Kidney Donation: You Could Be A Saint!

it's going. Yeah, we're we're in person again, by the way. Yeah, we should just tell everyone that I'm making a fool of myself right in front of you for a change. It's nice to see in person. Um. And I should also point out them that this is a double Dave Day because he did the last one too. Inflation right, interest rates? Yeah, I forgot what we talked about. I've already forgotten all of it. So Dave did some digging for us UM and came up with some pretty surprising

stats that I certainly had no idea about. With kidney disease in particular, but something like, of all American adults have some form of chronic kidney disease. Thirty seven million people right now, thirty seven million and ninety thousand Americans are on the list waiting for a kidney transplant. And each year, this is very sad, about five thousand Americans die while waiting and another three thousand more become too

sick to get that transplant. So basically, eight thousand ish people are either dying or on their way to dying because they don't have a kidney that they can get right. And then with you know, thirty seven million adults, just the adults alone with some form of chronic kid of diseases, their disease progresses, uh, they end up on the list, the transplant list. So um, what we'll talk about in

this second. What's what's really interesting about kidneys, and in particular kidney donations is it's one of a very select few organs that you could donate while you're alive and then whistle off back to your normal life. Down one kidney. Yeah, you can't donate your heart to somebody. It's very sweet gesture,

but you've got two kidneys, you only need one. I think the number the percentages if you donate a kidney which is interesting because the one kidney you have must ramp up production because your kidney function only goes down what was it fifteen or something like that, Yeah, something nothing, maybe, Yeah, it's not right, and that's definitely doable. Like you can go through life with one kidney performing of your previous function.

That's right, that's not bad. And we should probably just kind of point out some of the amazing things the kidneys do. There are these two fist size organs or one um depending on whether you've donated or not. That's right, back to the show. Just just under your rib cage, on either side of your spine. So have your loved one make a fist with each and come up behind you, put their fist under your rib cage gently. Yeah, just on either side of your spine, and there's your kidneys,

right uh. And kidneys do a lot of things. The main you know, like sort of the money job that the kidneys do is they act as the filter system for your for your blood. And that's the big thing. They filter about two arts fluids every day. And that's not just blood, that's blood and waste fluid. That's so much. That's a lot a lot. Kidneys are always working. And within the kidneys there are about one to one and a half a mill allion tiny little filters inside the

kidney called nephrons. If you just think Nora ephron or nefert d or nefert d uh, And those nephrons are what's doing the actual filtering. They're just tiny little filters. Uh. They also what else they do? They also release a hormone called uh erythra poton e p O. It regulates

production of red blood cells and bone marrow. Very big deal. Yeah. Um. They also convert vitamin D from a non usable form from like the sun, into a usable form, which is pretty important because vitamin D helps you retain and absorbed calcium and phosphorus for building bones, reduces inflammation, possibly combats tumor growth. Um. And all this is coming from your kidneys doing its thing. And then one other thing we kind of skipped over a little bit, I think is

worth pointing. Out of those two hundred quarts of fluid every day, two courts of it, I think you said, is waste. You pee it out, It gets converted into your and sent to the bladder and you pee it out and finally chuck. Finally, the eight eight ounce classes of water a day makes sense. It's not arbitrary anymore. You never realized that, No, I never understood. I thought

it was actually made up an arbitrary number. That sixty four ounces because that's how much you pee out on a normal day, because that's how much your kidneys filter out. Is waste, so you gotta replenish it. Yeah, this is funny that. Well, I'm this day's old when I finally realized, Uh, what else? They also release a hormone called rennan regulate your blood pressure, and we'll see blood pressure and kidneys have a lot to do with one another. Yep. And

what else anything? You know what? I bet you there's other things that kidney does it. It It just didn't like to take credit for her. So. Um. One of the problems with your kidneys is that they can break down. They're susceptible to all sorts of other stuff going on in your body. Um. And one of the big things that put stress on your kidneys, well, two of the big things that put stress on your kidneys is such chuck colon. You've got blood pressure, high blood pressure, which

exerts pressure on the walls of your blood vessels. Which in turn exerts pressure on your kidneys, damaging their function. And the big one, the big daddy of what causes kidney chronic kidney disease is diabetes. That's right, that's the number one. High blood pressure is number two. And uh, you know, basically high blood sugar is going to damage the blood vessels in the kidney. It's gonna kill those nephrons that we were talking about. Those are the filters

