Gerlach was born with a single kidney, instead of the usual two, and it doesn’t fully function. So, one day, he may need a transplant.

Quinn’s grandfather, retired Tulare County Superior Court judge Howard Broadman, 68, of Visalia, Calif., learned he has the right blood and tissue types to be a donor for Quinn. But Broadman feared he might die or be too sick to donate a kidney when it was needed.

The former judge tried to think creatively, as he had on the bench — where he was known for unconventional and sometimes sentencing.

He came up with what might be called the delayed kidney swap: He gave his kidney three years ago to Kathy DeGrandis, a retired airport manager in her 50s, at Ronald Reagan UCLA Medical Center. In exchange, Quinn was given a voucher that gives him priority to receive a live donor kidney, provided a match can be found when a transplant is necessary.

The idea caught on. Now about 30 hospitals around the country participate in this voucher program, administered by the National Kidney Registry. At least 21 kidneys have been donated by people in the U.S. in exchange for vouchers, according to the registry.

“If Quinn had needed the kidney right away, I was going to donate my kidney,” said Broadman. “But once he didn’t need it right away, I thought, why not pay it forward and maybe karma would come about.”

Still Waiting, But Worrying Less

More than 93,000 people await kidney transplants in the United States, and each year 4,500 people die before they can get one.

Most patients seeking a transplant join the long waiting list for kidneys from deceased donors. Some are able find a living person willing to donate a kidney. Live donor kidneys are most desirable — — but are less available.

Another limiting factor for a successful transplant is that the donor kidney must be a good “match,” carrying a compatible complement of genetic markers with the patient in need.

To address that problem, doctors more than a dozen years ago devised a process known as donation “chains.” If a friend or relative wanted to donate to a patient but was not a good match, he could donate to another kidney patient in the same predicament, with a willing but incompatible donor.

Each transplant patient in the chain must have a donor who matches someone who currently needs a kidney in the U.S. and is willing to donate to that stranger. Hospitals and transplant centers have matched up to 35 pairs in such chains.

Broadman, the Visalia grandfather, took that idea further, proposing that donors be able to give their organs in advance — essentially to save a person today so that a relative might be saved down the road.

“Sometimes [a patient] may be heading toward transplantation in the next few years, but it would be more convenient for a friend or family member to donate a kidney now,” said Dr. Jeffrey Veale, a transplant surgeon who initiated the voucher program at UCLA.

Maybe the donor is planning a pregnancy, travel or a new job or is worried about growing older — any of which could prevent a donation later, Veale said. Arranging the transaction early takes some — but not all — worry out of the situation.

Another possibility is for one compatible parent to directly donate a kidney to his or her child now while the other parent donates to a stranger for a voucher. That way, if the child’s first donated kidney fails — not uncommon — a second kidney might be obtained quickly.

Broadman’s idea was taken up by the National Kidney Registry, one of two registries in the U.S. that matches patients, through computer algorithms, with potential live donors. The registry works with participating hospitals such as UCLA, alerting them when a voucher holder matches a live donor in their system.

Experts and ethicists underscored that such surgeries can put donors at risk without benefiting their loved ones.

Christina Strong, an adjunct professor of health law at Rutgers in New Jersey who has worked extensively on health laws and policies for organ donation, says it has to be absolutely clear to everyone involved that having the donor give a kidney right now in no way guarantees that a compatible kidney will be found later for the intended recipient.

Contracts with donors contain a disclaimer to that effect.

UCLA officials say they have received dozens of inquiries from potential voucher donors, as well as from hospitals around the country, that want to set up voucher programs. Additional participating hospitals include those at UCSF, Georgetown, Emory and Cornell.

“We solve this problem one kidney at a time,” says Dr. Chris Freise, interim chief of the transplant division at UC-San Francisco Medical Center, which participates in the voucher program.

Freise and other kidney experts and advocates say the program also gives a boost to patients who don’t have a potential live donor or voucher. That’s because each time someone gets a live kidney, that almost always moves someone else up a notch on the deceased donor list.

Some researchers working on the holy grail of kidney transplantation, a bioengineered one, also are rooting for the success of voucher transplants.

“We’re a decade or more from being able to repair, restore or replace a kidney, so novel ideas like the voucher transplants are critical,” says Dr. Giuseppe Orlando, a transplant surgeon at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

The voucher is earmarked and issued to a specific person, who is the only one who can use it, making it unlikely to be bought or sold. The recipient is required to provide U.S. government identification before any transplant can occur, and his or her blood and tissue types are checked to ensure they match what’s in the medical records.

