Speaker 1: Welcome to Stuff you should know, a production of I
Speaker 1: Heart Radio. Hey, welcome to the podcast. I'm Josh Clark.
Speaker 1: There's Charles w to Kidney Bryant, and there's Jerry over there,
Speaker 1: and this is stuff you should know. The kid kidney
Speaker 1: donation addition. Yeah, we did one on Oregon donation, right, Yeah,
Speaker 1: and we did one on kidney stones and put them together.
Speaker 1: You get this episode. That's right, And this is from
Speaker 1: Dave Bruce or pal and uh this good? Should we
Speaker 1: should we? This good? It's that kind of day, how
Speaker 1: it's going. Yeah, we're we're in person again, by the way. Yeah,
Speaker 1: we should just tell everyone that I'm making a fool
Speaker 1: of myself right in front of you for a change.
Speaker 1: It's nice to see in person. Um. And I should
Speaker 1: also point out them that this is a double Dave
Speaker 1: Day because he did the last one too. Inflation right,
Speaker 1: interest rates? Yeah, I forgot what we talked about. I've
Speaker 1: already forgotten all of it. So Dave did some digging
Speaker 1: for us UM and came up with some pretty surprising
Speaker 1: stats that I certainly had no idea about. With kidney
Speaker 1: disease in particular, but something like, of all American adults
Speaker 1: have some form of chronic kidney disease. Thirty seven million
Speaker 1: people right now, thirty seven million and ninety thousand Americans
Speaker 1: are on the list waiting for a kidney transplant. And
Speaker 1: each year, this is very sad, about five thousand Americans
Speaker 1: die while waiting and another three thousand more become too
Speaker 1: sick to get that transplant. So basically, eight thousand ish
Speaker 1: people are either dying or on their way to dying
Speaker 1: because they don't have a kidney that they can get right.
Speaker 1: And then with you know, thirty seven million adults, just
Speaker 1: the adults alone with some form of chronic kid of diseases,
Speaker 1: their disease progresses, uh, they end up on the list,
Speaker 1: the transplant list. So um, what we'll talk about in
Speaker 1: this second. What's what's really interesting about kidneys, and in
Speaker 1: particular kidney donations is it's one of a very select
Speaker 1: few organs that you could donate while you're alive and
Speaker 1: then whistle off back to your normal life. Down one kidney. Yeah,
Speaker 1: you can't donate your heart to somebody. It's very sweet gesture,
Speaker 1: but you've got two kidneys, you only need one. I
Speaker 1: think the number the percentages if you donate a kidney
Speaker 1: which is interesting because the one kidney you have must
Speaker 1: ramp up production because your kidney function only goes down
Speaker 1: what was it fifteen or something like that, Yeah, something nothing, maybe, Yeah,
Speaker 1: it's not right, and that's definitely doable. Like you can
Speaker 1: go through life with one kidney performing of your previous function.
Speaker 1: That's right, that's not bad. And we should probably just
Speaker 1: kind of point out some of the amazing things the
Speaker 1: kidneys do. There are these two fist size organs or
Speaker 1: one um depending on whether you've donated or not. That's right,
Speaker 1: back to the show. Just just under your rib cage,
Speaker 1: on either side of your spine. So have your loved
Speaker 1: one make a fist with each and come up behind you,
Speaker 1: put their fist under your rib cage gently. Yeah, just
Speaker 1: on either side of your spine, and there's your kidneys,
Speaker 1: right uh. And kidneys do a lot of things. The
Speaker 1: main you know, like sort of the money job that
Speaker 1: the kidneys do is they act as the filter system
Speaker 1: for your for your blood. And that's the big thing.
Speaker 1: They filter about two arts fluids every day. And that's
Speaker 1: not just blood, that's blood and waste fluid. That's so much.
Speaker 1: That's a lot a lot. Kidneys are always working. And
Speaker 1: within the kidneys there are about one to one and
Speaker 1: a half a mill allion tiny little filters inside the
Speaker 1: kidney called nephrons. If you just think Nora ephron or
Speaker 1: nefert d or nefert d uh, And those nephrons are
Speaker 1: what's doing the actual filtering. They're just tiny little filters. Uh.
Speaker 1: They also what else they do? They also release a
Speaker 1: hormone called uh erythra poton e p O. It regulates
Speaker 1: production of red blood cells and bone marrow. Very big deal. Yeah. Um.
Speaker 1: They also convert vitamin D from a non usable form
Speaker 1: from like the sun, into a usable form, which is
Speaker 1: pretty important because vitamin D helps you retain and absorbed
Speaker 1: calcium and phosphorus for building bones, reduces inflammation, possibly combats
Speaker 1: tumor growth. Um. And all this is coming from your
Speaker 1: kidneys doing its thing. And then one other thing we
Speaker 1: kind of skipped over a little bit, I think is
Speaker 1: worth pointing. Out of those two hundred quarts of fluid
Speaker 1: every day, two courts of it, I think you said,
Speaker 1: is waste. You pee it out, It gets converted into
Speaker 1: your and sent to the bladder and you pee it
Speaker 1: out and finally chuck. Finally, the eight eight ounce classes
Speaker 1: of water a day makes sense. It's not arbitrary anymore.
Speaker 1: You never realized that, No, I never understood. I thought
Speaker 1: it was actually made up an arbitrary number. That sixty
Speaker 1: four ounces because that's how much you pee out on
Speaker 1: a normal day, because that's how much your kidneys filter out.
Speaker 1: Is waste, so you gotta replenish it. Yeah, this is
Speaker 1: funny that. Well, I'm this day's old when I finally realized, Uh,
Speaker 1: what else? They also release a hormone called rennan regulate
Speaker 1: your blood pressure, and we'll see blood pressure and kidneys
Speaker 1: have a lot to do with one another. Yep. And
Speaker 1: what else anything? You know what? I bet you there's
Speaker 1: other things that kidney does it. It It just didn't like
Speaker 1: to take credit for her. So. Um. One of the
Speaker 1: problems with your kidneys is that they can break down.