that actually do the filtering. And chronic c DK chronic kidney sorry c KD, chronic kidney disease. Uh. They call it the silent disease because you can be in you can be through the first few stages of chronic kidney disease and not feel any symptoms at all and not know what's going on. So it's very dangerous. There are five total, and stages one through four your kidneys are

still doing their thing, they're struggling. But stage five is when you're in in stage renal disease or renal failure, and that's when you your kidneys maybe aren't working at all and you're going to dialysis every day and you need a new kidney. Yes, um, And we'll talk a little more about dialysis. But yes, once you hit stage five, you're like, you, your kidneys just aren't doing the work anymore. And you know it's not like they're just stop functioning

little by little, they're unable to filter out waste. So the waste starts to accumulate and build up and you have all sorts of terrible symptoms like nausea, UM, fatigue, vomiting. You feel poisoned, is what I've heard. Yeah, I think that's basically what's going on. And your body is being poisoned because it's no longer able to filter it out. So UM. There's a lot of racial disparities too as far as kid new diseases go, and apparently it tracks

very closely to UM uh diabetes. UM. Apparently, if you're a Black American, you are four times more likely to have kidney failure UM than a white American, Hispanic Americans one point three times, in Native Americans one point two times, and again like that's those same rates are pretty close to the disparity in diabetes. But also it has to do with things like access to healthcare, access to certain kinds of food that may not lead to diabetes or will lead to diabetes. Um, there's a lot of stuff

kind of caught up into it that. Um, it's not entirely straightforward that everybody has an equal opportunity to develop kidney disease. Yeah, it's just I mean, it's really sad that it it. You know, it seems like everything comes down to money and access to money. And if you live in the United States and you are somewhere on the poverty spectrum, then you're more likely to not have healthcare, not go to the doctor, eat worse food, get diabetes,

have kidneys fail. It's all sort of in lockstep with one another. And then it gets even more insidious than that because once you get the stage five you might not have reliable transportation to go to dialysis, and dialysis is extremely time consuming. It is, so it's going to be hard for you to keep doing a job. Yeah, my neighbor before they moved and sadly he passed away, Miss Jesse and Mr Otis he had his Uh, he had the ambulance come or you know, it looks like

an ambulance, but it's not an emergency one. It's just the transpo. They picked him up every day, took him to dialysis. Brought him home and this was for the last couple of years of his life, you know, going every single day, and it's good. Dude. I wish I would have gotten to him a little bit better before he passed. But um so dialysis is short for hemo dialysis, and it is literally just a machine that does the

filtering that your kidneys do. So you sit there for or what is it like four hours, usually about three times a week. Yeah, three times a week, four hour sessions, and they just clean your blood in full with each session. Yeah, there's like a little membrane that um doesn't let the important stuff like red blood cells get through, but it does let those waste products get through and they just get slashed out, whereas the blood that doesn't go through

the membrane gets put back into your body. Yeah, and you're on dalysis for life until unless you can get a new kidney, and then even if you do get a new kidney, you might be on dalysis for a little while, as we'll see. Yeah, So, Chuck, I feel like this is a good time to take a break. Just off the top of my head, let's do it, Okay, So we're gonna take a break and we'll be right

back everybody. Okay. So it's not fun to have kidney failure, especially stage five kidney failure, because you're going to dialysis a lot um and there's a lot of terrible symptoms involved in it. Um. If you are at that point, you're going to be put on UM an organ donation list. You're going to become a m a recipient or potential

recipient of a donated kidney. That's right, and that means you have signed up with UH, the Organ Procurement and Transplantation Network, which is managed by a nonprofit called the United Network for organ sharing a lot worse places. You can donate your money too, by the way, and it's UH. You know, Day points out astutely that it's not like a waiting list, as in, you know, there's ninety thousand

people or more away eating for a kidney. So if you sign up for one, then you have eighty nine people in front of you, and it just very slowly, you know, that time ticks away. It's a network, it is, it's a pool of candidates. And because you have to get matched with a kidney, and there are all these criteria, one of which is blood type UM don't have to

