors.

Mr Johnson says the foundation does not want people to feel compelled to donate but to be aware that others are doing it, with a dramatic improvement to life.

* Issues for families

Professor John Morton, a former surgeon in charge of kidney transplants at Christchurch Hospital, who now informs families about the issues and procedures involved, says people experience a range of emotions.

"For the recipient there's great anticipation," he says. "Sometimes they feel anxious about their loved one giving them a kidney and one of the rules is that the recipient has to be prepared to take the kidney. Most times recipients will accept it.

"We like to know [the donor's] nearest and dearest are not violently opposed to what they are doing and that everyone is in it together."

To be a living donor the person must be in normal health, have two normal kidneys and no history of serious disease.

They must go through a battery of tests to check for blood and tissue compatibility.

In addition, they need to be able to understand what is involved and make an informed choice.

Professor Morton says one of his main tasks is to ensure no one is under undue pressure from other family members to donate a kidney.

"There were concerns long ago when we started this sort of thing that someone might be ganging up on the fittest member of the family," he says.

"On the other hand, the spouses will say to you, 'of course I'm under pressure, I'm living with this disease'. That's a good answer. That satisfies me. You're in that situation and you want to do something about it."

But Professor Morton says there have been rare occasions where someone appears to be under pressure to donate and in that case, the donation would not be accepted.

* Weighing risks and benefits

Professor Morton says the risks of a donor dying are "absolutely remote" but there are other risks such as infection in the wound. Facing between four and six weeks off work can be difficult for some people financially.

"The worst risk these days is that the kidney will be rejected," he says. "There's about a one in 10 chance of that happening. That's a shattering blow for the donor, going through all that and it not working out."

A transplant can make a huge difference to family relationships in many ways. For example, a woman might finally be able to have children.

"From a relationship point of view it takes a huge load off the partner because they have been living with a tired, listless, anxious person who is connected to a Machine two or three times a week," Professor Morton says.

"It's really thrilling to me how many family members sincerely want to do this. I think it is the nicest thing one person can do for another and I tell people who are becoming donors they are going to feel really good about themselves.

"I think people are often justifiably proud about what they have done."