Speaker 1: They're susceptible to all sorts of other stuff going on
Speaker 1: in your body. Um. And one of the big things
Speaker 1: that put stress on your kidneys, well, two of the
Speaker 1: big things that put stress on your kidneys is such
Speaker 1: chuck colon. You've got blood pressure, high blood pressure, which
Speaker 1: exerts pressure on the walls of your blood vessels. Which
Speaker 1: in turn exerts pressure on your kidneys, damaging their function.
Speaker 1: And the big one, the big daddy of what causes
Speaker 1: kidney chronic kidney disease is diabetes. That's right, that's the
Speaker 1: number one. High blood pressure is number two. And uh,
Speaker 1: you know, basically high blood sugar is going to damage
Speaker 1: the blood vessels in the kidney. It's gonna kill those
Speaker 1: nephrons that we were talking about. Those are the filters
Speaker 1: that actually do the filtering. And chronic c DK chronic
Speaker 1: kidney sorry c KD, chronic kidney disease. Uh. They call
Speaker 1: it the silent disease because you can be in you
Speaker 1: can be through the first few stages of chronic kidney
Speaker 1: disease and not feel any symptoms at all and not
Speaker 1: know what's going on. So it's very dangerous. There are
Speaker 1: five total, and stages one through four your kidneys are
Speaker 1: still doing their thing, they're struggling. But stage five is
Speaker 1: when you're in in stage renal disease or renal failure,
Speaker 1: and that's when you your kidneys maybe aren't working at
Speaker 1: all and you're going to dialysis every day and you
Speaker 1: need a new kidney. Yes, um, And we'll talk a
Speaker 1: little more about dialysis. But yes, once you hit stage five,
Speaker 1: you're like, you, your kidneys just aren't doing the work anymore.
Speaker 1: And you know it's not like they're just stop functioning
Speaker 1: little by little, they're unable to filter out waste. So
Speaker 1: the waste starts to accumulate and build up and you
Speaker 1: have all sorts of terrible symptoms like nausea, UM, fatigue, vomiting.
Speaker 1: You feel poisoned, is what I've heard. Yeah, I think
Speaker 1: that's basically what's going on. And your body is being
Speaker 1: poisoned because it's no longer able to filter it out.
Speaker 1: So UM. There's a lot of racial disparities too as
Speaker 1: far as kid new diseases go, and apparently it tracks
Speaker 1: very closely to UM uh diabetes. UM. Apparently, if you're
Speaker 1: a Black American, you are four times more likely to
Speaker 1: have kidney failure UM than a white American, Hispanic Americans
Speaker 1: one point three times, in Native Americans one point two times,
Speaker 1: and again like that's those same rates are pretty close
Speaker 1: to the disparity in diabetes. But also it has to
Speaker 1: do with things like access to healthcare, access to certain
Speaker 1: kinds of food that may not lead to diabetes or
Speaker 1: will lead to diabetes. Um, there's a lot of stuff
Speaker 1: kind of caught up into it that. Um, it's not
Speaker 1: entirely straightforward that everybody has an equal opportunity to develop
Speaker 1: kidney disease. Yeah, it's just I mean, it's really sad
Speaker 1: that it it. You know, it seems like everything comes
Speaker 1: down to money and access to money. And if you
Speaker 1: live in the United States and you are somewhere on
Speaker 1: the poverty spectrum, then you're more likely to not have healthcare,
Speaker 1: not go to the doctor, eat worse food, get diabetes,
Speaker 1: have kidneys fail. It's all sort of in lockstep with
Speaker 1: one another. And then it gets even more insidious than
Speaker 1: that because once you get the stage five you might
Speaker 1: not have reliable transportation to go to dialysis, and dialysis
Speaker 1: is extremely time consuming. It is, so it's going to
Speaker 1: be hard for you to keep doing a job. Yeah,
Speaker 1: my neighbor before they moved and sadly he passed away,
Speaker 1: Miss Jesse and Mr Otis he had his Uh, he
Speaker 1: had the ambulance come or you know, it looks like
Speaker 1: an ambulance, but it's not an emergency one. It's just
Speaker 1: the transpo. They picked him up every day, took him
Speaker 1: to dialysis. Brought him home and this was for the
Speaker 1: last couple of years of his life, you know, going
Speaker 1: every single day, and it's good. Dude. I wish I
Speaker 1: would have gotten to him a little bit better before
Speaker 1: he passed. But um so dialysis is short for hemo dialysis,
Speaker 1: and it is literally just a machine that does the
Speaker 1: filtering that your kidneys do. So you sit there for
Speaker 1: or what is it like four hours, usually about three
Speaker 1: times a week. Yeah, three times a week, four hour sessions,
Speaker 1: and they just clean your blood in full with each session. Yeah,
Speaker 1: there's like a little membrane that um doesn't let the
Speaker 1: important stuff like red blood cells get through, but it
Speaker 1: does let those waste products get through and they just
Speaker 1: get slashed out, whereas the blood that doesn't go through
Speaker 1: the membrane gets put back into your body. Yeah, and
Speaker 1: you're on dalysis for life until unless you can get
Speaker 1: a new kidney, and then even if you do get
Speaker 1: a new kidney, you might be on dalysis for a
Speaker 1: little while, as we'll see. Yeah, So, Chuck, I feel
Speaker 1: like this is a good time to take a break.
Speaker 1: Just off the top of my head, let's do it, Okay,
Speaker 1: So we're gonna take a break and we'll be right
Speaker 1: back everybody. Okay. So it's not fun to have kidney failure,
Speaker 1: especially stage five kidney failure, because you're going to dialysis
Speaker 1: a lot um and there's a lot of terrible symptoms
Speaker 1: involved in it. Um. If you are at that point,
Speaker 1: you're going to be put on UM an organ donation list.
Speaker 1: You're going to become a m a recipient or potential
Speaker 1: recipient of a donated kidney. That's right, and that means
Speaker 1: you have signed up with UH, the Organ Procurement and
Speaker 1: Transplantation Network, which is managed by a nonprofit called the
Speaker 1: United Network for organ sharing a lot worse places. You
Speaker 1: can donate your money too, by the way, and it's UH.