have necessarily exact blood type. I think if you have like A, you can get a b uh So, there's a little bit across over there and oh is universal right? How is it? Oh negative? We did a thing on blood it was. It was a good one. We did a live one, that's right. Remember my father in law spoke up when I did a blood test. He said, Josh is pregnant. That's right. He got more last than all of mine combined that night. I remember that that was a very like one of the only funny audience

jokes that we've ever had. It really was was yelled out, it's high quality. Heckline. That was like, that's for the Atlanta Science vessel Um. Where was that? That just totally through me that I'm trying to picture your break it now we'll get a load of me, buddy. Uh So, Yeah, blood type is one the size of the organ. It's got to be a good fit. So like a little kid can't get a big adult kidney. You wouldn't think

about that, but it is true. And I mean it's not just true with kidneys, with any oregan like I saw it, put like a basketball players a long mon't fit in a child. Right, It's like sure, yeah, those are wise words. Good point. Uh. And then geography is one because as you'll see, if you get a kidney donated from someone that you don't know, it's not like a family member, then that kidney is going to be

on ice basically for a little while. That's gonna be transported maybe or maybe you're transported, but there's gonna be a little bit of time. Uh. They don't just like you know, put you on the table like in the movies that put you on the table next to your brother, and they would just like slide one kidney right in, you know, just across the room to the other. Right. So, uh so geography is a consideration. So within this network, you know, there's a big garrhythm that's going to match

blood types and all these things. And like, hey, you live in Birmingham. We got a kidney in Tuscaloosa, So you guys are pretty good match. Yeah. And so with each new organ that comes up for UM donation, uh, you get a new a new score calculated by the computer. Like it's not like you get your score as signed. It's all contextual based on your relation to that organ.

That's that's being considered, that's being donated. Yeah, and also we should point out that it's also based on your need, like if you're you know, how urgent it is in a lot of cases. Yeah, it's also based though on on some other stuff too, which is, you know, kind of calculating. But it makes sense. Um, your age, the younger you are, the higher your score, which makes it likelier for you to get that um, the likelihood that you will survive the procedure, the likelihood that you will

um reject the organ or not. Sensitization, I think is what they call it. There's a bunch of different factors. And this is fairly recent, this pool um um method. Uh, and I it's kind of revolutionized things and apparently made it a lot better a lot um it's from what

I understand, it's a lot more sensible and fair. Yeah, and it also makes sense, like once you see the numbers, like every kidney is super important, and so they want to give them to people where you have the best chance for that kidney to work over you know, for ten to fifteen twenty years. Yeah. I can't waste no kidney left behind. No, Oh man, can you imagine if they were just like, oh, we left it on the plane, just forget about it. You're like, I just donated that

kidney for nothing, Right, it's in the trash. Now there's a story out there, and I kind of want to hear it. See. I pictured more like Cheech and Chong. We're piloting the plane and they're like, what's in the cooler man? And all of a sudden it's a movie they're looking for like some some ah good marijuana. That reminds me of Snoop Dogg as the pilot. Sole Plaine. I never saw that was like, you know, it wasn't at all at all. Yeah. It looked like a sort

of homage to the sort of bad seventies comedies. You know. It was where there was no It was like, hey, here's an idea. Let's get a bunch of like funny people and get them really high or drunk, and there's your movie. That that was exactly what is an airport? Right? That's the that's the twist, all right, I'm not going to see it twist. Yeah, no, there's no reason to. I demand that you not see it. Actually, how are you gonna sign up to be an organ donor? What

are the couple of good ways you can do that. Well. One way is whenever you go get your license renewed at the old d m V in the United States, uh or the d m V in France. Um, they're gonna ask you if you want to be an organ donor and and you can say yes, and they will

put it on your license, yes organ donor. So that if you you know, by the farm out and about, and you've got your driver's license on you, the doctors and the people at the hospital are going to look at your I D. And if they see yes, they're going to go to your family and say, your your loved one here, um who's now regretfully deceased, said that they want to donate their organs or will you sign off on this? It seems to have been their wishes.

