Ethical dilemma

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Yaniv
Posts: 4
Joined: Tue May 19, 2015 12:45 am

Ethical dilemma

Post by Yaniv »

I have a bit of an ethical dilemma. My girlfriend is a young professional (26), who is the prime of her life. She suffers from Type 1 diabetes and injects insulin into her stomach on a daily basis. Her step father who is in his mid 40’s has lung cancer, and due to the severity of his condition his kidneys are failing. He is currently on dialysis and the doctors say that a kidney transplant is crucial to his survival. To perplex matters further, the kidney needs to be AB- which I’m told is a rare type. Despite many family members offering to donate their kidney, no one besides my girlfriend is a compatible match.

Please advise on the long term effects she could encounter if she donates her kidney, as well the effect on a pregnancy, and your general view on the matter as I am extremely concerned that the repercussions will be detrimental despite her good intentions.

Your perspective is sincerely appreciated.
AmberH
Posts: 33
Joined: Wed Feb 26, 2014 9:05 am

Re: Ethical dilemma

Post by AmberH »

Hi Yaniv,

Sounds like an awful situation and a hugely difficult decision. Whilst i can't comment on the long term effects of your girlfriends health if she chooses she wants to donate a kidney, i can only say that my husband has type 1 diabetes from the age of 8 and this caused his renal failure at the age of 30/31, 3 - 4 years ago. He is extremely fortunate that he has recently had a sucessful transplant now and whilst i would never say that type 1 diabetes will defintely cause renal failure in the future, it might be something that is worth bearing in mind when she makes her decision.

I'm sure others on here will have a different opinion to me though!

Wish you all the best of luck whatever happens.
Dixie1
Posts: 283
Joined: Mon Apr 15, 2013 4:19 pm

Re: Ethical dilemma

Post by Dixie1 »

Hi Yaniv

I am not in any way medically trained and am only offering an opinion based on information I have gathered whilst my husband and I go through the work up with a view to him being hopefully able to donate a kidney to me.

Firstly, from what I understand, there are VERY strict rules with regard to who is able to donate, in terms of the donor's health, and the doctors/surgeons will not entertain any kind of risk whatsoever to them. In my opinion (I again stress that I am not talking from fact), I think it would be highly unlikely that any surgeon would agree to your girlfriend donating with type 1 diabetes, as people with diabetes are already at an increased risk of developing kidney issues themselves over time.

With regard to your girlfriend's step father's blood group, AB negative. I am also AB negative. Firstly, the 'negative' bit is irrelevant when it comes to kidney transplantation. Secondly, although you are right about AB being rare, it is also a 'universal recipient'. This means that someone with AB blood can receive a kidney from any other blood group eg A, B, AB or O, so your girlfriend's step father should be able to receive a kidney from any blood group. That doesn't mean however that any other blood group donor will match with regard to tissue types etc etc, which is a whole other different subject!

I hope what I have said is of some help to you and wish you all the best of luck.
SKM23435
Posts: 289
Joined: Wed Oct 16, 2013 2:39 pm

Re: Ethical dilemma

Post by SKM23435 »

I agree with everything Dixie has said.
Started APD July 2014
On transplant and paired exchange lists.
Transplant 9/5/15
Yaniv
Posts: 4
Joined: Tue May 19, 2015 12:45 am

Re: Ethical dilemma

Post by Yaniv »

Thank you for sharing your views and shedding some light on the situation. It’s been tremendously helpful and is sincerely appreciated. With regards to the blood type you are definitely correct. I did misunderstand things, and to clarify it is her tissue type which would make her kidney compatible. Kind regards, Yaniv
Thumps
Posts: 1302
Joined: Thu Sep 14, 2006 3:50 pm
Location: London, England

Re: Ethical dilemma

Post by Thumps »

They won't let her donate if it'd be a risk to her health. It's pretty much as simple as that.
PKD/PLD diagnosed 1994, CKD stage 5 Oct 2007, Living Donor Kidney Transplant Dec 2008, still going strong!
Henriettab
Posts: 48
Joined: Sun Jan 11, 2015 7:15 pm

Re: Ethical dilemma

Post by Henriettab »

Is her uncle hoping she will offer? Personally I certainly wouldn't want a younger generation donating any organ to an oldie like me . I realise that mid forties is not "old" but the principal remains. Your girlfriend is the next generation down and has her own health concerns. I know many will not share my views and some people are beyond generous with their actions.
Yaniv
Posts: 4
Joined: Tue May 19, 2015 12:45 am

