Stuff You Should Know - Kidney Donation: You Could Be A Saint!

Episode Date: June 2, 2022

Kidneys are one of the few organs that you can donate while you’re alive. And the vast majority of donors experience no complications and their remaining kidney functions just fine. Yet thousands of people die each year waiting for a donated kidney. Why?See omnystudio.com/listener for privacy information.

Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology is way more widespread than any of us want to

believe. You can find in Major League Baseball, International Banks, K-pop groups, even the White House. But just when I thought I had a handle on this subject, something completely unbelievable happened to me and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes because I think your ideas are about to change too. Listen to Skyline Drive on the iHeart radio app, Apple podcast, or wherever you get your podcasts. Welcome to Stuff You Should Know, a production of iHeart Radio. Hey and welcome to the podcast. I'm Josh Clark and there's Charles W. Two Kidney Bryant and there's Jerry over there. And this is Stuff You Should Know, the Kidney donation edition.

Yeah, we did one on organ donation, right? Yeah, and we did one on kidney stones. And kidney stones. So you put them together, you get this episode. That's right. And this is from Dave Ruse, our pal. And this is good. Should we this good? It's that kind of day. How it's going. Yeah, 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. And I should also point out that this is a double Dave day because he did the last one too. That's right. Our interest rates. Right, interest rates. I forgot what we talked about. I've already forgotten all of it.

So Dave did some digging for us and came up with some pretty surprising stats that I certainly had no idea about with kidney disease in particular. But something like 15% of all American adults have some form of chronic kidney disease. 37 million people right now. 37 million and 90,000 Americans are on the list waiting for a kidney transplant. And each year, this is very sad, about 5,000 Americans die while waiting and another 3,000 more become too sick to get that transplant. So basically 8,000-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, 37 million adults, just the adults alone with some form of chronic kidney disease is

their disease progresses, they end up on the list, the transplant list. So... Which we'll talk about in a sec. 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. That's right. And then whistle off back to your normal life down one kidney. Yeah, you can't donate your heart to somebody. No. It's a very sweet gesture. Sure. But you got two kidneys, you only need one. I think the number, the percentage is 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, 15 to 20% or something like that? Yeah, something, 25 to 35 maybe? Yeah, it's not 50%. Right. And that's definitely doable. Like you can go through life with one kidney performing 65% 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, depending on whether you've donated or not. That's right. We're three, which we'll get back to the show.

Just under your ribcage on either side of your spine. So have your loved one make a fist with each hand, come up behind you, put their fist under your ribcage gently. Yeah, just on either side of your spine and there's your kidneys. Right. 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 blood. Yeah. And that's the big thing. They filter about 200 quarts of fluids every day. And that's not just blood. That's blood and waste fluid. That's so much. That's a lot. 200 quarts is a lot. Yeah.

And kidneys are always working. Yeah. And within the kidneys, there are about one to one and a half million tiny little filters inside the kidney called nephrons. If you just think norephron. Or nephrotidi. Or nephrotidi. And those nephrons are what's doing the actual filtering. They're just tiny little filters. They also, what else do they do? They also release a hormone called erythropoietin, EPO. It regulates production of red blood cells in bone marrow. Very big deal. Yeah. 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 absorb calcium and phosphorus for building bones, reduces inflammation, possibly combats tumor growth. And all this is coming from your kidneys doing its thing. And then one other thing we kind of skipped over a little bit that I think is worth pointing out of those 200 quarts of fluid every day, two quarts of it, I think you said, is waste. Yeah. You pee it out. It gets converted into urine, sent to the bladder and you pee it out. Yeah. And finally, Chuck, finally the eight, eight ounce glasses of water a day makes sense. It's not arbitrary anymore. You never realized that that? No. I never understood. I thought it was actually made up an arbitrary number that 64 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 got to replenish it. Yeah. This is funny. Well, I'm this day's old when I finally realized that. This many days old. Yeah. What else? They also release a hormone called renin, regulates 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 a kidney does that I just don't like to take credit for. So 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. And one of the big things that puts 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 you know, basically high blood sugar is going to damage the blood vessels in the kidney. It's going to kill those nephrons that we were talking about. Those are the filters that actually do the filtering and chronic CDK, chronic kidney, sorry, CKD, chronic kidney disease. 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 an end stage renal disease or renal failure. And that's when your kidneys maybe aren't working at all and you're going to dialysis every day and you need a new kidney. Yes. And we'll talk a little more about dialysis. But yes, once you hit stage five, your kidneys just aren't doing the work anymore. And it's not like they 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, fatigue, vomiting. I think you feel poisoned is what I've heard. Yeah, I think that's basically what's going on is your body is being poisoned because it's no longer able to filter it out. So there's a lot of racial disparities too as far as kidney diseases go. And apparently it tracks very closely to diabetes. Yeah. Apparently if you're a black American, you are four times more likely to have kidney failure than a white American. Hispanic Americans 1.3 times and Native Americans 1.2 times. And again, 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. There's a lot of stuff kind of caught up into it that it's not entirely straightforward that everybody has an equal opportunity to develop kidney disease. Yeah. I mean, it's really sad that 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 and 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 to stage five, you might not have reliable transportation to go to dialysis. And dialysis is extremely

