Here’s How to Become a Kidney Donor

Would you be willing to be considered as a possible kidney donor? Marsha Goldstein got her much-needed transplant, but there are another 800 or so other patients waiting for the same procedure in Israel alone.

Moish Levy and his wife Nili, are among the country's best-known kidney donors. While they each decided to donate separately, thanks to a program on Channel 2 which documented their experiences, they have become particularly well known for their involvement.

They are both distinguished professionals in their own right – Moish is one of the two current deputy City Mayors of Modiin, and Nili is a highly regarded academic at Bar Ilan University.

Moish pointed out that if a couple both decide to donate, then any consequences for their children need to be particularly carefully considered. Should they require a kidney at some point in the future, with one kidney each, then neither parent would be eligible as donors.

Moish and Nili are the proud parents of three sons, the youngest of whom are twins and they did not decide to proceed with donation until their children had reached the ages of 21 and 18, respectively, and then they only did so after full discussion with their children. The twins pointed out that should either need a kidney in the future, then the most likely donor would be the other twin.

The Levy experience – while unusual – is no longer unique and Moish is aware of at least one other couple who has both become kidney donors. Nevertheless, at the time, their decision to each become a kidney donor was unheard of in Israeli experience – and was subsequently recognized by their joint nomination in 2016 to light one of the flames at the Yom Ha'Atzmut Ceremony on Mount Herzl.

It takes around six months between an individual deciding to become a kidney donor and the procedure taking place. The choice of the hospital lies with the recipient and the Levy's experienced two different hospitals, Sourasky (Ichilov) in Tel Aviv in the case of Moish, and Beilinson in Petach Tikvah in the case of Nili.

Initially, Moish and Nili had thought of donating their kidneys at the same time, but since their sons were due to be away, it was decided that it would be better to donate at separate times, so that one could be there to help the other during the recovery period. Moish donated first and a month later Nili, by which time he was totally and fully recovered.

Dr Tamar Ashkenazi, the distinguished Chief Executive of Israel's National Transplant Center and Director of the Halachic Organ Donor Society who had been one of the principal speakers at an information evening on organ donation arranged by ESRA Modiin in October 2017, explained that individuals are initially asked to complete a form indicating their willingness to be considered donors.

There are stringent requirements to be eligible, since it is essential to protect the well-being of the donor as well as that of the recipient. For example, anyone regularly taking medication is unlikely to be eligible and while age per se is not a bar to becoming a donor, it is unlikely that those aged over 72 would be considered.

There is a full assessment of the prospective donor's physical and psychological history and the approval of an assessment board comprising medical and lay personnel is required. They check that the donor is agreeing voluntarily to the donation, and that they have as much information as possible about the procedure and its consequences.

Another organization responsible for encouraging kidney donation. is Matnat Haim. Founded in 2009 by Rabbi Yeshayahu Heber of Jerusalem after his own life was saved by a kidney donation, it brings donors and recipients together.

While both organizations are keen to increase the number of donors, the Halachic Organ Donor Society arranges donations purely on the basis of the urgency of the medical needs of the recipients. Matnat Haim, however, tries to match any specific preferences of the donors to the characteristics of the recipients – for example, a donor may specify that they would like a recipient to be male or female.

The success rate of living kidney donations is very high. Matnat Haim states that 95% of transplants are successful and that the kidney can survive for many years. This is in no small measure due to the medical skill and care taken in matching donors and recipients, and in the change to using living donors rather than organs from the deceased. The procedure for transplanting has also changed radically and the recuperation period is consequently much shorter.

About 80% of the kidneys transplanted survive for at least five years and about half of those transplanted from living donors survive for more than 25 years, with some lasting even as long as 40 years.

There are exceptions, and in fact, both the recipients of Moish and Nili Levy's kidneys had had previous transplants, and had been waiting a number of years for a new organ. Such was the acute medical need, Moish was advised that although his kidney was not an ideal match, without it, the recipient would have been unlikely to survive much longer. The procedure was successful.

Recipients are asked if they would like to meet donors. Moish met his just once. However, Nili is still in touch with hers, a 37-year-old man, the father of two children. He and his wife went on to have a third child, and Moish and Nili were honored guests at the baby's Brit Mila, where Moish was made the boy's godfather.

There can be no greater mitzvah than saving a life. Perhaps fortunately, it is not often that the opportunity presents itself. Moish was taken aback that anyone should regard his and Nili's decision as extraordinary.

"Why would someone not help save a life it he/she could?" he asks. "Why were human beings given two kidneys, if, as experience has shown, people can live totally normal lives with just one?"

But in the absence of even one fully functioning kidney, then the prospects of a normal life are not only very different, but the day-to-day reality as a kidney patient can be very challenging. It is not just difficult for the patient, but also for their family.

Lives have to be planned around dialysis and access to equipment, the avoidance of infection and so on. The impact of donating a kidney on the life of a kidney patient can hardly be over-estimated. However – and perhaps more surprisingly – neither can its impact on the life of a donor.

■The link for registration with Matnat Chaim and more information in English is available at www.kilya.org.il/en/ telephone 02 500 0755■Israel's National Transplant Center: Log on to https://www.adj.gov.il/en