And you can still say no if you're a family member, but um, probably you're going to say yes, especially if you're deceased loved one said Hey, I marked yes my that I want to donate organs on my driver's license. If I die, make sure my organs get donated. They're probably gonna go along with it. Yeah, I think it's kind of funny that I wonder what percentage of people that sign up at the d m V for organ donation and the kid needs that actually go to other

people and organs that successfully save lives. How many of those start with the two words why not? Yet you're at the d m V, you're bored out of your mind, you've been there for far too long, and they ask you this question, you go, yes, why not? Yeah, that is the most interesting question you've been asked in that whole experience, Like, maybe the biggest question you can answer in your life is whether or not you will donate your kidneys and your organs to save a human life.

And people probably just go, yeah, why not. So if you've been to the d m V and you said no, and you okay, But if you said no you wanted to your you can still go in register right, Yeah, You've got to register me m E dot org and you can register there. Uh, and here's the deal in one, here's some more stats for you. There were forty thousand total organ transplants. I think most of those are I

think was it like or kidney transplants? Far and away the most are kidney transplants, and only six hundred of those forty five. Uh, came from living donors, which was I have a relative or I'm just a benevolent human who wants to give a kidney to anonymously to somebody. I mean, yeah, talk about st hood. Uh So two

thirds of all kidney transplants are from deceased donors. So, like you said, it's a lot of times it's accidents, car and motorcycle accidents where there's like traumatic head injury, uh in the but the organs are still in pretty good shape. You're young, you're in good shape, and so um, you know, you may be brain dead, and they can the word harvests always sounds so cruel, but they can, they can harvest borrow your organs. No, it's hardly, it's

definitely harvest. Remember in our our book of that chapter in Jack Kevorkian he had that that idea in the I think sixties or seventies where he was like, well, we're going to execute people, let's just execute them through

organ harvesting. You know, we' started to perform surgery on him and we harvest their organs and then once we're done, they're just they're dead, right, Yeah, then we're joining their organs and everybody's like, it's a really great idea, but you're creepy, dude, and I think you're the last person who should be espousing this kind of stuff. Well, maybe he shouldn't have expressed this idea while imitating Verner Hertzog, right,

and where are your pants? That's right? Uh? So that means at the end of the day, one human body can save uh up to Nold does a pretty good Verna herd so he's yeah, but the best ever is Paula Tompkins his Verner fantast Just look it up on the internet. It's great, one single human body an organ donor can save up to eight lives. Uh. And that is just with the organs. And then you've got tissue donation. You've got eyes that can bring sight to someone. We

should totally do one on Ie the transplants. Yeah, might also show you the killer of the person whose eyes you got, in which case you're morally responsible for chasing that killer down and turning them into bringing the justice or exacting revenge. If it's a really good movie, a bridget Fon type movie, was that then the actual plot of one? Or was it was that just a typical movie plot? I don't remember who was in it though,

Jennifer eight, I don't know. No No, Jennifer eight was a blind woman, a sightless woman who was going to be the eighth victim of a serial color who's targeting blind women. And I could spoil it for everybody. I'm not going to. It's actually we're seeing it's a good Nighties movie with Andy Garcia and yeah, I don't remember what was it. Yeah,

it's good, good movie. I think it's out there still, or I'm thinking of the movie, uh where the guy got the hand transplant and the hand was from a serial killer and so he got a bad hand that wanted to do bad things. Jeff Fahey, I think the lawnmower man. But Jeff Ahey was the lawnmower man. Okay, I never saw that one. I mean it might have been called something as basically like bad Hand. Was it called idle Hands? No, that was different, and that was not good. I'll look it up, and well, well how

about this, so folks stick around for the stormail. We'll look it up. In the interim, we'll announce it at the beginning of Finally, year fourteen, we've got a new hook for the show. Or maybe I can just make up an email that fake Jeff Ahey sent in. Remember me, we need to fake Jeff Ahey sound effect like side effect? Uh? Alright, So living donation is something we should talk about. This is, like you said at the beginning, one of the only

organs you can donate, I mean, is it the only one? No, you can also donate his portion of your uterus and a portion of your liver, okay portions, yes, But other than that, that's it. Right. So I got a little bit of history here. Um, if you're talking kidney transplants, you gotta go back to nineteen o two was when they did a dog kidney transplant in Austria. The dog did not make it, of course, but the it did produce urine for a couple of days. The kidney man