‘Fully Engaged In The World’

Broadman’s grandson hasn’t had to use his voucher yet. Maybe he never will. But the retired judge has no regrets.

Months after his surgery, he met with the recipient, DeGrandis, at a barbecue the two families arranged.

“How has your life changed since the transplant?” he recalls asking DeGrandis.

She replied: “Where do you want me to start?”

DeGrandis had been diagnosed decades earlier with polycystic kidney disease, a genetic condition causing the organs to fail over time. She remembers telling Broadman that she is healthier than she’s been in years, no longer “chained to dialysis,” that her singing voice came back. “And I feel fully engaged in the world around me rather than trying to struggle from moment to moment.”

At that point, Broadman said, his eyes welled up.

Sure, the recovery from surgery was painful, he tells would-be donors. Then he adds: “When you think of the downside, that is small, compared to the goodness.”

This story was produced by , which publishes , an editorially independent service of the .

This <a target="_blank" href="/health-industry/this-gift-voucher-might-just-get-you-a-kidney/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Will Mama consider a kidney donation from her daughter, Carla, or turn her down, worried the procedure will keep Carla from having another baby?

These two telenovela plots have gripped some viewers in the past few months. But don’t expect to see the Spanish-language dramas on a network or streaming service. They’re customized for  a new bilingual website dedicated to using culturally familiar methods to educate Latinos about options for living kidney donation.

The marketing strategy is intended to address a growing need among Latinos. Kidney failure in this population has increased by more than , and more than  are on the kidney transplant list, according to federal statistics. But too often, researchers and doctors said, families are not aware of the transplant regimen involving a live donor and have unfounded fears about what could happen if they volunteer to offer a kidney to a relative or friend.

“Right now, Latino patients often don’t learn about live kidney donation until they are in crisis, and that is a bad time to be learning about something complex and somewhat foreign to their culture,” said Junichiro Sageshima, a transplant surgeon at the University of California, Davis.

Twenty percent of U.S. kidney disease patients on the current (UNOS) transplant waiting list are Latino, but in California that rate rises to 40 percent, about the same as the percentage of Latinos in the state, said Charlene Zettel, CEO of Donate Life California, the parent organization of Living Donation California, a San Diego-based nonprofit that offers referrals and resources for living kidney donations.

While researchers aren’t fully sure why Latinos are so severely affected by kidney disease, rates of high blood pressure and diabetes are also elevated among Latinos, and both conditions are key contributing factors. In addition, large numbers of Latinos lack health coverage, which can prevent getting timely care and can aggravate chronic diseases.

Need For Live Donors

Yet Latinos are less than half as likely as non-Latino whites to get a transplanted kidney from a live donor. That’s an important distinction because almost 6,000 kidney transplants annually are from live donors, close to a third of all kidney transplants, according to UNOS.

Part of that discrepancy is because of cultural concerns about transplants — and especially about live donor kidney transplants, researchers say.

Elisa Gordon, an associate professor of surgery at Northwestern University who led the development and testing of Infórmate, said many Latino families are afraid that donation can decrease virility and fertility. Other concerns are that the Catholic Church opposes it or that becoming a donor could trigger a report to immigration officials. None of those are true.

In addition, many Latinos worry about related costs and don’t know that insurance generally covers most of the expenses for both the donor and recipient.

Infórmate deals with all those issues. Besides the telenovelas, the site includes quizzes and games to help dispel cultural and religious myths and video testimonials in English and Spanish from donors and recipients. It also has information on financial issues and links to help patients find transplant centers.

Dr. Elena Rios, president and CEO of the National Hispanic Medical Association in Washington, D.C., said the telenovelas are an especially important feature of the site because they are “familiar.” Many Latino families watch television together so the stories are likely to generate conversation, she said.

Zettel said her group has added a link to Infórmate on the site’s page. “We’ve long needed more targeted information health care professionals can use to better inform their Latino patients about live kidney donation,” she said.

Both UC Davis and Northwestern University transplant centers also have added Infórmate to the resources that they offer Latino patients. Researchers at the centers that found the website increased knowledge about live kidney donation among Latino patients and their family members.

