Tuesday, December 21, 1999
Living organ donations soar
Procedures safer, recovery quicker
BY TIM BONFIELD
The Cincinnati Enquirer
Years ago, Richard McGaughy gave his sister Jean Wright an organ to play at church. On Thursday, he gave her another organ — this time to save her life.
In so doing, Mr. McGaughy and Mrs. Wright may have become the oldest kidney-donor, kidney-recipient duo in America, maybe even the world, according to doctors at University Hospital.
Mr. McGaughy, of Cedar Rapids, Iowa, is 69. Mrs. Wright, of Hamilton, Ohio, is 74.
“There have been older donors and there have been older recipients, but (after searching a national data base of kidney transplants) I could not find an older combination,” said Dr. Roy First, medical director of kidney transplantion at University Hospital.
With waiting lists getting longer every year for cadaver-donated organs, living organ donations are soaring in popularity. In fact, the record-setting couple at University Hospital was one of two families leaving local hospitals Monday after sharing the ultimate Christmas present.
On Friday at Christ Hospital, Pleasant Ridge resident Dederia Montgomery, 38, donated one of her kidneys to her husband, Robert, 41.
All four were doing well Monday.
The United Network for Organ Sharing, the national agency that manages and tracks organ donations, said Monday that it had no information that would dispute University Hospital's claim.
The oldest living organ donation in UNOS records occurred in 1990 in Milan, Italy. The donor was 71, the recipient was 47.
That's far less than the combined age of 143 for Mr. McGaughy and Mrs. Wright, said Bob Spieldenner, UNOS spokesman.
“We're seeing more use in general of older donors (both living and deceased) because there's such a demand out there,” Mr. Spieldenner said.
Mrs. Wright's son, a niece and a family friend also offered to be kidney donors, but only Mr. McGaughy had the right blood type. Despite his age, the risk of total anesthesia and the chance that disease or injury might someday hurt his remaining kidney, Mr. McGaughy said there was no real choice in his mind about becoming an organ donor.
“There was never any question,” he said. “My belief is if more people understood what (medical technology) can do nowadays, a lot more people would be willing to be donors.”
Mrs. Wright needed a kidney after years of high blood pressure caused hers to fail. She had started home dialysis in September, but was still in strong overall health.
Yet she faced waiting one to three years for a cadaver kidney, while dialysis promised to gradually sap her strength.
“Dialysis isn't a permanent solution,” Mrs. Wright said. “If I had to wait three years, it wouldn't have worked.”
So, Mrs. Wright and Mr. Montgomery joined the thousands of people getting help from family and friends to skip the waiting list. Living donations have grown from about 32 percent of kidney donations in 1998 to about 43 percent in 1998, according to UNOS.
In addition to longer waiting lists pushing the decision, improving technology is making living organ donation more tolerable.
Years ago, a person willing to donate a kidney endured a 12-to-18-inch incision wrapping around one side of the body. Now, the donated kidney can be removed through laparoscopic surgery — which occurred for Mr. McGaughy and Mrs. Montgomery.
Rather than an open cut, surgeons make several small holes or “ports” to insert a tiny video camera and a variety of long, thin instruments. Recovery time is much shorter, which makes the procedure safer for an older donor, Dr. First said.
Better anti-rejection drugs also allow using organs that do not match as precisely as in years past. That allows more non-blood-related spouses and friends to become organ donors, if they are willing to take the risk.
Even though tissue matching is less precise, more people survive five years longer after a living organ donation than they do after a cadaver-donated transplant, Dr. First said.
That's partly because the recipient's health doesn't suffer as much while sitting on a waiting list, and partly because the organ from a living donor suffers less damage than cadaver organs that can sit for hours or days before being transplanted.
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