not bad, I know. And that really just kind of takes you back to some nineteen o two really unseatily black and white view of like some terrible experiment. Yeah, um, let me see. In nineteen o nine, apparently there were efforts to transplant kidneys from humans dead humans to monkeys as you do. Thirty nine, the first deceased human donor I think was performed in Russia. But the organ it didn't take. Organ never worked, but they tried it. In

thirty nine, they tried their best. From human to human. Uh. Fifty three, you finally had your first successful temporary human kidney trans in Paris. It was twins, right, Uh sixteen, your boy received one from his mother as a living donor. And then fifty four I think was the twins. It was the first long term successful kidney transplant by Joseph Murray. He won a Nobel Prize for that, sure. And then sixty two is the first non related no genetics involved whatsoever.

So it's only been since the nineteen fifties nineteen sixties that we've been able to successfully transplant kidneys. But once we got it, we got it pretty good. Yeah, we have it down path. Let's do this a lot, guys. This is fun. So um. If you are a living donor and you do donate your kidney, I think it makes out about a quarter of kidney donations today, right, Yeah, is a living donor somebody saying, take my kidney, put it in somebody else. More often than not, it's put

it in my brother, put it in my spouse. Three quarters of the time it's you're related. Um, but there's that still means that of all kidney donations, So that means, however, many thousand kidney donations are are donated by people who are just saying like, here, take my kidney and give it to whoever needs it. That's right. And sometimes that it's anonymously. Sometimes it's a friend, sometimes it's a spouse.

Sometimes you hear about someone in your community. But yeah, sometimes it's you don't even know anybody, and you're just like, you know what, I'm gonna save a life. Yeah, I'm at the d m V right, I don't want to save a life. Yeah, I'm gonna do it. So if you do do that, you're a living donor UM. And there's a lot of advantages to a living donation compared to a dead deceased donation donation. You know, an organ

taken from somebody who's died, right, UM. So if you donate your kidney, UM, there's like the chances of the kidney being rejected are lower compared to a deceased donor UM. The the kidney will probably start functioning independently, like on its own UM much more quickly than a deceased donor one because the deceased donor one is going to be um basically put on ice for a little while while

it's transported kept you know kind of you know, yes, exactly. Um. There's also, um, a difference in the amount of time that the average kidney lasts between a deceased donor and a living donor. Right. Yeah, Well you tend to live longer and your kidney last between fifteen and twenty years on average from a living donor. Uh, It's only about a decade from a deceased owner. And you also have a better chance if you are genetically related of avoiding rejection.

So living genetically related living donor is like the crime dela crime of getting a kidney, right exactly. Um. There's also more convenient to um if you are a living donor. You can say, let's do this like a week from Tuesday. That works best for me, not this guy just died. We need to we need to get this into a recipient like as soon as possible. Um it, let's find somebody kind of thing, you know what I mean? Um,

So that that's that's another big advantage too. So I think we've established here living kidney donations are the way to go if you can do it from a relatively So let's take a break, because, um, there's actually ways to maximize how kidneys get donated, chuck, and we're gonna tell everybody about it after this. Let's do it alright. So on the kidney exchange, it's pretty cool how they've

worked this out over the years. Uh. There's something called paired exchanges, and it goes a little something like this. You want to donate a kidney to your relative, to your to your niece, but you don't have the right blood type. You can get paired up with someone who does have the right blood type who needs your kidney. They'll be like, wait a minute, my niece needs a kidney. You've got her blood type and I've got your nieces blood type. So let's just get together and make this

all work out criss cross paired exchange. But then that is multiplied exponentially by the donor chain, right, yes, So like if if you have a good computer handy to run an algorithm for you, because apparently it's very difficult to do, Um, you can take a bunch of these mismatched pairs rather than four people, you can take I think up to seventy people, and one good Samaritan donor who says, take my kidney, I don't care who gets it can set off a chain of paired matching that

can satisfy up to seventy seventy recipients through the through a combination of one person donating it without any you know, just saying take my kidney, put in somebody, and then a bunch of paired, paired matches all all like seventy people.