Javier Oregel, 34, of  Yuba City, California, undergoes daily dialysis and said he learned of the site from the staff at UC Davis. Oregel, formerly a farmworker, became too sick to work and receives medical benefits through Medicare and California’s Medicaid program, known as Medi-Cal. Through a translator, Oregel explained that before scrolling through Infórmate, all the information he had on kidney transplants came from talking with the transplant center staff. Infórmate allows him to get information himself, in Spanish.

He is on the UNOS list for a kidney transplant and is worried about what expenses will fall to him. Although his insurance will pick up much of the medical costs, he learned on Infórmate about some of the associated out-of-pocket spending that a surgery would entail. The site provided him with useful links to organizations that take applications to help cover those costs — even the bill for the hotel room his wife will need if he gets the transplant.

“If a transplant become available, I know I can go back to the Infórmate site to follow up on those resources,” Oregel said.

Paying For A Transplant

Kidney transplants cost $150,000 to $250,000, according to information on Infórmate, not including about $20,000 per year for medication and other expenses necessary for the rest of a recipient’s life. Health plans usually cover dialysis and transplants, as does Medi-Cal, which serves some low-income residents.

Immigrants living in the country illegally who don’t have insurance are generally eligible only for emergency treatment in hospitals. A handful of states, including California, offer coverage of dialysis on an outpatient basis under certain circumstances.

Yet dialysis is just a stopgap measure until a donated kidney — either from a live person or from someone who has died — can be found. The average wait for a deceased person’s kidney is three and a half years.

Kidney transplants save money over the cost of dialysis, but that’s not why medical officials favor them, said Luke Preczewski, executive director of the kidney transplant center at UC Davis. “We do them because research shows that transplants offer a longer and better quality life.”

“Live kidney donations generally come from family members, who are the most likely to be a genetic match, but [they] often come from spouses, friends and even strangers,” said Juan Caicedo, the director of the Hispanic Transplant Program at Northwestern Memorial Hospital and a co-developer of the Infórmate site.

“The bottom line,” Caicedo said, “is we have learned that there is a lot of lack of knowledge about live kidney donation among communities, clinicians, priests, grandparents and others, and everyone has different concerns or misconceptions because of that lack of knowledge. We are trying to solve that with this website.”

supports KHN’s work with California ethnic media.

This <a target="_blank" href="/medicare/telenovelas-spanish-website-seek-to-inform-hispanics-about-kidney-donations/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Gerlach was born with a single kidney, instead of the usual two, and it doesn’t fully function. So, one day, he may need a transplant.

Quinn’s grandfather, retired Tulare County Superior Court judge Howard Broadman, 68, of Visalia, Calif., learned he has the right blood and tissue types to be a donor for Quinn. But Broadman feared he might die or be too sick to donate a kidney when it was needed.

The former judge tried to think creatively, as he had on the bench — where he was known for unconventional and sometimes sentencing.

He came up with what might be called the delayed kidney swap: He gave his kidney three years ago to Kathy DeGrandis, a retired airport manager in her 50s, at Ronald Reagan UCLA Medical Center. In exchange, Quinn was given a voucher that gives him priority to receive a live donor kidney, provided a match can be found when a transplant is necessary.

The idea caught on. Now about 30 hospitals around the country participate in this voucher program, administered by the National Kidney Registry. At least 21 kidneys have been donated by people in the U.S. in exchange for vouchers, according to the registry.

“If Quinn had needed the kidney right away, I was going to donate my kidney,” said Broadman. “But once he didn’t need it right away, I thought, why not pay it forward and maybe karma would come about.”

Still Waiting, But Worrying Less

More than 93,000 people await kidney transplants in the United States, and each year 4,500 people die before they can get one.

Most patients seeking a transplant join the long waiting list for kidneys from deceased donors. Some are able find a living person willing to donate a kidney. Live donor kidneys are most desirable — — but are less available.

Another limiting factor for a successful transplant is that the donor kidney must be a good “match,” carrying a compatible complement of genetic markers with the patient in need.

To address that problem, doctors more than a dozen years ago devised a process known as donation “chains.” If a friend or relative wanted to donate to a patient but was not a good match, he could donate to another kidney patient in the same predicament, with a willing but incompatible donor.

Each transplant patient in the chain must have a donor who matches someone who currently needs a kidney in the U.S. and is willing to donate to that stranger. Hospitals and transplant centers have matched up to 35 pairs in such chains.

Broadman, the Visalia grandfather, took that idea further, proposing that donors be able to give their organs in advance — essentially to save a person today so that a relative might be saved down the road.

