Primary Cause of the Current Trend
In simple words, the term organ donation could be easily defined as giving an organ or part of an organ to be transplanted into another individual. As a matter of fact, it needs to be stated that organ transplantation could be identified as the only option which enables the process of life-saving in patients diagnosed with terminal organ failures. Adding to that, this also helps in the process of significantly improving the quality of life of the patients (Pérez-San-Gregorio, Martín-Rodríguez, Luque-Budia & Conrad, 2017). As stated by Goldberg et al. (2015) in their paper, there has been the presence of a significant disparity could be identified between the supply and demand of donated organs which ultimately leads to individuals dying out of diseases without any cure. Looking at the positive side, it needs to be stated that there has been a gradual increase in transplantation in the last two decades. This has also created the most important aspect which could be identified that all the relevant aspects of the health issues.
It has also been identified that the consequences of organ transplantation have been able to improve is due to the fact that there is a significant growth in innovations and developments in peri-operative administration (Bezinover & Saner, 2019). That being said, the current trend on which the paper will be focused is the challenge that there is a growing proportion of elderly transplant patients with comorbidity and this has resulted in the quality of organs available is getting poorer. This essay will help the readers with the understanding of the causes and the effects of the current trend in relevance to organ donation that has been identified.
Now, this part of the essay will present arguments regarding the primary cause in relevance to the current trend that has already been identified. To begin with, it needs to be stated that with time there has been significant growth in the need for organ transplantation but on the other hand, the growth in the availability of the organs has not amplified to meet the exact demands in relevance to the number of patients. Based on the sample that has been presented, it could be seen that 90% of adults in relevance to the entire U.S. population tends to support organ donation, whereas it could be realised that only 60% are actually signed up as donors (Morgan & Miller, 2002). Based on this huge gap between the two percentages, it could be realised that the demand of the donors is significantly high as compared to that of the availability of the number of donors.
Even, there are available donors but under certain circumstances, it could be seen that the quality of the organs that are being offered are not up to the mark. Due to this, there has been significant growth in different kinds of organ donations. As stated by Lentine, Lam & Segev (2019), it could be seen that living kidney donation has been recognized progressively and this is based on the fact that there is a significant growth in the quantity of end-stage renal disease patients waiting for organs to be donated. In relevance to this, it has also been identified that there has been a significant increase in using grafts from marginal donors such as with advanced age and this has been identified in worldwide practice. However, this practice has been started in Turkey and is most relevant in that particular country (Ma?den et al., 2015). Based on this observation it could be realized that anesthetic management of donors in connection to the process of donation has proved too significant important under all the circumstances. Also, it becomes significantly important to state the fact that, it is only possible for the living donors to donate only one of their kidneys. Also, it has been identified that living kidney donation could be identified as one of the most common living donations (Timmerman et al., 2015) and also it has been identified that it has been able to save thousands of lives each year.
Effects of the Current Trend
Now the main reason or the primary cause behind the significant growth of living donor kidney transplantation (LDKT) is due to the fact that there has been organ shortage due to the lack of cadaver kidneys (Wu et al., 2017). However, the number of recipients has not decreased under any circumstances and also at the same time it could be seen that there has been a growth in the demand. Throughout the world, this has been identified as the choice of therapy for individuals who have been identified with end-stage kidney disease. The living donors for these cases have mostly been their family members or certain close relatives. Based on this, there has been significant growth in the median age of donors.
Apart from that, it could also be identified that elderly donors, tend to often present with numerous comorbidities, and this is seen as the challenge in the process of perioperative management for anesthesiologists and they are able to justify meticulous care as receivers (Wasson, Deer & Suresh, 2017). Based on the above discussion that has been presented, it could be realized that the main cause behind this trend is due to the fact that there has been a discrepancy between demand and supply in kidney transplantation. Also, due to this, there has been a significant expansion in the limits on donors’ characteristics, which also includes their age.
This part of the paper will talk about all the relevant effects that could be identified in connection with the current trend that has been identified. The type of surgeries that are required for the live donor transplantation to take place, it could be identified that the geriatric donor has signed a very high danger of developing venous thromboembolism (Heit, 2015). Based on that, the individuals are provided with advanced stockings and heparin formerly applied of arterial clamp intraoperatively.
A study that was conducted, stated that regional anesthesia was preferred based on this observation and analgesia in relevance to the patient that was selected for the study. The patients were under continuous monitoring in order to prevent nerve injuries and stress ulcers. It was also identified that the main reason behind such precautions being taken is based on the fact that the patients who were the donor belonged to the old age category. It has also been identified that in cases of such old patients open surgeries are extremely painful and are highly risky (Partridge, Sbai & Dhesi, 2018). Apart from that, even after the transplantation has taken place there are major complications that could be identified in the cases of elderly donors. Based on that, it could be realized that, that the demand of the donors is significantly high as compared to that of the availability of the number of donors.