So it makes it really difficult to say, like, I don't really want to donate my kidney, when not only are you saving one person's life, you're setting off a chain reaction that allows for seventy different people to get their kidney because you donated yours without without directing it towards anybody in particular. And if that's not the first thing you say on every first date you go to for the rest of your life, right, then you're doing

it wrong. We should mention that the there was a Nobel Prize winning economist named Alvin Roth who who came up with his donor chain idea. And I don't think we said you, um, you have to be eighteen to donate a kidney you have to be in good health and you have like rock and kidneys basically, and also in good health otherwise, Yeah, like a sixteen year old can't donate a kid That's the other reason why a living donor is advantageous because of that luxury of time,

because you can run a battery of tests. Yes, you have time to run tons of tests to make sure they're a perfect match for this other person. That's right. So when you do say okay, I'm gonna do it. And by the way, uh Dave said from researching this, he was inspired to do it. I think he may have put himself on a list or was going to although it may have worn off by now, who knows, we'll have to ask him. But if you do this, um, you are going to undergo surgery. Um. It's just as

simple as that. And it's a serious surgery, like they're removing your kidney. Like I said, we've got it down pat since we've been doing it since the fifties or sixties, and now they can usually do it laparoscopically. How does that work? I think they just squeeze it real tightened. It's really long, pencil like really, Now, how do they get the kidney out. I don't know. I have no idea. That's the one thing that Flum makes me and I almost like Google to see if I could find, you know,

a surgery. I could watch laparoscopic kidney removal, because laparoscopic means it's like a very small incision using very very thin like cameras and very thin tools. But then how do you get the kidney out if it's fist size? I don't know. I mean this is larger than a laparoscopic you know in decision, Yeah, this is a window maker right here? Uh and here to me is the fact of the show. I never knew this. They don't take out your bad kidney. Did not know that. They

just leave it in there. I guess they did the research and found out that they didn't need to and that doesn't do any harm and maybe me more dangerous to take it out, you can see that than to leave it in. But you end up if you have a kidney with three kidneys. Yeah, so I don't I mean, surely they detach those kidneys, yeah, because you got to attach the other right, Yeah, I guess so, so that's what they do. The surgery is to they take it out. Of you. And at that point you're like, okay, I'm done.

It's all recovery for me. But they have to put it in the other person. And like you said, they leave the other kidneys. They attached the one to the blood vessels so that it's you know, getting the blood supply to filter, and then also they attach it to your reader, um, so that it can transport waste to your bladder. And I supposedly it's actually a pretty effective

surgery and with minimal um uh negative outcomes. Yeah. Recovery time for the donors, a couple of days in the hospital, one to two weeks at home, six to eight weeks total, and then you've got to come in at six, twelve and twenty four months for checkups. Um. Like uh, we said, you lose twenty five to thirty five of your kidney function, but that's not fifties, so your one kidney must like ramp it up. Um. And then you said, pretty good outcomes there. I think this is between two thousand and

six and two thousand eight of the seventeen thousand. Oh, there's your number right there. If the numbers hold, that would be seventeen thousand over three years, So about five, five thousand and change year at least back then unless there's been a rush. Um. Only twelve donor deaths out of the seventeen thousand, four hundred and two, and only one of those was from the surgery from like hemorrhaging, hemorrhaging, hemorrhagering.

It's close him, hemoraging, hemorrhaging. God, that sounds weird. Hemorrhaging, hemorrhaging. Yeah, okay, it was purposely weird during surgery. Yeah, bleeding too much and don't forget to complete the sentence. That was very porky pick of me. So um, yeah, that's a pretty good trek record. Twelve deaths out of four hundred and

two transplants. Um. They also studied people for long term effects and found that somebody who had donated kidney had about the same um chance of suffering and stage renal failure as the general population, so it didn't increase their chances one bit. And I was like, okay, alright, Internet, let me go a few more pages deep, like where's where's the where's the real talk about the long term

consequences of donating a kidney? And from what I can see, study after study is shows like there's really not any long term effects. Um that after about six or eight weeks of recovery, you can go back to a normal life. During that time, you're gonna feel very fatigued. Your function is going to be decreased. But if you say I'm donating my kidney, I'm just gonna take two months off

basically um of life, you know, like stressful life. Um, that's really not too bad considering that you basically go back to normal life after two months and your kidney, the one kidney you have, is still doing of the original function. Yeah, like if you work from home, you have no excuse exactly. Uh, Dave did put in here, And I looked into this a little more that a drawback might be, Um, it might affect your life insurance or disqualify you or increase your rates. So I poked