Speaker 1: You know, Day points out astutely that it's not like
Speaker 1: a waiting list, as in, you know, there's ninety thousand
Speaker 1: people or more away eating for a kidney. So if
Speaker 1: you sign up for one, then you have eighty nine
Speaker 1: people in front of you, and it just very slowly,
Speaker 1: you know, that time ticks away. It's a network, it is,
Speaker 1: it's a pool of candidates. And because you have to
Speaker 1: get matched with a kidney, and there are all these criteria,
Speaker 1: one of which is blood type UM don't have to
Speaker 1: have necessarily exact blood type. I think if you have
Speaker 1: like A, you can get a b uh So, there's
Speaker 1: a little bit across over there and oh is universal right?
Speaker 1: How is it? Oh negative? We did a thing on
Speaker 1: blood it was. It was a good one. We did
Speaker 1: a live one, that's right. Remember my father in law
Speaker 1: spoke up when I did a blood test. He said,
Speaker 1: Josh is pregnant. That's right. He got more last than
Speaker 1: all of mine combined that night. I remember that that
Speaker 1: was a very like one of the only funny audience
Speaker 1: jokes that we've ever had. It really was was yelled out,
Speaker 1: it's high quality. Heckline. That was like, that's for the
Speaker 1: Atlanta Science vessel Um. Where was that? That just totally
Speaker 1: through me that I'm trying to picture your break it
Speaker 1: now we'll get a load of me, buddy. Uh So, Yeah,
Speaker 1: blood type is one the size of the organ. It's
Speaker 1: got to be a good fit. So like a little
Speaker 1: kid can't get a big adult kidney. You wouldn't think
Speaker 1: about that, but it is true. And I mean it's
Speaker 1: not just true with kidneys, with any oregan like I
Speaker 1: saw it, put like a basketball players a long mon't
Speaker 1: fit in a child. Right, It's like sure, yeah, those
Speaker 1: are wise words. Good point. Uh. And then geography is
Speaker 1: one because as you'll see, if you get a kidney
Speaker 1: donated from someone that you don't know, it's not like
Speaker 1: a family member, then that kidney is going to be
Speaker 1: on ice basically for a little while. That's gonna be
Speaker 1: transported maybe or maybe you're transported, but there's gonna be
Speaker 1: a little bit of time. Uh. They don't just like
Speaker 1: you know, put you on the table like in the
Speaker 1: movies that put you on the table next to your brother,
Speaker 1: and they would just like slide one kidney right in,
Speaker 1: you know, just across the room to the other. Right. So,
Speaker 1: uh so geography is a consideration. So within this network,
Speaker 1: you know, there's a big garrhythm that's going to match
Speaker 1: blood types and all these things. And like, hey, you
Speaker 1: live in Birmingham. We got a kidney in Tuscaloosa, So
Speaker 1: you guys are pretty good match. Yeah. And so with
Speaker 1: each new organ that comes up for UM donation, uh,
Speaker 1: you get a new a new score calculated by the computer.
Speaker 1: Like it's not like you get your score as signed.
Speaker 1: It's all contextual based on your relation to that organ.
Speaker 1: That's that's being considered, that's being donated. Yeah, and also
Speaker 1: we should point out that it's also based on your need,
Speaker 1: like if you're you know, how urgent it is in
Speaker 1: a lot of cases. Yeah, it's also based though on
Speaker 1: on some other stuff too, which is, you know, kind
Speaker 1: of calculating. But it makes sense. Um, your age, the
Speaker 1: younger you are, the higher your score, which makes it
Speaker 1: likelier for you to get that um, the likelihood that
Speaker 1: you will survive the procedure, the likelihood that you will
Speaker 1: um reject the organ or not. Sensitization, I think is
Speaker 1: what they call it. There's a bunch of different factors.
Speaker 1: And this is fairly recent, this pool um um method. Uh,
Speaker 1: and I it's kind of revolutionized things and apparently made
Speaker 1: it a lot better a lot um it's from what
Speaker 1: I understand, it's a lot more sensible and fair. Yeah,
Speaker 1: and it also makes sense, like once you see the numbers,
Speaker 1: like every kidney is super important, and so they want
Speaker 1: to give them to people where you have the best
Speaker 1: chance for that kidney to work over you know, for
Speaker 1: ten to fifteen twenty years. Yeah. I can't waste no
Speaker 1: kidney left behind. No, Oh man, can you imagine if
Speaker 1: they were just like, oh, we left it on the plane,
Speaker 1: just forget about it. You're like, I just donated that
Speaker 1: kidney for nothing, Right, it's in the trash. Now there's
Speaker 1: a story out there, and I kind of want to
Speaker 1: hear it. See. I pictured more like Cheech and Chong.
Speaker 1: We're piloting the plane and they're like, what's in the
Speaker 1: cooler man? And all of a sudden it's a movie
Speaker 1: they're looking for like some some ah good marijuana. That
Speaker 1: reminds me of Snoop Dogg as the pilot. Sole Plaine.
Speaker 1: I never saw that was like, you know, it wasn't
Speaker 1: at all at all. Yeah. It looked like a sort
Speaker 1: of homage to the sort of bad seventies comedies. You know.
Speaker 1: It was where there was no It was like, hey,
Speaker 1: here's an idea. Let's get a bunch of like funny
Speaker 1: people and get them really high or drunk, and there's
Speaker 1: your movie. That that was exactly what is an airport? Right?
Speaker 1: That's the that's the twist, all right, I'm not going
Speaker 1: to see it twist. Yeah, no, there's no reason to.
Speaker 1: I demand that you not see it. Actually, how are
Speaker 1: you gonna sign up to be an organ donor? What
Speaker 1: are the couple of good ways you can do that. Well.
Speaker 1: One way is whenever you go get your license renewed
Speaker 1: at the old d m V in the United States,
Speaker 1: uh or the d m V in France. Um, they're
Speaker 1: gonna ask you if you want to be an organ
Speaker 1: donor and and you can say yes, and they will
Speaker 1: put it on your license, yes organ donor. So that
Speaker 1: if you you know, by the farm out and about,
Speaker 1: and you've got your driver's license on you, the doctors
Speaker 1: and the people at the hospital are going to look
Speaker 1: at your I D. And if they see yes, they're
Speaker 1: going to go to your family and say, your your
Speaker 1: loved one here, um who's now regretfully deceased, said that
Speaker 1: they want to donate their organs or will you sign
Speaker 1: off on this? It seems to have been their wishes.