time consuming. So it's going to be hard for you to keep down a job. Yeah. My neighbor, before they moved and sadly he passed away, Ms. Jesse and Mr. Otis, he had the ambulance come or it looks like an ambulance, but it's not an emergency when 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, going every single day. And it's good, dude. I wish I would have gotten to know him a little bit better before he passed. So dialysis is short for a hemo dialysis and it is literally just a machine that does the filtering that your kidneys do. So you sit there for, what is it, like four hours? Yep. 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 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 sloshed out, whereas the blood that doesn't go through the membrane gets put back into your body. Yeah. And you're on dialysis for life until, unless you can get a new kidney. And then even if you do get a new kidney, you might be on dialysis 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 going to take a break and we'll be right back, everybody.

In this situation, if you do, you've come to the right place because I'm here to help. This, I promise you. Oh God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man. And so my husband, Michael. Um, hey, that's me. Yep. We know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart

radio app, Apple podcast, or wherever you listen to podcasts. I'm Mangesh Atikular. And to be honest, I don't believe in astrology. But from the moment I was born, it's been a part of my life in India. It's like smoking. You might not smoke, but you're going to get secondhand astrology. And lately I've been wondering if the universe has been trying to tell me to stop running and pay attention. Because maybe there is magic in the stars, if you're willing to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop. But just when I thought I had a handle on this sweet and curious show about astrology, my whole world came crashing down. Situation doesn't

look good. There is risk to father. And my whole view on astrology, it changed. Whether you're a skeptic or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart Radio App, Apple Podcast, or wherever you get your podcasts. Okay, so it's not fun to have kidney failure, especially stage five kidney failure. Because you're going to dialysis a lot and there's a lot of terrible symptoms involved in it. If you are at that point, you're going to be put on an organ donation list. You're going to become a recipient or potential recipient of a donated kidney. That's right. And that means you have signed up with 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 to, by the way. And day points out very astutely that it's not like a waiting list as in there's 90,000 people or more waiting for a kidney. So if you sign up for one, then you have 89,999 people in front of you. And it just very slowly, that time ticks away. It's a network. 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. Do I have to have necessarily the exact blood type? I think if you have A, you can get AB. So there's a little bit of crossover there. And O is universal, right?

Is it O negative or just O? We did a thing on blood. 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 laughs 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. Those yelled out. It's high quality heckling.

That was really good. I thought that. That's for the Atlanta Science Festival. Yeah, yeah. Where was I? That just totally threw me that I'm trying to picture you pregnant now. Well, get a load of me, buddy. 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 organ. Like I saw it put like a basketball

player's lung won't fit in a child. Right. It's like, sure. Those are wise words. It's a good point. And then geography is one because as you'll see, if you get a kidney donated from someone that you don't know, and it's not like a family member, then that kidney is going to be on ice basically for a little while. That's going to be transported maybe or maybe you're transported, but there's going to be a little bit of time. They don't just like, you know, put you on the table like in the movies,

they 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. Make the bee. So geography is a consideration. So within this network, you know, there's a big algorithm 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 donation, you get a new score calculated by the computer. Like it's not like you get your score assigned. It's all contextual based on your relation to that organ 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 some other stuff too, which is, you know, kind of calculating, but it makes sense.