“Sometimes [a patient] may be heading toward transplantation in the next few years, but it would be more convenient for a friend or family member to donate a kidney now,” said Dr. Jeffrey Veale, a transplant surgeon who initiated the voucher program at UCLA.

Maybe the donor is planning a pregnancy, travel or a new job or is worried about growing older — any of which could prevent a donation later, Veale said. Arranging the transaction early takes some — but not all — worry out of the situation.

Another possibility is for one compatible parent to directly donate a kidney to his or her child now while the other parent donates to a stranger for a voucher. That way, if the child’s first donated kidney fails — not uncommon — a second kidney might be obtained quickly.

Broadman’s idea was taken up by the National Kidney Registry, one of two registries in the U.S. that matches patients, through computer algorithms, with potential live donors. The registry works with participating hospitals such as UCLA, alerting them when a voucher holder matches a live donor in their system.

Experts and ethicists underscored that such surgeries can put donors at risk without benefiting their loved ones.

Christina Strong, an adjunct professor of health law at Rutgers in New Jersey who has worked extensively on health laws and policies for organ donation, says it has to be absolutely clear to everyone involved that having the donor give a kidney right now in no way guarantees that a compatible kidney will be found later for the intended recipient.

Contracts with donors contain a disclaimer to that effect.

UCLA officials say they have received dozens of inquiries from potential voucher donors, as well as from hospitals around the country, that want to set up voucher programs. Additional participating hospitals include those at UCSF, Georgetown, Emory and Cornell.

“We solve this problem one kidney at a time,” says Dr. Chris Freise, interim chief of the transplant division at UC-San Francisco Medical Center, which participates in the voucher program.

Freise and other kidney experts and advocates say the program also gives a boost to patients who don’t have a potential live donor or voucher. That’s because each time someone gets a live kidney, that almost always moves someone else up a notch on the deceased donor list.

Some researchers working on the holy grail of kidney transplantation, a bioengineered one, also are rooting for the success of voucher transplants.

“We’re a decade or more from being able to repair, restore or replace a kidney, so novel ideas like the voucher transplants are critical,” says Dr. Giuseppe Orlando, a transplant surgeon at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

The voucher is earmarked and issued to a specific person, who is the only one who can use it, making it unlikely to be bought or sold. The recipient is required to provide U.S. government identification before any transplant can occur, and his or her blood and tissue types are checked to ensure they match what’s in the medical records.

‘Fully Engaged In The World’

Broadman’s grandson hasn’t had to use his voucher yet. Maybe he never will. But the retired judge has no regrets.

Months after his surgery, he met with the recipient, DeGrandis, at a barbecue the two families arranged.

“How has your life changed since the transplant?” he recalls asking DeGrandis.

She replied: “Where do you want me to start?”

DeGrandis had been diagnosed decades earlier with polycystic kidney disease, a genetic condition causing the organs to fail over time. She remembers telling Broadman that she is healthier than she’s been in years, no longer “chained to dialysis,” that her singing voice came back. “And I feel fully engaged in the world around me rather than trying to struggle from moment to moment.”

At that point, Broadman said, his eyes welled up.

Sure, the recovery from surgery was painful, he tells would-be donors. Then he adds: “When you think of the downside, that is small, compared to the goodness.”

This story was produced by , which publishes , an editorially independent service of the .

This <a target="_blank" href="/health-industry/this-gift-voucher-might-just-get-you-a-kidney/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Will Mama consider a kidney donation from her daughter, Carla, or turn her down, worried the procedure will keep Carla from having another baby?

These two telenovela plots have gripped some viewers in the past few months. But don’t expect to see the Spanish-language dramas on a network or streaming service. They’re customized for  a new bilingual website dedicated to using culturally familiar methods to educate Latinos about options for living kidney donation.

The marketing strategy is intended to address a growing need among Latinos. Kidney failure in this population has increased by more than , and more than  are on the kidney transplant list, according to federal statistics. But too often, researchers and doctors said, families are not aware of the transplant regimen involving a live donor and have unfounded fears about what could happen if they volunteer to offer a kidney to a relative or friend.

“Right now, Latino patients often don’t learn about live kidney donation until they are in crisis, and that is a bad time to be learning about something complex and somewhat foreign to their culture,” said Junichiro Sageshima, a transplant surgeon at the University of California, Davis.

Twenty percent of U.S. kidney disease patients on the current (UNOS) transplant waiting list are Latino, but in California that rate rises to 40 percent, about the same as the percentage of Latinos in the state, said Charlene Zettel, CEO of Donate Life California, the parent organization of Living Donation California, a San Diego-based nonprofit that offers referrals and resources for living kidney donations.