Speaker 1: And you can still say no if you're a family member,
Speaker 1: but um, probably you're going to say yes, especially if
Speaker 1: you're deceased loved one said Hey, I marked yes my
Speaker 1: that I want to donate organs on my driver's license.
Speaker 1: If I die, make sure my organs get donated. They're
Speaker 1: probably gonna go along with it. Yeah, I think it's
Speaker 1: kind of funny that I wonder what percentage of people
Speaker 1: that sign up at the d m V for organ
Speaker 1: donation and the kid needs that actually go to other
Speaker 1: people and organs that successfully save lives. How many of
Speaker 1: those start with the two words why not? Yet you're
Speaker 1: at the d m V, you're bored out of your mind,
Speaker 1: you've been there for far too long, and they ask
Speaker 1: you this question, you go, yes, why not? Yeah, that
Speaker 1: is the most interesting question you've been asked in that
Speaker 1: whole experience, Like, maybe the biggest question you can answer
Speaker 1: in your life is whether or not you will donate
Speaker 1: your kidneys and your organs to save a human life.
Speaker 1: And people probably just go, yeah, why not. So if
Speaker 1: you've been to the d m V and you said no,
Speaker 1: and you okay, But if you said no you wanted
Speaker 1: to your you can still go in register right, Yeah,
Speaker 1: You've got to register me m E dot org and
Speaker 1: you can register there. Uh, and here's the deal in one,
Speaker 1: here's some more stats for you. There were forty thousand
Speaker 1: total organ transplants. I think most of those are I
Speaker 1: think was it like or kidney transplants? Far and away
Speaker 1: the most are kidney transplants, and only six hundred of
Speaker 1: those forty five. Uh, came from living donors, which was
Speaker 1: I have a relative or I'm just a benevolent human
Speaker 1: who wants to give a kidney to anonymously to somebody.
Speaker 1: I mean, yeah, talk about st hood. Uh So two
Speaker 1: thirds of all kidney transplants are from deceased donors. So,
Speaker 1: like you said, it's a lot of times it's accidents,
Speaker 1: car and motorcycle accidents where there's like traumatic head injury,
Speaker 1: uh in the but the organs are still in pretty
Speaker 1: good shape. You're young, you're in good shape, and so um,
Speaker 1: you know, you may be brain dead, and they can
Speaker 1: the word harvests always sounds so cruel, but they can,
Speaker 1: they can harvest borrow your organs. No, it's hardly, it's
Speaker 1: definitely harvest. Remember in our our book of that chapter
Speaker 1: in Jack Kevorkian he had that that idea in the
Speaker 1: I think sixties or seventies where he was like, well,
Speaker 1: we're going to execute people, let's just execute them through
Speaker 1: organ harvesting. You know, we' started to perform surgery on
Speaker 1: him and we harvest their organs and then once we're done,
Speaker 1: they're just they're dead, right, Yeah, then we're joining their
Speaker 1: organs and everybody's like, it's a really great idea, but
Speaker 1: you're creepy, dude, and I think you're the last person
Speaker 1: who should be espousing this kind of stuff. Well, maybe
Speaker 1: he shouldn't have expressed this idea while imitating Verner Hertzog, right,
Speaker 1: and where are your pants? That's right? Uh? So that
Speaker 1: means at the end of the day, one human body
Speaker 1: can save uh up to Nold does a pretty good
Speaker 1: Verna herd so he's yeah, but the best ever is
Speaker 1: Paula Tompkins his Verner fantast Just look it up on
Speaker 1: the internet. It's great, one single human body an organ
Speaker 1: donor can save up to eight lives. Uh. And that
Speaker 1: is just with the organs. And then you've got tissue donation.
Speaker 1: You've got eyes that can bring sight to someone. We
Speaker 1: should totally do one on Ie the transplants. Yeah, might
Speaker 1: also show you the killer of the person whose eyes
Speaker 1: you got, in which case you're morally responsible for chasing
Speaker 1: that killer down and turning them into bringing the justice
Speaker 1: or exacting revenge. If it's a really good movie, a
Speaker 1: bridget Fon type movie, was that then the actual plot
Speaker 1: of one? Or was it was that just a typical
Speaker 1: movie plot? I don't remember who was in it though,
Speaker 1: Jennifer eight, I don't know. No No, Jennifer eight was a
Speaker 1: blind woman, a sightless woman who was going to be
Speaker 1: the eighth victim of a serial color who's targeting blind women.
Speaker 1: And I could spoil it for everybody. I'm not going to.
Speaker 1: It's actually we're seeing it's a good Nighties movie with
Speaker 1: Andy Garcia and yeah, I don't remember what was it. Yeah,
Speaker 1: it's good, good movie. I think it's out there still,
Speaker 1: or I'm thinking of the movie, uh where the guy
Speaker 1: got the hand transplant and the hand was from a
Speaker 1: serial killer and so he got a bad hand that
Speaker 1: wanted to do bad things. Jeff Fahey, I think the
Speaker 1: lawnmower man. But Jeff Ahey was the lawnmower man. Okay,
Speaker 1: I never saw that one. I mean it might have
Speaker 1: been called something as basically like bad Hand. Was it
Speaker 1: called idle Hands? No, that was different, and that was
Speaker 1: not good. I'll look it up, and well, well how
Speaker 1: about this, so folks stick around for the stormail. We'll
Speaker 1: look it up. In the interim, we'll announce it at
Speaker 1: the beginning of Finally, year fourteen, we've got a new
Speaker 1: hook for the show. Or maybe I can just make
Speaker 1: up an email that fake Jeff Ahey sent in. Remember me,
Speaker 1: we need to fake Jeff Ahey sound effect like side effect? Uh? Alright,
Speaker 1: So living donation is something we should talk about. This is,
Speaker 1: like you said at the beginning, one of the only
Speaker 1: organs you can donate, I mean, is it the only one? No,
Speaker 1: you can also donate his portion of your uterus and
Speaker 1: a portion of your liver, okay portions, yes, But other
Speaker 1: than that, that's it. Right. So I got a little
Speaker 1: bit of history here. Um, if you're talking kidney transplants,
Speaker 1: you gotta go back to nineteen o two was when
Speaker 1: they did a dog kidney transplant in Austria. The dog
Speaker 1: did not make it, of course, but the it did
Speaker 1: produce urine for a couple of days. The kidney man
Speaker 1: not bad, I know. And that really just kind of
Speaker 1: takes you back to some nineteen o two really unseatily
Speaker 1: black and white view of like some terrible experiment. Yeah, um,
Speaker 1: let me see. In nineteen o nine, apparently there were
Speaker 1: efforts to transplant kidneys from humans dead humans to monkeys
Speaker 1: as you do. Thirty nine, the first deceased human donor
Speaker 1: I think was performed in Russia. But the organ it
Speaker 1: didn't take. Organ never worked, but they tried it. In
Speaker 1: thirty nine, they tried their best. From human to human. Uh.