around that because that sounded like a horrible thing. Uh, And it wouldn't have surprised me. But it looks like there are a lot of protections in place from the Affordable Care Act for stuff like this. Thankfully, And if you have never had insurance, you have your kidney removed and you go to get life insurance for the first time, then you may not be able to get it as easily. But you know, you're not booted from your life insurance policy because you donated a kidney, or your rates aren't

gonna skyrocket because you donated a kidney. It's against the law. It should be. Yeah, So, um, there's a risk of rejection, Like that's something you have to go into it knowing, like you might donate your kidney and it just might not work, probably just by all the tests, despite all of the um the care given into matching you and your kidney with a recipient, it still might get rejected. But they have developed um a lot of different drugs

to cut down on the chance of rejection. Right. Yeah, they're called anti rejection drugs or immunosuppressants, And there are a couple kinds. There's one that they that are super powerful that they give you at the time of the transplant called induction agents, and then you've got maintenance agents. Uh. And there were basically four different kinds of maintenance agents.

And the way this one website I saw put it, I think it was a kidney dot org or whatever uh was that they said, look at it, it's like a mortgage, your down payment is the induction agent like the heavy duty drugs they give you when they do the transplant, and the maintenance agents are like your monthly payment, and the bigger the down payment, the lower the monthly So if you if the induction agents are really really work well, then you're not going to be on as

many long term medications for maintenance. And I didn't really recognize any of the drugs except for pregnisone, the steroid. Yeah, I didn't either. I saw the most common combination of drugs is three things, one called tachra limits which is a calcine calcinevrin inhibitor, one called mico finilate mo fatil which is an anti proliferate, and then pregn his own. And I saw that you're generally on these for life, but they can, you know, scale down. I don't know

if you're ever off of them completely. But um, yeah, I think of kidney recipients experienced some sort of rejection, so those But it doesn't necessarily it doesn't mean that like that's it didn't work. I don't think the square one necessarily. Yeah. I think like in a lot of those cases, you can keep that kidney if the drugs are working. So um the the entire thing, this entire thing.

But whether it's a dead donor, a deceased donor, sorry, keep calling it dead donor, I know it's not quite right, even though it's accurate, um or living donors of kidneys. All of this is based on altruism. The entire organ procurement organ donation system everywhere in the world save for one country, is based on the kindness of of in generosity of donors who do it for no money whatsoever, just out of the goodness of their hearty. And that's the way that a lot of people think it should be.

That's the way that it's um. It's enshrined in law, that that's the way that it has to be. In the United States, there's an UH law called the National Organ Transplant Act of nine four UM that says you cannot gain financially um or I can't remember exactly how they put it, but you can't make any kind of like gain from from donating your organ. And I was like, well, where did that law come from? What prompted that? Well, probably the black market for organs. H It turned out

there was there was a guy. So that was the Act N two there was a doctor in Virginia named H. Barry Jacobs who announced that he was setting up a market for organs. He was going to create a brokerage

for organs. There's no federal law. Again, that's exactly right, and so they went and made a federal law against it because they're like, that is objectively unethical and immoral, and that's kind of the basis for organ donation in this country, and again every country in the world except for Iran, that it's unethical to make money selling organs or to pay someone for the organs, because they're worried

that it sets off a whole cascade of problems. Yeah, I think they try and make it cost neutral for the donor, which means your expenses are covered, like you're not gonna be paying like the recipient's insurance is going to be paying for all the operations and surgeries and all that stuff. And then there are uh, you know, private nonprofits that can also help cover like travel and if you're a low income donor, help pay for stuff like that, but you're still not getting like paid to

do it. And the idea there is ethically is that um, you know, the dystopian science fiction plot, which is there's a class of wealthy people who harvest the poor on organ farms. And you know, it's like something out of a movie, but it's also something that could very well happen if you let that kind of thing, you know, take place, uh, you know, black market human trafficking again

like you mentioned. And then another one I didn't think of, is that, um the motivation for someone doing it if you're getting paid like you may not, you may fudge a little bit on your questionnaires, like fake something to make money to get an organ taken out of your body. It's almost like they've identified it as such a valuable thing that you can't you can't assign any kind of monetary value to it. You you can't allow that to happen or else nothing but bad things are going to happen.

