Currently, about 122,000 patients in the U.S. are in need of a potentially life-saving transplant, and every 10 minutes, another name is to the wait list, according the U.S. Department of Health and Human Services.
Although African Americans make up only about 13 percent of the population, they comprise 30 percent of those individuals needing a transplant. High levels of diabetes and hypertension within the African American community are partially to blame for such disparate statistics. In addition, people of color are also less likely to register as organ donors.
Dr. Henry Randall, St. Louis University liver and kidney transplant surgeon, said preventable chronic illnesses are a culprit.
“The number one reason why people require a kidney transplant in the African American community is high blood pressure and diabetes,” Randall said. “And of course, those being some of the leading causes or related factors to obesity.”
Randall is the division chief of Adult and Pediatric Transplants at SLU and Cardinal Glennon Children’s Medical Center as well as associate professor of surgery for the School of Medicine. He said patients with End State Renal Disease go on dialysis as they await an available kidney for transplant. He said living kidney donors is the pathway to avoid going on dialysis.
“You can get a living donor transplant and not have to wait on dialysis, but you have to have healthy donors,” Randall said. “If you donors happen to have diabetes, high blood pressure and obesity in their own medical problems, then they can’t donate, lest they end up in the same position that you are.”
Lifestyle and fat factors into the need for liver transplants as well.
“The No. 1 reason for that is hepatitis C nowadays, also, alcohol abuse, former alcohol abuse is pretty high, and then there are a number of other causes of liver disease,” Randall said. “What’s up-and-coming with the new hepatitis C drugs being able to cure hepatitis, is NASH – Nonalcoholic Steatohepatitis. That’s essentially a fatty liver.”
NASH is sometimes known as the silent liver disease, because in some people, it may cause no symptoms or problems. For others, NASH causes inflammation and liver damage due to the accumulation of fat in the liver. Randall said you do not have to be obese to have fatty liver disease; some of it is genetics.
“You can have so much fat in your liver that it causes inflammation and it causes cirrhosis,” Randall added. In cirrhosis, normal liver cells are replaced with scar tissue. It gets worse over time and becomes life threatening.
To avoid eating your way onto an already full transplant list, Dr. Randall has some advice.
“You’ve got to watch what you eat, how much you eat, exercise; stay away from things with lots of sugar – sodas, candy, high fructose corn syrup-containing foods,” Randall said. “It is really important that we read what’s on the label of foods that we eat.”
Additionally, the aversion to going to seeing doctors does not bode well.
“If you go 10, 20 years without good health care, or even access to health care, then we tend to see on the health care side, some of the extreme of complications of people’s liver disease,” Randall described. “They’ve had it longer without medical attention. Whether that is income- related or some of it is access to care; some of it is how we do or don’t access health care ourselves. Men tend to do worse than women in accessing health care.”
Randall asks everyone to designate themselves as organ donors.
“I bet you there is somebody out there who knows or has a family member that has kidney disease, who is eventually going to be referred either to us or another program for a transplant,” he said. “It’s good for people to try and live healthy. Live healthy if you need to donate an organ to someone else. You yourself may need an organ one day, so be mindful of that in terms of organ donation and accessing health care.”
And he said, “don’t be afraid to go to the doctor.”
“Some people are afraid, ‘they are going to tell me bad news,’” Randall said.
“Nope – not necessarily bad news if you find out early and make some modifications to try and live a nice, long, healthy life.”
For information on becoming a donor, visit Mid-America Transplant Services at www.mts-stl.org.