Speaker 1: Fifty three, you finally had your first successful temporary human
Speaker 1: kidney trans in Paris. It was twins, right, Uh sixteen,
Speaker 1: your boy received one from his mother as a living donor.
Speaker 1: And then fifty four I think was the twins. It
Speaker 1: was the first long term successful kidney transplant by Joseph Murray.
Speaker 1: He won a Nobel Prize for that, sure. And then
Speaker 1: sixty two is the first non related no genetics involved whatsoever.
Speaker 1: So it's only been since the nineteen fifties nineteen sixties
Speaker 1: that we've been able to successfully transplant kidneys. But once
Speaker 1: we got it, we got it pretty good. Yeah, we
Speaker 1: have it down path. Let's do this a lot, guys.
Speaker 1: This is fun. So um. If you are a living
Speaker 1: donor and you do donate your kidney, I think it
Speaker 1: makes out about a quarter of kidney donations today, right, Yeah,
Speaker 1: is a living donor somebody saying, take my kidney, put
Speaker 1: it in somebody else. More often than not, it's put
Speaker 1: it in my brother, put it in my spouse. Three
Speaker 1: quarters of the time it's you're related. Um, but there's
Speaker 1: that still means that of all kidney donations, So that means, however,
Speaker 1: many thousand kidney donations are are donated by people who
Speaker 1: are just saying like, here, take my kidney and give
Speaker 1: it to whoever needs it. That's right. And sometimes that
Speaker 1: it's anonymously. Sometimes it's a friend, sometimes it's a spouse.
Speaker 1: Sometimes you hear about someone in your community. But yeah,
Speaker 1: sometimes it's you don't even know anybody, and you're just like,
Speaker 1: you know what, I'm gonna save a life. Yeah, I'm
Speaker 1: at the d m V right, I don't want to
Speaker 1: save a life. Yeah, I'm gonna do it. So if
Speaker 1: you do do that, you're a living donor UM. And
Speaker 1: there's a lot of advantages to a living donation compared
Speaker 1: to a dead deceased donation donation. You know, an organ
Speaker 1: taken from somebody who's died, right, UM. So if you
Speaker 1: donate your kidney, UM, there's like the chances of the
Speaker 1: kidney being rejected are lower compared to a deceased donor UM.
Speaker 1: The the kidney will probably start functioning independently, like on
Speaker 1: its own UM much more quickly than a deceased donor
Speaker 1: one because the deceased donor one is going to be
Speaker 1: um basically put on ice for a little while while
Speaker 1: it's transported kept you know kind of you know, yes, exactly. Um.
Speaker 1: There's also, um, a difference in the amount of time
Speaker 1: that the average kidney lasts between a deceased donor and
Speaker 1: a living donor. Right. Yeah, Well you tend to live
Speaker 1: longer and your kidney last between fifteen and twenty years
Speaker 1: on average from a living donor. Uh, It's only about
Speaker 1: a decade from a deceased owner. And you also have
Speaker 1: a better chance if you are genetically related of avoiding rejection.
Speaker 1: So living genetically related living donor is like the crime
Speaker 1: dela crime of getting a kidney, right exactly. Um. There's
Speaker 1: also more convenient to um if you are a living donor.
Speaker 1: You can say, let's do this like a week from Tuesday.
Speaker 1: That works best for me, not this guy just died.
Speaker 1: We need to we need to get this into a
Speaker 1: recipient like as soon as possible. Um it, let's find
Speaker 1: somebody kind of thing, you know what I mean? Um,
Speaker 1: So that that's that's another big advantage too. So I
Speaker 1: think we've established here living kidney donations are the way
Speaker 1: to go if you can do it from a relatively
Speaker 1: So let's take a break, because, um, there's actually ways
Speaker 1: to maximize how kidneys get donated, chuck, and we're gonna
Speaker 1: tell everybody about it after this. Let's do it alright.
Speaker 1: So on the kidney exchange, it's pretty cool how they've
Speaker 1: worked this out over the years. Uh. There's something called
Speaker 1: paired exchanges, and it goes a little something like this.
Speaker 1: You want to donate a kidney to your relative, to
Speaker 1: your to your niece, but you don't have the right
Speaker 1: blood type. You can get paired up with someone who
Speaker 1: does have the right blood type who needs your kidney.
Speaker 1: They'll be like, wait a minute, my niece needs a kidney.
Speaker 1: You've got her blood type and I've got your nieces
Speaker 1: blood type. So let's just get together and make this
Speaker 1: all work out criss cross paired exchange. But then that
Speaker 1: is multiplied exponentially by the donor chain, right, yes, So
Speaker 1: like if if you have a good computer handy to
Speaker 1: run an algorithm for you, because apparently it's very difficult
Speaker 1: to do, Um, you can take a bunch of these
Speaker 1: mismatched pairs rather than four people, you can take I
Speaker 1: think up to seventy people, and one good Samaritan donor
Speaker 1: who says, take my kidney, I don't care who gets
Speaker 1: it can set off a chain of paired matching that
Speaker 1: can satisfy up to seventy seventy recipients through the through
Speaker 1: a combination of one person donating it without any you know,
Speaker 1: just saying take my kidney, put in somebody, and then
Speaker 1: a bunch of paired, paired matches all all like seventy people.
