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Catherine Garvey

Publications and source records attributed to Catherine Garvey.

3 recordsLinked to original sources

Persistent, asymptomatic, microscopic hematuria in prospective kidney donors.

BACKGROUND: Asymptomatic, microscopic hematuria is seen in 8-21% of the general population, has a good prognosis, and is generally not an indication for kidney biopsy. But whether it should preclude kidney donation is unclear. METHODS: Of 512 consecutive prospective donors, 14 (2.7%) continued to have asymptomatic, microscopic hematuria over 1 month. If the medical history, physical examination, and computerized tomographic angiography were unremarkable, and if they still wished to donate, a kidney biopsy was performed. RESULTS: In two prospective donors, hematuria resolved after treatment for urinary tract infection; two others declined donation and were referred to their primary care provider. Kidney biopsy in the remaining 10 showed: two normal; four thin basement membrane nephropathy (TBMN); one nonhomogeneous basement membrane abnormalities; one IgA nephropathy, 5 of 16 glomeruli globally sclerotic; one in a patient with a family history of Schimke's Syndrome, 7 of 30 glomeruli globally sclerotic; and one TBMN and early hypertensive changes without systemic hypertension. Only 4 of the 10 who underwent kidney biopsy donated (two normal, two TBMN). CONCLUSIONS: Kidney abnormalities are common in young, otherwise healthy, prospective kidney donor candidates with persistent, asymptomatic, microscopic hematuria. A kidney biopsy is often abnormal and aids in the decision-making process.

Adolescent↗

Twenty-two nondirected kidney donors: an update on a single center's experience.

At the University of Minnesota, we have defined 'nondirected donation' as organ donation by a volunteer who offered to donate an organ to anyone on the cadaver waiting list. From October 1, 1997, through October 31, 2003, we have had 360 inquiries about nondirected donation, have completed 42 detailed nondirected donor (NDD) evaluations for kidney donation, and have performed 22 NDD transplants. We herein review our program policies and how they have evolved, describe our evaluation and the motivation of our potential donors, summarize the outcome of NDD transplants, and raise issues requiring further attention and study. Our experience continues to support nondirected donation for kidney transplants.

Academic Medical Centers↗

Evolution of a nondirected kidney donor program: lessons learned.

From October 1, 1997 through November 30, 2003, the University of Minnesota received 362 inquiries from potential NDDs. Of these, 53 (15%) then underwent partial or full donor evaluation at our transplant center. Of these 53 potential NDDs, 24 have been accepted (23 donated, and one donation is pending), 23 were denied (15 for medical reasons, 8 for psychosocial reasons), and 6 chose not to pursue donation. Most of our potential NDDs were motivated by altruistic reasons. Their decision-making process was not impulsive or instantaneous, but rather rational and deliberate. They were self-educated about donation before contacting our transplant center. After donation, all 23 of our NDDs said they were glad they donated and were grateful for the opportunity to help another. Many desired to become involved in the transplant community by promoting donation. All NDDs who heard from their recipient appreciated the contact and the chance to learn how the recipient was doing posttransplant. An NDD program clearly mandates a dedicated donor team and additional time and resources, given the high number of inherent practical, logistical, and ethical issues. Our protocol has been a work in progress and continues to evolve with our ever-growing experience. Transplant centers interested in using NDDs must develop NDD protocols to address specific issues and must examine their available staffing and resources.

Academic Medical Centers↗