Studies have identified that; donors are frequently faced with transient complications which tend to include issues such as microalbuminuria or under certain circumstances a significant upsurge in serum creatinine could also be identified (Tittelbach?Helmrich et al., 2015). The health condition of donors tends to deteriorate under all the conditions and this has an adverse effect on the entire health condition. This again major effect on the health index of the entire country.
Peri-operative Administration and Innovative Developments
Apart from that, it could also be identified that especially in Turkey, this trend is significantly relevant. It could also be identified that the practice of elderly living donor kidneys has been significantly growing nowadays, based on the fact that there have been more than 20,000 patients waiting for a suitable organ. In order to meet this demand, it could be identified that the increase in the number of donors could be deemed as relevant. Such aspects have been able to make this entire anesthesiologist focus on the topics like safety, safeguarding, and optimization of donors as well as the recipient. Thus, the primary reason behind the relevance of such a trend is based on the fact the older population has multiple health issues and further surgeries tends to create major problems for them.
On a concluding note, it could be stated that the paper has been able to present all the relevant arguments in connection with the causes and effects of the increase in elderly donors. It has been concluded in the paper that this particular trend could be considered very important based on the fact that there has been an increase in the need for body organs. Also, this trend has also been identified as extremely risky based on the age group that has been participating in this entire trade. Based on the discussion, it has also been realised that the health condition of the donor tends to play a very important role in this entire process. All the discussion that has been presented in the paper has been backed with the relevant source of information and this again makes this paper a reliable source of study for further studies in this particular area of research.
References
Bezinover, D., & Saner, F. (2019). Organ transplantation in the modern era. BMC anesthesiology, 19(1), 1-4.
Goldberg, D. S., French, B., Abt, P. L., & Gilroy, R. K. (2015). Increasing the number of organ transplants in the United States by optimizing donor authorization rates. American Journal of Transplantation, 15(8), 2117-2125.
Heit, J. A. (2015). Epidemiology of venous thromboembolism. Nature Reviews Cardiology, 12(8), 464-474.
Lentine, K. L., Lam, N. N., & Segev, D. L. (2019). Risks of living kidney donation: current state of knowledge on outcomes important to donors. Clinical Journal of the American Society of Nephrology, 14(4), 597-608.
Ma?den, K., Ucar, F. B., Velio?lu, A., Ar?kan, H., Ye?en, ?. C., Tu?lular, S., & Özener, I. Ç. (2015, June). Donor contraindications to living kidney donation: a single-center experience. In Transplantation Proceedings (Vol. 47, No. 5, pp. 1299-1301). Elsevier.
Morgan, S., & Miller, J. (2002). Communicating about gifts of life: The effect of knowledge, attitudes, and altruism on behavior and behavioral intentions regarding organ donation. Journal of Applied Communication Research, 30(2), 163-178.
Partridge, J., Sbai, M., & Dhesi, J. (2018). Proactive care of older people undergoing surgery. Aging Clinical and Experimental Research, 30(3), 253-257.
Pérez-San-Gregorio, M. Á., Martín-Rodríguez, A., Luque-Budia, A., & Conrad, R. (2017). Concerns, mental health, and quality of life in living kidney donation–parent donor candidates worry less about themselves. Frontiers in psychology, 8, 564.
Timmerman, L., Ismail, S. Y., Luchtenburg, A. E., Zuidema, W. C., IJzermans, J. N., Busschbach, J. J., … & Massey, E. K. (2015). Exploring knowledge about dialysis, transplantation, and living donation among patients and their living kidney donors. International journal of behavioral medicine, 22(5), 580-589.
Tittelbach?Helmrich, D., Thurow, C., Arwinski, S., Schleicher, C., Hopt, U. T., Bausch, D., … & Pisarski, P. (2015). Poor organ quality and donor–recipient age mismatch rather than poor donation rates account for the decrease in deceased kidney transplantation rates in a Germany Transplant Center. Transplant International, 28(2), 191-198.
Wasson, N. R., Deer, J. D., & Suresh, S. (2017). Anesthetic management of pediatric liver and kidney transplantation. Anesthesiology clinics, 35(3), 421-438.
Wu, D. A., Robb, M. L., Watson, C. J., Forsythe, J. L., Tomson, C. R., Cairns, J., … & Oniscu, G. C. (2017). Barriers to living donor kidney transplantation in the United Kingdom: a national observational study. Nephrology Dialysis Transplantation, 32(5), 890-900.
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