Speaker 1: So it makes it really difficult to say, like, I
Speaker 1: don't really want to donate my kidney, when not only
Speaker 1: are you saving one person's life, you're setting off a
Speaker 1: chain reaction that allows for seventy different people to get
Speaker 1: their kidney because you donated yours without without directing it
Speaker 1: towards anybody in particular. And if that's not the first
Speaker 1: thing you say on every first date you go to
Speaker 1: for the rest of your life, right, then you're doing
Speaker 1: it wrong. We should mention that the there was a
Speaker 1: Nobel Prize winning economist named Alvin Roth who who came
Speaker 1: up with his donor chain idea. And I don't think
Speaker 1: we said you, um, you have to be eighteen to
Speaker 1: donate a kidney you have to be in good health
Speaker 1: and you have like rock and kidneys basically, and also
Speaker 1: in good health otherwise, Yeah, like a sixteen year old
Speaker 1: can't donate a kid That's the other reason why a
Speaker 1: living donor is advantageous because of that luxury of time,
Speaker 1: because you can run a battery of tests. Yes, you
Speaker 1: have time to run tons of tests to make sure
Speaker 1: they're a perfect match for this other person. That's right.
Speaker 1: So when you do say okay, I'm gonna do it.
Speaker 1: And by the way, uh Dave said from researching this,
Speaker 1: he was inspired to do it. I think he may
Speaker 1: have put himself on a list or was going to
Speaker 1: although it may have worn off by now, who knows,
Speaker 1: we'll have to ask him. But if you do this, um,
Speaker 1: you are going to undergo surgery. Um. It's just as
Speaker 1: simple as that. And it's a serious surgery, like they're
Speaker 1: removing your kidney. Like I said, we've got it down
Speaker 1: pat since we've been doing it since the fifties or sixties,
Speaker 1: and now they can usually do it laparoscopically. How does
Speaker 1: that work? I think they just squeeze it real tightened.
Speaker 1: It's really long, pencil like really, Now, how do they
Speaker 1: get the kidney out. I don't know. I have no idea.
Speaker 1: That's the one thing that Flum makes me and I
Speaker 1: almost like Google to see if I could find, you know,
Speaker 1: a surgery. I could watch laparoscopic kidney removal, because laparoscopic
Speaker 1: means it's like a very small incision using very very
Speaker 1: thin like cameras and very thin tools. But then how
Speaker 1: do you get the kidney out if it's fist size?
Speaker 1: I don't know. I mean this is larger than a
Speaker 1: laparoscopic you know in decision, Yeah, this is a window
Speaker 1: maker right here? Uh and here to me is the
Speaker 1: fact of the show. I never knew this. They don't
Speaker 1: take out your bad kidney. Did not know that. They
Speaker 1: just leave it in there. I guess they did the
Speaker 1: research and found out that they didn't need to and
Speaker 1: that doesn't do any harm and maybe me more dangerous
Speaker 1: to take it out, you can see that than to
Speaker 1: leave it in. But you end up if you have
Speaker 1: a kidney with three kidneys. Yeah, so I don't I mean,
Speaker 1: surely they detach those kidneys, yeah, because you got to
Speaker 1: attach the other right, Yeah, I guess so, so that's
Speaker 1: what they do. The surgery is to they take it out.
Speaker 1: Of you. And at that point you're like, okay, I'm done.
Speaker 1: It's all recovery for me. But they have to put
Speaker 1: it in the other person. And like you said, they
Speaker 1: leave the other kidneys. They attached the one to the
Speaker 1: blood vessels so that it's you know, getting the blood
Speaker 1: supply to filter, and then also they attach it to
Speaker 1: your reader, um, so that it can transport waste to
Speaker 1: your bladder. And I supposedly it's actually a pretty effective
Speaker 1: surgery and with minimal um uh negative outcomes. Yeah. Recovery
Speaker 1: time for the donors, a couple of days in the hospital,
Speaker 1: one to two weeks at home, six to eight weeks total,
Speaker 1: and then you've got to come in at six, twelve
Speaker 1: and twenty four months for checkups. Um. Like uh, we said,
Speaker 1: you lose twenty five to thirty five of your kidney function,
Speaker 1: but that's not fifties, so your one kidney must like
Speaker 1: ramp it up. Um. And then you said, pretty good
Speaker 1: outcomes there. I think this is between two thousand and
Speaker 1: six and two thousand eight of the seventeen thousand. Oh,
Speaker 1: there's your number right there. If the numbers hold, that
Speaker 1: would be seventeen thousand over three years, So about five,
Speaker 1: five thousand and change year at least back then unless
Speaker 1: there's been a rush. Um. Only twelve donor deaths out
Speaker 1: of the seventeen thousand, four hundred and two, and only
Speaker 1: one of those was from the surgery from like hemorrhaging, hemorrhaging, hemorrhagering.
Speaker 1: It's close him, hemoraging, hemorrhaging. God, that sounds weird. Hemorrhaging, hemorrhaging. Yeah, okay,
Speaker 1: it was purposely weird during surgery. Yeah, bleeding too much
Speaker 1: and don't forget to complete the sentence. That was very
Speaker 1: porky pick of me. So um, yeah, that's a pretty
Speaker 1: good trek record. Twelve deaths out of four hundred and
Speaker 1: two transplants. Um. They also studied people for long term
Speaker 1: effects and found that somebody who had donated kidney had
Speaker 1: about the same um chance of suffering and stage renal
Speaker 1: failure as the general population, so it didn't increase their
Speaker 1: chances one bit. And I was like, okay, alright, Internet,
Speaker 1: let me go a few more pages deep, like where's
Speaker 1: where's the where's the real talk about the long term
Speaker 1: consequences of donating a kidney? And from what I can see,
Speaker 1: study after study is shows like there's really not any
Speaker 1: long term effects. Um that after about six or eight
Speaker 1: weeks of recovery, you can go back to a normal life.