While researchers aren’t fully sure why Latinos are so severely affected by kidney disease, rates of high blood pressure and diabetes are also elevated among Latinos, and both conditions are key contributing factors. In addition, large numbers of Latinos lack health coverage, which can prevent getting timely care and can aggravate chronic diseases.

Need For Live Donors

Yet Latinos are less than half as likely as non-Latino whites to get a transplanted kidney from a live donor. That’s an important distinction because almost 6,000 kidney transplants annually are from live donors, close to a third of all kidney transplants, according to UNOS.

Part of that discrepancy is because of cultural concerns about transplants — and especially about live donor kidney transplants, researchers say.

Elisa Gordon, an associate professor of surgery at Northwestern University who led the development and testing of Infórmate, said many Latino families are afraid that donation can decrease virility and fertility. Other concerns are that the Catholic Church opposes it or that becoming a donor could trigger a report to immigration officials. None of those are true.

In addition, many Latinos worry about related costs and don’t know that insurance generally covers most of the expenses for both the donor and recipient.

Infórmate deals with all those issues. Besides the telenovelas, the site includes quizzes and games to help dispel cultural and religious myths and video testimonials in English and Spanish from donors and recipients. It also has information on financial issues and links to help patients find transplant centers.

Dr. Elena Rios, president and CEO of the National Hispanic Medical Association in Washington, D.C., said the telenovelas are an especially important feature of the site because they are “familiar.” Many Latino families watch television together so the stories are likely to generate conversation, she said.

Zettel said her group has added a link to Infórmate on the site’s page. “We’ve long needed more targeted information health care professionals can use to better inform their Latino patients about live kidney donation,” she said.

Both UC Davis and Northwestern University transplant centers also have added Infórmate to the resources that they offer Latino patients. Researchers at the centers that found the website increased knowledge about live kidney donation among Latino patients and their family members.

Javier Oregel, 34, of  Yuba City, California, undergoes daily dialysis and said he learned of the site from the staff at UC Davis. Oregel, formerly a farmworker, became too sick to work and receives medical benefits through Medicare and California’s Medicaid program, known as Medi-Cal. Through a translator, Oregel explained that before scrolling through Infórmate, all the information he had on kidney transplants came from talking with the transplant center staff. Infórmate allows him to get information himself, in Spanish.

He is on the UNOS list for a kidney transplant and is worried about what expenses will fall to him. Although his insurance will pick up much of the medical costs, he learned on Infórmate about some of the associated out-of-pocket spending that a surgery would entail. The site provided him with useful links to organizations that take applications to help cover those costs — even the bill for the hotel room his wife will need if he gets the transplant.

“If a transplant become available, I know I can go back to the Infórmate site to follow up on those resources,” Oregel said.

Paying For A Transplant

Kidney transplants cost $150,000 to $250,000, according to information on Infórmate, not including about $20,000 per year for medication and other expenses necessary for the rest of a recipient’s life. Health plans usually cover dialysis and transplants, as does Medi-Cal, which serves some low-income residents.

Immigrants living in the country illegally who don’t have insurance are generally eligible only for emergency treatment in hospitals. A handful of states, including California, offer coverage of dialysis on an outpatient basis under certain circumstances.

Yet dialysis is just a stopgap measure until a donated kidney — either from a live person or from someone who has died — can be found. The average wait for a deceased person’s kidney is three and a half years.

Kidney transplants save money over the cost of dialysis, but that’s not why medical officials favor them, said Luke Preczewski, executive director of the kidney transplant center at UC Davis. “We do them because research shows that transplants offer a longer and better quality life.”

“Live kidney donations generally come from family members, who are the most likely to be a genetic match, but [they] often come from spouses, friends and even strangers,” said Juan Caicedo, the director of the Hispanic Transplant Program at Northwestern Memorial Hospital and a co-developer of the Infórmate site.

“The bottom line,” Caicedo said, “is we have learned that there is a lot of lack of knowledge about live kidney donation among communities, clinicians, priests, grandparents and others, and everyone has different concerns or misconceptions because of that lack of knowledge. We are trying to solve that with this website.”

supports KHN’s work with California ethnic media.

This <a target="_blank" href="/medicare/telenovelas-spanish-website-seek-to-inform-hispanics-about-kidney-donations/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">