Re: Ethical dilemma

Post by Yaniv »

Hi Henriettab. Thanks for your point of view. I am really not sure of her step dads intent. But I can tell you that she has an altruistic demeanour, and will go above and beyond to help someone in need. It is a great quality to possess but due to her illness, donating a kidney will be detrimental in the long run. On a personal note, due to the sensitivity of this invidious scenario I can’t really express to her how preposterous I think it all is. Hopefully she will see the long term repercussions and come to terms with the inevitable.
jbell
Posts: 389
Joined: Sat Apr 14, 2012 7:47 pm

Re: Ethical dilemma

Post by jbell »

Hi has your girlfriend actually spoken to a dr about donating or is she still thinking about it ? As a diabetic myself I am quite sure she won't be able to donate a kidney. Diabetics cannot carry a donor card as their organs unfortunately are not suitable to transplant. There are very strict guidelines about donation as there should be and someone with a disease like diabetes which in itself can cause kidney failure cannot donate. It was incredibly kind of your girlfriend to want to do this though...jbell
Age 48
CKD diagnosed 2010
Diabetic chronic complications since age 12
Registered Blind 2000
Need kidney/pancreas tx
Egfr 12
Yaniv
Posts: 4
Joined: Tue May 19, 2015 12:45 am

Re: Ethical dilemma

Post by Yaniv »

Hi Jbell. She has only spoken to the treating doctor about it, and he has expressed that although she is a diabetic she falls within the safety margin. I must also point out that I am from South Africa, and as far as I know, nothing precludes a diabetic patient from donating. To vex matters further, her family are solely guided by this doctor’s mindset, which in turn compels her to “do the right thing”. I personally believe that this doctor has more of a financial agenda, so am currently awaiting a consultation with a specialist to confirm/eliminate my theory.
wagolynn
Posts: 1362
Joined: Thu May 23, 2013 2:49 pm

Re: Ethical dilemma

Post by wagolynn »

Hi Yaniv,

I see your point about the money side.

I think, I would get your girlfriend to look at information from other countries on the internet, Perhaps another, sympathetic, member of her family as well. What they should be looking at is the risks involved in a diabetic donating. This website is a start but there are others.

http://www.hopkinsmedicine.org/transpla ... _know.html

She will be under great pressure from the family as they will see her as the lifeline for the patient, so she needs help. I assume that medicine and treatment have to be paid for over there, apart from cost, dialysis enables people to live a good life.

Best wishes to you both.
sporti
Posts: 355
Joined: Fri Aug 25, 2006 7:51 pm

Re: Ethical dilemma

Post by sporti »

Hi

I honestly don't think anyone would accept her as a donor. Certainly not in UK or USA. X
MatthewC
Posts: 75
Joined: Sat May 05, 2012 3:37 pm
Location: Oxfordshire

Re: Ethical dilemma

Post by MatthewC »

Yaniv wrote:Hi Jbell. She has only spoken to the treating doctor about it, and he has expressed that although she is a diabetic she falls within the safety margin. I must also point out that I am from South Africa, and as far as I know, nothing precludes a diabetic patient from donating. To vex matters further, her family are solely guided by this doctor’s mindset, which in turn compels her to “do the right thing”. I personally believe that this doctor has more of a financial agenda, so am currently awaiting a consultation with a specialist to confirm/eliminate my theory.
This is so wrong. Whatever the treating doctor thinks, it's not his call and a person volunteering to donate should have nothing to do with him. And a financial interest? Your girl friend needs to make sure that when she gets tested, the treating doctor plays no part - she doesn't even want to let anyone know she is being tested until after the event. Personally I would really doubt that she should be a donor.

Here in the UK a donor is assessed by a completely different set of people to those treating the patient. I (a recent donor) had my own nephrologist whose interests were solely about me, not the patient, and if he had been at all concerned for my health then he would have not let the operation go ahead. Period. And as far as family pressures go, it was always understood that even if I had got cold feet and pulled out, they would simply have said "no go" without giving a reason; in other words, they would have protected me from the pressure that the patient's family could have exerted as no one would have known that it wasn't a medical reason. In fact, the system is clearly designed so that there can be no suggestion whatever that anyone has tried to pressurise the donor - I felt that every time I chased the hospital I was reinforcing my volunteer status, as they didn't even want to call me as that could be seen as pressure.

I start to see how the system in the UK is to be admired!

Matthew
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