Speaker 1: During that time, you're gonna feel very fatigued. Your function
Speaker 1: is going to be decreased. But if you say I'm
Speaker 1: donating my kidney, I'm just gonna take two months off
Speaker 1: basically um of life, you know, like stressful life. Um,
Speaker 1: that's really not too bad considering that you basically go
Speaker 1: back to normal life after two months and your kidney,
Speaker 1: the one kidney you have, is still doing of the
Speaker 1: original function. Yeah, like if you work from home, you
Speaker 1: have no excuse exactly. Uh, Dave did put in here,
Speaker 1: And I looked into this a little more that a
Speaker 1: drawback might be, Um, it might affect your life insurance
Speaker 1: or disqualify you or increase your rates. So I poked
Speaker 1: around that because that sounded like a horrible thing. Uh,
Speaker 1: And it wouldn't have surprised me. But it looks like
Speaker 1: there are a lot of protections in place from the
Speaker 1: Affordable Care Act for stuff like this. Thankfully, And if
Speaker 1: you have never had insurance, you have your kidney removed
Speaker 1: and you go to get life insurance for the first time,
Speaker 1: then you may not be able to get it as easily.
Speaker 1: But you know, you're not booted from your life insurance
Speaker 1: policy because you donated a kidney, or your rates aren't
Speaker 1: gonna skyrocket because you donated a kidney. It's against the law.
Speaker 1: It should be. Yeah, So, um, there's a risk of rejection,
Speaker 1: Like that's something you have to go into it knowing,
Speaker 1: like you might donate your kidney and it just might
Speaker 1: not work, probably just by all the tests, despite all
Speaker 1: of the um the care given into matching you and
Speaker 1: your kidney with a recipient, it still might get rejected.
Speaker 1: But they have developed um a lot of different drugs
Speaker 1: to cut down on the chance of rejection. Right. Yeah,
Speaker 1: they're called anti rejection drugs or immunosuppressants, And there are
Speaker 1: a couple kinds. There's one that they that are super
Speaker 1: powerful that they give you at the time of the
Speaker 1: transplant called induction agents, and then you've got maintenance agents. Uh.
Speaker 1: And there were basically four different kinds of maintenance agents.
Speaker 1: And the way this one website I saw put it,
Speaker 1: I think it was a kidney dot org or whatever
Speaker 1: uh was that they said, look at it, it's like
Speaker 1: a mortgage, your down payment is the induction agent like
Speaker 1: the heavy duty drugs they give you when they do
Speaker 1: the transplant, and the maintenance agents are like your monthly payment,
Speaker 1: and the bigger the down payment, the lower the monthly
Speaker 1: So if you if the induction agents are really really
Speaker 1: work well, then you're not going to be on as
Speaker 1: many long term medications for maintenance. And I didn't really
Speaker 1: recognize any of the drugs except for pregnisone, the steroid. Yeah,
Speaker 1: I didn't either. I saw the most common combination of
Speaker 1: drugs is three things, one called tachra limits which is
Speaker 1: a calcine calcinevrin inhibitor, one called mico finilate mo fatil
Speaker 1: which is an anti proliferate, and then pregn his own.
Speaker 1: And I saw that you're generally on these for life,
Speaker 1: but they can, you know, scale down. I don't know
Speaker 1: if you're ever off of them completely. But um, yeah,
Speaker 1: I think of kidney recipients experienced some sort of rejection,
Speaker 1: so those But it doesn't necessarily it doesn't mean that
Speaker 1: like that's it didn't work. I don't think the square
Speaker 1: one necessarily. Yeah. I think like in a lot of
Speaker 1: those cases, you can keep that kidney if the drugs
Speaker 1: are working. So um the the entire thing, this entire thing.
Speaker 1: But whether it's a dead donor, a deceased donor, sorry,
Speaker 1: keep calling it dead donor, I know it's not quite right,
Speaker 1: even though it's accurate, um or living donors of kidneys.
Speaker 1: All of this is based on altruism. The entire organ
Speaker 1: procurement organ donation system everywhere in the world save for
Speaker 1: one country, is based on the kindness of of in
Speaker 1: generosity of donors who do it for no money whatsoever,
Speaker 1: just out of the goodness of their hearty. And that's
Speaker 1: the way that a lot of people think it should be.
Speaker 1: That's the way that it's um. It's enshrined in law,
Speaker 1: that that's the way that it has to be. In
Speaker 1: the United States, there's an UH law called the National
Speaker 1: Organ Transplant Act of nine four UM that says you
Speaker 1: cannot gain financially um or I can't remember exactly how
Speaker 1: they put it, but you can't make any kind of
Speaker 1: like gain from from donating your organ. And I was like, well,
Speaker 1: where did that law come from? What prompted that? Well,
Speaker 1: probably the black market for organs. H It turned out
Speaker 1: there was there was a guy. So that was the
Speaker 1: Act N two there was a doctor in Virginia named H.
Speaker 1: Barry Jacobs who announced that he was setting up a
Speaker 1: market for organs. He was going to create a brokerage
Speaker 1: for organs. There's no federal law. Again, that's exactly right,
Speaker 1: and so they went and made a federal law against
Speaker 1: it because they're like, that is objectively unethical and immoral,
Speaker 1: and that's kind of the basis for organ donation in
Speaker 1: this country, and again every country in the world except
Speaker 1: for Iran, that it's unethical to make money selling organs
Speaker 1: or to pay someone for the organs, because they're worried
Speaker 1: that it sets off a whole cascade of problems. Yeah,
Speaker 1: I think they try and make it cost neutral for
Speaker 1: the donor, which means your expenses are covered, like you're
Speaker 1: not gonna be paying like the recipient's insurance is going
Speaker 1: to be paying for all the operations and surgeries and
Speaker 1: all that stuff. And then there are uh, you know,
Speaker 1: private nonprofits that can also help cover like travel and
Speaker 1: if you're a low income donor, help pay for stuff
Speaker 1: like that, but you're still not getting like paid to
Speaker 1: do it. And the idea there is ethically is that um,
Speaker 1: you know, the dystopian science fiction plot, which is there's
Speaker 1: a class of wealthy people who harvest the poor on
Speaker 1: organ farms. And you know, it's like something out of
Speaker 1: a movie, but it's also something that could very well
Speaker 1: happen if you let that kind of thing, you know,
Speaker 1: take place, uh, you know, black market human trafficking again
Speaker 1: like you mentioned. And then another one I didn't think of,
Speaker 1: is that, um the motivation for someone doing it if
Speaker 1: you're getting paid like you may not, you may fudge
Speaker 1: a little bit on your questionnaires, like fake something to
Speaker 1: make money to get an organ taken out of your body.
