Authors

  1. Catlin, Anita PhD, FNP, CNL, FAAN

Article Content

As pediatric surgical nurses, we see parents and siblings who donate organs, partial organs, or bone marrow to children in our care. Those of us not working in that field may wonder what the process is for a living donor. This new book, Kidney to Share, discusses living donorship between adults. It may not answer pediatric questions, but it is a beginning for knowledge about organ donation.

 

As an experienced nurse and bioethicist, I was enthralled with this book. The book is a back-and-forth conversation between two wonderful writers. The story is about the arduous journey it takes to be a living kidney donor. Rather than being respected for giving a gift of life, Martha Gershun depicts the complexity, dysfunction, and convolution she experienced. In fascinating detail, she describes 9 months of her life, from the day she reads about a person who needs a kidney to being the one who donates it.

 

John Lantos is well known in the bioethics world. He is also a marvelous writer. He answers each of Martha's chapters with chapters of his own. He brings us the history of kidney transplants, the ethical debates, and the progress from identical twins to cadaver donor to only related donor to nonrelated donors to chain donations involving multiple persons. He discusses pros and cons of countries in which organ selling is legal. He presents how history is determined by the interplay of ethics, law, and medicine.

 

Martha tells her story. One cannot imagine (neither could she) the level of testing of her every parameter-blood tests, kidney function, substance use, psychological status, chest x-rays, electrocardiograms, abdominal computed tomography scans, HIV status, pap smears, mammograms, and more. She is told to drink fluids all night to collect a 24-hour urine at the same time she is told to fast for various blood tests. Communications are fraught with missteps. She must remind the kidney center when tests are due, and she must independently learn to ship her blood as the sender of "dangerous" dry ice.

 

She is doubted about her intentions, treated with suspicion. She is interviewed many times by physicians, social workers, and committees. Why does she want to donate? Why give to a stranger? Why do something that could impact her own future health? What does her husband think? Martha responds to the doubters. There are many ways to give, she says. "Some people adopt children, some raise foster children, some donate money to charity, some help a nonprofit or help their neighbors. Donating a kidney happened to be mine."

 

Lantos answers with facts. The living donor has no increased risk for chronic diseases. The living donor lives just as long as everyone else. However, the cost to society for someone with end-stage renal disease is much less for a transplant than for continued dialysis. Rather than putting up a continual path of obstacles, Lantos suggests that the living donor should be respected and treated well, much like the philanthropist who donates to the hospital.

 

Kidney to Share is a book that opens our eyes to a topic of which we were previously unaware. Martha Gershun's journey is one of interest. As a reader, I was very glad she shared it.