Donate kidney to prolong life: What are the hazards of donating kidney?

March 8, 20 12 is the seventh "world kidney day". This year's theme is "Donate kidney, prolong life", aiming to appeal to the whole society to support organ donation, so that more patients with renal failure have the opportunity to receive kidney transplantation and be reborn. According to statistics, there are about 6.5438+0.5 million uremic patients in China, and the number is increasing by 6.5438+0.5 million every year. However, there are only about 5,000 cases of kidney transplantation in China every year (of which more than 654.38+0,000 are relatives). That is to say, among nearly 300 patients waiting for transplantation, there is only one "lucky", and the fundamental reason for this situation is the shortage of kidney sources and no kidney to replace.

Why are there more and more uremic patients? Is there any way to find kidney disease early? What are the advantages of kidney transplantation in treating uremia? Where should I register if I want to donate my organs after death? How to ensure the public welfare of organ donation and the fairness of organ use? With these questions, the reporter interviewed Professor Zhu Tongyu, director of Shanghai Key Laboratory of Organ Transplantation and vice president of Zhongshan Hospital affiliated to Fudan University.

Popular Science: In recent years, there are often touching stories about "donating organs to save several people after death" in newspapers, but it is the first time to solemnly put forward "donating kidneys" as the slogan of world kidney day. Can you introduce the background of the slogan?

Zhu Tongyu: In recent years, the prevalence of chronic kidney disease in China has been increasing year by year (about 10 people have chronic kidney disease). At the same time, because the onset of chronic kidney disease is hidden, there are no obvious symptoms or atypical symptoms in the early stage, it is easy to be ignored, so that more than half of the patients are in uremia at the first visit, and they have to wait in line for a suitable kidney source for kidney transplantation while receiving dialysis treatment.

According to statistics, there are about 1.5 million uremic patients in China now, and the number is increasing by 1.5 million every year. It is estimated that there will be 2.5 million uremic patients in China by 20 15 years. With the continuous improvement of the medical security system, more and more uremic patients can prolong their lives by receiving hemodialysis or peritoneal dialysis. However, it is also obvious that long-term dialysis brings great pain and heavy economic burden to patients and their families. As the most successful model of all organ transplants, kidney transplantation can not only prolong the life of uremic patients, but also greatly improve their quality of life, so that they can truly return to society and enjoy a harmonious and happy family life. In China, many patients have lived a high-quality life for twenty or thirty years after kidney transplantation.

However, the current reality is that kidney transplantation has become a "luxury" for most uremic patients due to a serious shortage of organ sources. 20 1 1 year, there are 5,200 cases of kidney transplantation in China, including relatives (donors) 1.300 cases. Compared with the huge base of10.5 million uremic patients, it is equivalent to only one "lucky" in every 300 uremic patients, and there must be more uremic patients.

Facing the increasing number of uremic patients, the increasingly severe organ shortage and the widening gap between supply and demand of organs, encouraging citizens to donate organs for free after heart death has become the key to solve this problem. The so-called organ donation after heart death (DCD) means that citizens are willing to donate their organs to patients waiting for transplantation in the form of free donation after heart death. Organ donation is the main source of transplanted organs in western countries, and it will certainly become the main source of organs in China in the future.

Popular medicine: what is the current situation of organ donation in China?

Zhu Tongyu: At present, the organ donation rate in China is very low. In China, more than 654.38+million people die every year due to accidents or emergencies, but the organ donation rate is only one thousandth of that of western countries. In Spain, the number of organ donations by its citizens has fully met the needs of domestic patients, and there are almost no "organ transplant waiters". In China, it takes at least five years for uremia patients to receive kidney transplantation from registration. So, what is the reason for the slow progress of organ donation in China? Are China people more unloving than foreigners? Of course not. In fact, the Chinese nation is an extremely caring nation. It can be said that the popularity of the general public is beyond everyone's imagination. I once made a program on the radio to tell the audience the significance of organ donation. Results In the short one-hour live broadcast, * * * more than 150 listeners called and expressed their willingness to donate their organs to help others after their death, which made me very moved! I think that the low organ donation rate in China may be related to the insufficient publicity of the mainstream media, the general public's lack of understanding of organ donation, and the imperfect organ donation system in China, resulting in some caring people "unable to donate". Thankfully, with the vigorous promotion of the Ministry of Health and the leadership of the China Red Cross, the pilot work of organ donation in China has been successfully started. After nearly a year's trial, the Red Cross human organ donation and distribution network system has become increasingly perfect, and the donation channels have become increasingly smooth. More and more people become Red Cross organ donation volunteers. In less than two years, the system has benefited nearly 200 uremic patients.