Speaker 1: It's almost like they've identified it as such a valuable
Speaker 1: thing that you can't you can't assign any kind of
Speaker 1: monetary value to it. You you can't allow that to
Speaker 1: happen or else nothing but bad things are going to happen.
Speaker 1: And there's actually polls that support this, although some people
Speaker 1: say that's stupid, we should we No matter how how
Speaker 1: many um generous people are donating organs, the demand is
Speaker 1: still not there. I mean, you said it yourself. Like
Speaker 1: five thousand people die on organ transplant waiting lists every
Speaker 1: year in the United States alone. That's just in the
Speaker 1: U S alone. People die all over the world on
Speaker 1: organ transplant lists every year, and so people say that's stupid.
Speaker 1: If people are willing to sell like their kidney in particular, UM,
Speaker 1: let them do it. It's a free world, it's a
Speaker 1: free country at least. So what's the problem. Yeah, I mean,
Speaker 1: I think the idea. I'm not libbying for this, but
Speaker 1: they have floated things like a like a fifty dollar
Speaker 1: tax rebate that you can absorb over like a decade,
Speaker 1: or wipe out your student loans or something like that,
Speaker 1: Like they're not literally just cutting you a check. Things
Speaker 1: like that are interesting because, um, donating a kidney saves
Speaker 1: taxpayers close to a hundred and fifty thousand dollars in
Speaker 1: medical costs paid out by Medicare for dialysis and things
Speaker 1: like at and there was another analysis that found that
Speaker 1: paying donors forty dollars for kidney would result in a
Speaker 1: net gain of forty six billion dollars in lowered medical
Speaker 1: costs and better health overall health and outcomes. So like,
Speaker 1: something like that is interesting, not just like harvesting organs
Speaker 1: for cash, but if people want to take a big
Speaker 1: fat tax rebate over a decade, it leads to less
Speaker 1: taxpayer payouts for Medicaid and UH or for Medicare better
Speaker 1: health outcomes. I don't know some we're thinking about. Yeah,
Speaker 1: and other people would say this, that's already going on.
Speaker 1: There's a very healthy black market for organs all around
Speaker 1: the world. I saw an estimate on some human trafficking
Speaker 1: website that was something like ten thousand kidneys a year
Speaker 1: are procured and transplanted on the black market. But then, Chuck,
Speaker 1: ultimately you have there is one country, Iran it allows
Speaker 1: payment for organs. Its something like and then also like,
Speaker 1: you're right, it's a pretty in substantial amount if you're
Speaker 1: selling a kidney compared to say, like the forty five
Speaker 1: grand the US is considering, or I shouldn't say the
Speaker 1: US is considering people Americans have come up within a study,
Speaker 1: but um, the there is the one stat that stood
Speaker 1: out to me that I think kind of suggests, you know,
Speaker 1: not applying money to organ procareman, is that of a
Speaker 1: two thousand one study of three hundred Iranian paid organ
Speaker 1: donors said that if they could go back, they would
Speaker 1: not have sold their kidney. There you have it. Pretty
Speaker 1: much anything else about kidney transplants and donations and all that. Well, again,
Speaker 1: if you want to uh donate your organs uh and
Speaker 1: you aren't going to the d m V anytime soon.
Speaker 1: Go to register me dot org. Uh. And since I
Speaker 1: said register me dot org, it's time for a listener mail.
Speaker 1: I'm gonna call this dB Cooper follow up. Oh wow, no,
Speaker 1: pretty interesting And this is from Holly. Hey, guys, Holly
Speaker 1: from Texas here. I've been listening about six months and
Speaker 1: I'm obsessed. Turned to the Facebook groups to suggest some
Speaker 1: fan favorite episodes, and dB Cooper the live episode was
Speaker 1: mentioned a lot, and it reminded me of a story
Speaker 1: you might enjoy several years ago, as it a small
Speaker 1: family gathering at my grandparents and we were sitting around
Speaker 1: chatting about different topics of memories, and my grandma casually says, Oh,
Speaker 1: that's just like the time when the FBI tapped our
Speaker 1: phones because they thought Grandpa was TP Cooper WHOA. I
Speaker 1: of course did a dramatic double take, slam both of
Speaker 1: my hands on the table and exclaimed what I mean.
Speaker 1: I was floored. At the time, I was in l
Speaker 1: a thirties and never heard this story in my whole life.
Speaker 1: That's the thing with grandparents, You hear this stuff like
Speaker 1: how did I not know that I know? Um, I
Speaker 1: of course had to dramatically turn to my grandpa with
Speaker 1: narrowed eyes and say, who are you. My grandma was
Speaker 1: very nonchal line about the whole thing, and I was like, wait, wait, wait,
Speaker 1: explain please. She didn't have much more info, but I
Speaker 1: guess my grandpa was cleared obviously. Uh. And it's still
Speaker 1: a mystery why they suspected my grandpa, mainly considering the
Speaker 1: fact that they lived in New Mexico at the time.
Speaker 1: We sadly lost my grandma in July, but I'm happy
Speaker 1: to report that my grandpa is still doing well. Even
Speaker 1: though I could never picture my cowboy boot levin heavily
Speaker 1: starched wrangler gene wearing Grandpa and a skinny tie from J. C. Penny,
Speaker 1: although he does enjoy his daily bourbon. And that's a clue.
Speaker 1: Maybe that was it. So that's from Holly, And that's
Speaker 1: a great email. Holly as one of the all time greats. Holly.
Speaker 1: I love that she's like. Also, my grandpa pays for
Speaker 1: everything from a bag of money that he keeps the
Speaker 1: ship out back. Yeah, we always got unmarked dollar bills
Speaker 1: for birthdays. If you want to be like Holly, and
Speaker 1: tell us one of the great family stories that you
Speaker 1: heard from your grandparents about. We want to hear those two.
Speaker 1: You can send them to us at stuff Podcasts at
Speaker 1: i heart radio dot com. Stuff you Should Know is
Speaker 1: a production of I heart Radio. For more podcasts my
Speaker 1: heart Radio, visit the i heart Radio app, Apple Podcasts,
Speaker 1: or wherever you listen to your favorite shows. H