Can Your Lifestyle Affect Your Decision To Become an Organ Donor?

Dr. Deepak Shankar Ray – Consultant & Chief Nephrologist (Renal Transplant Programme), Narayana RN Tagore, Mukundapur, KolkataOrgan donation—two words that can tip a conversation into animated debate or measured silence depending on how people perceive it. There is no denying that organ donation is important for the health of a population as a single donor can help up to eight other individuals. There are two types of organ donations: living organ donation and donation after death. The most important consideration for organ donation, besides intent, is the health of the donor. One of the important questions that individuals might want to ask before signing up to be a living organ donor is the impact of their personal lifestyle on their intended donation. Will being overweight make a difference? What if one smokes or drinks alcohol? Is it possible to be a living organ donor if one has hypertension or diabetes?There are no specific lifestyle requirements for a potential organ donor who wishes to register for such donation. However, a basic health check is generally advised. The overall health condition of the potential donor, the health of the organ/s being pledged for donation, and whether or not the surgery can be done safely, are some factors that are evaluated as part of the process of organ donation.Smoking and alcohol, a part of health assessmentSmoking is a pertinent issue as it causes heart and lung disease, and other complications. In addition, clinical guidelines suggest that smoking as a risk factor should be modified, as smoking may cause cardiovascular and renal disorders in kidney donations. This does not mean that everybody who ever smoked is immediately disqualified. The decision is based on each case individually, taking into account the general health status of a potential donor.In addition, alcohol consumption is taken under active consideration, especially in cases of liver donation. The state of health and functioning of the liver are critical factors for the assessment of organ donation.Is your weight important?Weight can have an effect on your eligibility as a donor, but it is never assessed in isolation. Obesity, coupled with prior medical problems, might increase complications associated with organ transplant surgery.Data from a sample study conducted by the United States’ Scientific Registry of Transplant Recipients suggest that obesity, diabetes or increased diabetes risk and liver abnormalities, were among the medical factors preventing acceptance of potential living liver donors. Nevertheless, these factors cannot be used as absolute indicators of your fitness as an organ donor.Other aspects of your overall health like blood pressure, blood sugar levels, cardiovascular condition, renal or hepatic functions are also assessed. Their presence may lower the chances of being accepted in some individuals, but the decision is made on a case-by-case basis after assessing the severity of the condition, the overall health of the donor and the potential risks of donation.What if you have a prior health condition?A pre-existing medical condition doesn’t automatically disqualify you from becoming an organ donor. Nevertheless, there are a few health conditions that can make organ donation dangerous.Conditions like hypertension, diabetes, infections, cancer, or some psychiatric disorders might prevent an individual from being considered as a potential donor. The decision about donor suitability is usually made by the transplant centre after meticulous consideration.While evaluating kidney donors, particular attention is paid to health problems that might cause kidney disease in the recipient in the future. The Kidney Disease: Improving Global Outcomes (KDIGO), a global non-profit organisation that develops evidence-based clinical practice guidelines for the care of kidney disease worldwide, suggests looking at all possible risks related to a donor’s health in general rather than at just one particular risk factor.Related donors and the importance of early evaluationIn living donation, related donors may be considered when they are medically suitable and willing to donate voluntarily. However, being a relative alone does not make someone eligible to become a donor. The potential related donor must undergo a detailed medical evaluation to ensure that donation can be performed safely.Importantly, donor evaluation should not necessarily be delayed until the patient reaches end-stage kidney disease or requires dialysis. In a patient with progressive kidney disease, the process of identifying and evaluating a potential related donor should begin at an earlier stage, for example, when the patient’s creatinine is around 3 – 4 mg/dL, depending on the individual clinical situation.Starting the evaluation early provides adequate time to identify a suitable donor, complete the necessary medical assessments and plan transplantation before the patient reaches the stage of dialysis.Fitness is not only about physical activities.Physical activities have a great impact on health in general, but being ‘fit’ alone is not sufficient in order to become a donor. All potential donors go through a thorough medical examination to determine whether or not their bodies can handle the donation procedure. The examinations could include blood and urine tests, heart and lungs tests, imaging of the organ that the donor wants to donate, infectious diseases screening, psychosocial evaluation to confirm voluntary consent, and a general medical check-up. A living donor must be fit enough to be able to return to normal active life after the donation. In the case of a deceased donor, fitness would mean the viability of the organs being donated.Safeguarding the donor is of utmost importanceAnother very critical point to consider is the fact that the donation of a living organ is not just about an individual’s capability to donate. The donor, too, needs to be safeguarded from harm. Potential donors should be made aware of the risks and benefits involved in the process and get evaluated medically and psychologically, without which the process can be terminated at any point in time. The aim of the evaluation process is to decide if a certain person is fully eligible for donation or not, rather than making the transplant alone successful.Living donation is a noble act, and one that requires more people to register too; however, it should never be made under coercion. It is advisable for potential donors to consult with a transplantation team and proceed according to their instructions, after getting thoroughly evaluated as per prescribed guidelines.It is not necessary to be ‘perfectly healthy’ in order to enquire about the process of living donation. But if you decide to sign up to be a donor, you must ensure that you are safe and healthy enough to continue your life normally even after organ donation.