Popular Science: Where should I go to go through the formalities if I want to be an organ donation volunteer?

Zhu Tongyu: In 20 10, the pilot work of human organ donation in China was officially launched in Tianjin, Liaoning, Shanghai, Jiangsu (Nanjing), Zhejiang, Fujian (Xiamen), Jiangxi, Shandong, Hubei (Wuhan), Guangdong, Hunan, etc. At present, Guangdong, Jiangsu, Zhejiang, Shandong and other places have successfully implemented organ donation after heart death. If you want to be an organ donation volunteer, you can call the local Red Cross to ask about it.

Universal medicine: Many people don't understand why organ donation must be free, while recipients have to pay.

Zhu Tongyu: China's "Regulations on Human Organ Transplantation" clearly stipulates that human organs may not be bought or sold; Organ donation follows the principle of voluntariness and free of charge; No organization or individual may donate or remove organs from citizens who have clearly expressed their disapproval of organ donation before their death. Therefore, organ donation must be free, and any behavior suspected of organ trading is illegal.

As the beneficiaries of receiving organs, the expenses they pay are not the money for "buying organs", but various expenses incurred in the process of organ acquisition, preservation and transportation. As for organ acquirers, there are also clear regulations in China: Organ acquirement team is an independent non-profit organization led by China Red Cross Society, and the treatment of its members has nothing to do with the number of organs acquired, so transplant doctors must never participate in organ acquirement.

Popular medicine: People have two kidneys. Can you donate one kidney to help others?

Zhu Tongyu: First of all, this kind of love of donating organs to help others is worthy of recognition, but legally, this kind of behavior is not allowed. The Regulations on Human Organ Transplantation in People's Republic of China (PRC) clearly stipulates that the recipients of living organs are limited to the spouses, lineal blood relatives (parents, children, brothers and sisters) or collateral blood relatives (cousins, aunts) within three generations, or there is evidence to prove that they are related to living organ donors.

Popular medicine: although the curative effect of kidney transplantation is positive, it is a "better late than never" policy. As an ordinary person, how to protect the kidney and avoid uremia?

Zhu Tongyu: Because the kidney has a strong compensatory function, only 1/2 nephrons can work normally to meet people's normal physiological needs. So it often takes a long time from kidney problems to uremia. Clinically, many young people are diagnosed with uremia at the time of initial diagnosis, mainly because of lack of health awareness and failure to insist on regular physical examination. In fact, as long as Hua 10 yuan makes a urine routine, we can find out whether there is proteinuria or hematuria, so as to find kidney diseases early.

It is worth mentioning that in recent years, there are more and more cases of renal damage caused by metabolic diseases such as hypertension, diabetes and gout. In 1970s and 1980s, 90% of uremia developed from chronic nephritis. Now the proportion of uremia caused by diabetes and hypertension is rising. Therefore, for patients with hypertension and diabetes, it is also helpful to treat the primary disease actively and go to the hospital regularly to check urine routine, renal function and renal B-ultrasound.

Reporter's notes

As a well-known expert in the field of organ transplantation in China, Professor Zhu Tongyu has been committed to the smooth progress of organ donation in recent years, and is also actively studying the "good prescription" to reduce the dosage of immunosuppressants after kidney transplantation. What moved the reporter was that Professor Zhu himself was an organ donation volunteer. He said that as a doctor specializing in organ transplantation, this is what he should do. People can't choose the length of life, but they can choose the continuation of life. When you come to the end of your life, donating your useful organs so that others can be reborn is actually a continuation of your life. Isn't this a wonderful thing?

Expert introduction

Zhu tongyu

Professor of urology and doctoral supervisor of Zhongshan Hospital affiliated to Fudan University, director of Shanghai Key Laboratory of Organ Transplantation, member of Organ Transplantation Branch of Chinese Medical Association, and member of Shanghai Organ Transplantation Branch.

Medical expertise: Long-term commitment to clinical and basic research of kidney transplantation.

Expert clinic: Monday morning, Thursday morning.