And there's actually polls that support this, although some people say that's stupid, we should we No matter how how many um generous people are donating organs, the demand is still not there. I mean, you said it yourself. Like five thousand people die on organ transplant waiting lists every year in the United States alone. That's just in the U S alone. People die all over the world on organ transplant lists every year, and so people say that's stupid.

If people are willing to sell like their kidney in particular, UM, let them do it. It's a free world, it's a free country at least. So what's the problem. Yeah, I mean, I think the idea. I'm not libbying for this, but they have floated things like a like a fifty dollar tax rebate that you can absorb over like a decade, or wipe out your student loans or something like that,

Like they're not literally just cutting you a check. Things like that are interesting because, um, donating a kidney saves taxpayers close to a hundred and fifty thousand dollars in medical costs paid out by Medicare for dialysis and things like at and there was another analysis that found that paying donors forty dollars for kidney would result in a net gain of forty six billion dollars in lowered medical

costs and better health overall health and outcomes. So like, something like that is interesting, not just like harvesting organs for cash, but if people want to take a big fat tax rebate over a decade, it leads to less taxpayer payouts for Medicaid and UH or for Medicare better health outcomes. I don't know some we're thinking about. Yeah, and other people would say this, that's already going on. There's a very healthy black market for organs all around

the world. I saw an estimate on some human trafficking website that was something like ten thousand kidneys a year are procured and transplanted on the black market. But then, Chuck, ultimately you have there is one country, Iran it allows

payment for organs. Its something like and then also like, you're right, it's a pretty in substantial amount if you're selling a kidney compared to say, like the forty five grand the US is considering, or I shouldn't say the US is considering people Americans have come up within a study, but um, the there is the one stat that stood out to me that I think kind of suggests, you know, not applying money to organ procareman, is that of a two thousand one study of three hundred Iranian paid organ

donors said that if they could go back, they would not have sold their kidney. There you have it. Pretty much anything else about kidney transplants and donations and all that. Well, again, if you want to uh donate your organs uh and you aren't going to the d m V anytime soon. Go to register me dot org. Uh. And since I said register me dot org, it's time for a listener mail. I'm gonna call this dB Cooper follow up. Oh wow, no, pretty interesting And this is from Holly. Hey, guys, Holly

from Texas here. I've been listening about six months and I'm obsessed. Turned to the Facebook groups to suggest some fan favorite episodes, and dB Cooper the live episode was mentioned a lot, and it reminded me of a story you might enjoy several years ago, as it a small family gathering at my grandparents and we were sitting around chatting about different topics of memories, and my grandma casually says, Oh, that's just like the time when the FBI tapped our

phones because they thought Grandpa was TP Cooper WHOA. I of course did a dramatic double take, slam both of my hands on the table and exclaimed what I mean. I was floored. At the time, I was in l a thirties and never heard this story in my whole life. That's the thing with grandparents, You hear this stuff like how did I not know that I know? Um, I of course had to dramatically turn to my grandpa with

narrowed eyes and say, who are you. My grandma was very nonchal line about the whole thing, and I was like, wait, wait, wait, explain please. She didn't have much more info, but I guess my grandpa was cleared obviously. Uh. And it's still a mystery why they suspected my grandpa, mainly considering the fact that they lived in New Mexico at the time. We sadly lost my grandma in July, but I'm happy

to report that my grandpa is still doing well. Even though I could never picture my cowboy boot levin heavily starched wrangler gene wearing Grandpa and a skinny tie from J. C. Penny, although he does enjoy his daily bourbon. And that's a clue. Maybe that was it. So that's from Holly, And that's a great email. Holly as one of the all time greats. Holly. I love that she's like. Also, my grandpa pays for everything from a bag of money that he keeps the

ship out back. Yeah, we always got unmarked dollar bills for birthdays. If you want to be like Holly, and tell us one of the great family stories that you heard from your grandparents about. We want to hear those two. You can send them to us at stuff Podcasts at i heart radio dot com. Stuff you Should Know is a production of I heart Radio. For more podcasts my heart Radio, visit the i heart Radio app, Apple Podcasts, or wherever you listen to your favorite shows. H