By Lori Ehde
Luverne's Fred Manfred Jr. is living on borrowed time.
His 10-year-old transplanted kidney is failing, and he's back on the national waiting list for another donation, his third, if heÕs fortunate enough to get one.
To increase his odds, Manfred's doctors have encouraged him to seek help from living, non-related donors - a new trend in organ transplants.
"It's a hard thing to do - to ask for such a thing," Manfred said. "It's asking a lot."
As awkward as it may be to ask, it's an option that can't be overlooked for Manfred, who's had chronic kidney disease for more than 20 years.
Requesting donations from the community not only increases his odds for a match, it drastically increases the likelihood of a successful transplant.
For example, Manfred's first transplant in 1981 arrived on the surgical table two days after being harvested from a 40-year-old accident victim.
That kidney lasted only one month.
In 1992, Manfred's second kidney arrived, two hours after the donor, another accident victim, died. That kidney lasted almost 10 years.
In a live kidney donation, as opposed to one harvested from a cadaver, the kidney is transplanted directly from the donor to the patient.
"The time it spends out of the body is crucial" Manfred said.
Live donations
proven more successful
In the year 2000, five-year survival rates for living donors were 78.4 percent compared with 64.7 percent for cadaveric donors.
In 2001, the number of living donors increased by 13.4 percent on top of a 16.5 percent increase the previous year, according to the United Network for Organ Sharing.
By contrast, donations from dead people increased just 1.6 percent during that same time period.
In addition, transplant professionals across the country are working to implement anonymous donor protocols to further increase the pool of available kidneys.
WhatÕs making the process less daunting for would-be donors is that modern medicine has made it possible for people to donate kidneys with very little risk to their own health.
The procedure is now done laproscopically, making the surgery less invasive, allowing donors to get back on their feet in a matter of days, as opposed to several weeks.
Manfred joins about 260,000 people in the United States who are receiving dialysis for kidney failure.
Those on the waiting list for a transplant wait, on average three years, and many die before they get a chance at a transplant.
Waiting game
Manfred knows the waiting game all too well. He waited 11 years for his current kidney, and now that one's failing, too.
He started dialysis in April 2001, and spends four to five hours a day, three days a week in Sioux Falls connected to machines.
The process removes toxins from his system, something his kidney is no longer doing.
"Everything you eat becomes a toxin," Manfred explained, "because you have no way to clean anything out. Even the healthiest foods slowly become impurities."
Between dialysis days on Tuesdays, Thursdays and Saturdays, he gains four to five pounds of body fluid. He limits his daily intake of fluid because two cups of fluid translates to one pound of body weight.
While dialysis cleans out the system, it's a taxing process both physically and emotionally, said Manfred, who has become familiar with the eight to 10 other dialysis patients in the unit with the same schedule.
"One of the emotional events of dialysis patients is to show up at your unit and see an empty chair," he said.
The majority of kidney patients die of heart failure, so they're encouraged to exercise for endurance. "That's why I ride my bike everywhere," he said.
Being on the national waiting list for an organ is stressful in itself.
"Often when the phone rings, I think maybe this is it," he said. "There is anxiety in waiting. Then, there's a lot of anxiety when you get that call, because you have to be able to drop what youÕre doing and go immediately."
That's part of the reason a living donor appeals so much to Manfred. "It takes so much of the anxiety out of it," he said. "You can find the better match, because you have all this time to test the donor."
For information about donating a kidney to Manfred, or to the South Dakota Renal Transplant Center, call 888-909-1112.
Also, visit the National Kidney Foundation Web site at www.kidney.org. Click on "Organ and Tissue Donors and Recipients," and then on "Living Donors."