About 90K Americans on kidney transplant waiting list

AUSTIN, Texas - According to the U.S. Health Resources and Services Administration, about 90,000 Americans are on the waiting list for a kidney transplant. 

The average wait time is about 3 to 5 years for a kidney from a deceased donor, but it can be much longer, and that's where living kidney donors can really make a difference. New research shows it is safer than ever to become one. 

Dr. James Lim, a surgical transplant program director at St. David's North Austin Medical Center, joined FOX 7 Austin's Rebecca Thomas to discuss.

Rebecca Thomas: Dr. Lim According to a recent study published in the Journal of the American Medical Association, or Jama, the risk of death for people who donate a kidney has dropped by more than half in the last decade. Talk a little bit about the study itself. What were researchers looking at?

Dr. Lim: Well, they were looking for the last 30 years, since 1993, each period of ten years, and comparing how safe living donation is. I think we have to remember that prior to 1995, all the living donors were done what we call open method. And we'll talk a little bit about later what we're doing as of today and further for the past almost 30 years. But the mortality rate, but the rate of dying or the odds of dying have decreased to the point where now we're looking at a little less than one case per 10,000 that would have mortality for the last ten years. And that's really remarkable. And I think that's a testimony to all the physicians and surgeons who have been able to do these surgeries for so long and so well that we've been able to kind of piggyback off of them.

Rebecca Thomas: Yeah. So being a living donor was relatively safe to begin with. What advancements have been made to make it so safe now? 

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Dr. Lim: I think part of it is just the fact that we're doing more. It's much more widespread. I think like anything else, the more you do, the better you get at it. The other is the technology. It's interesting, when I was trying to find the history of laparoscopic surgery, it was amazing to see that it wasn't all that long ago that this was put on as far as doing something through what's called minimally invasive versus the open method procedure. And now fast-forward to the last three years with really advancements in technology, with some instruments which are amazing. The camera that we use now to place inside a patient to take a good look inside for a laptop procedures. And if I have my pen. Yeah. So here's my pen. It's actually maybe a little bit wider than my pen. The instruments that we use to dissect the kidney out are a little wider than that. But really, the rate limiting step is typically how big the kidney is and sometimes how big the donor or the donor surgeon's hands are. So we can make our decisions about six, six, half centimeters big. And considering in the past what we used to do for these what we call open donors, that's quite a remarkable feat. 

Rebecca Thomas: Talk about the screening process to become a living donor. How extensive is it to make sure it is unlikely they'll have any problems down the road?

Dr. Lim: Right. So when we see our potential donors, I tell them at the end of the day, what we want to know is, do we think that years down the road you'll be okay with one kidney? That's really what it comes down to. So the workup may seem extensive as far as blood work that we have to do, urine studies and scans and so forth. But actually, it doesn't take a whole lot of time because by definition, living donors have to be healthy. And if they're not, they get screened out pretty quickly. So when we were first doing living donors many, many years ago, we're talking back to the 50s when we first met our first successful living donor transplant. Our criteria for what could be a donor were much more strict because we didn't know what were or were not good factors to have from a donors point of view. Now, we know that we've been we've got time behind this to see that we've been pretty good about the parameters and the characteristics that we look at.

Rebecca Thomas: Dr. James Lim with St. David's North Austin Medical Center. Thank you so much for sharing your time and your expertise with us tonight.