Your age, the younger you are, the higher your score, which makes it likelier for you to get that. The likelihood that you will survive the procedure, the likelihood that you will 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 method and it's kind of revolutionized things and apparently made it a lot better. 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 10 to 15, 20 years. Right. Yeah. Can't wait. 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 good marijuana. That reminds me of Snoop Dogg as the pilot in Soulplane. I never saw that. Was that good?

No, 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 was exactly what they tried to do. But this is an airport. Right.

That's the twist. Yeah. All right. I'm not going to see it then. The twist. Yeah, no, there's no reason to. I demand that you not see it actually. Don't waste your time. How are you going to 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 DMV in the United States or the DMV in France, they're going to ask you if you want to be an organ donor. And you can say yes and they will put it on your license. Yes, organ donor so that if you buy 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 ID. And if they see yes, they're going to go to your family and say your loved one here, who's now regretfully deceased, said that they want to donate their organs. Will you sign off on this?

That seems to have been their wishes. And you can still say no if you're a family member, but probably you're going to say yes, especially if your deceased loved one said, hey, I marked yes that I want to donate organs on my driver's license. If I die, make sure my organs get donated. They're probably going to go along with it. Yeah, I think it's kind of funny that I wonder what percentage of people that sign up at the DMV for organ donation and the kidneys that actually go to other people and organs that successfully

save lives, how many of those start with the two words? Why not? Yeah, I don't need them. You're at the DMV, you're bored out of your mind, you've been there for far too long and they ask you this question and you go, yeah, sure, why not? Yeah, that is the most interesting question you've been asked in that whole experience. Yeah, 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. The DMV.

Yeah, why not? So if you've been to the DMV and you said no and you regretted it, but if you said no and you wanted to, you can still go and register, right? Yeah, you got to register me, me.org, and you can register there. And here's the deal. In 2021, here's some more stats for you. There were 40,000 total organ transplants. I think most of those are, I think, was it like 85% or kidney transplants? Yes.

Like far and away the most are kidney transplants. And only 6,500 of those 45 came from living donors, which was, I have a relative or I'm just a benevolent human who wants to give a kidney anonymously to somebody. I know, man. I mean, yeah, I talk about St. Hood. Yeah. 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, but the organs are still in pretty good shape. Yeah. You're young, you're in good shape, and so, you know, you may be brain dead and they can, the word harvest always sounds so cruel, but they can harvest, borrow your organs? No, it's harvest. It's definitely harvest. Remember in our book of that chapter on Jack Kevorkian, he had that idea in the, I think, 60s or 70s where he was like, well, if we're going to execute people, let's just execute them through organ harvesting.

You know, we start to perform surgery on them and we harvest their organs, and then once we're done, they're just, they're dead. Right. Then we've got the organs. Yeah, then we're donating their organs and everybody's like, it's a really great idea, but you're a 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 his idea while imitating Werner Herzog.

Right. And where are your pants? That's right. So that means at the end of the day, one human body can save, up to, hey, Noel does a pretty good Werner Herzog. Oh, yeah? He's doing a movie crush, yeah. But the best ever is Paula Tompkins.

His Werner Herzog is fantastic. I have never heard this. Yeah, just look it up on the internet. Okay, all right. It's great. One single human body and organ donor can save up to eight lives, 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 eye 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 in. And bringing the justice or exact revenge if it's a really good movie. Sure. A bridge of font type movie? Was that then the actual plot of one, or was that just a typical movie plot? I don't remember who was in it though.

Jennifer Aitton, I don't know. No, Jennifer Aitton was a blind woman, a sightless woman, who was going to be the eighth victim of a serial killer who's targeting blind women. Okay. And I could spoil it for everybody. I'm not going to. It's actually worth seeing. It's a good 90s movie with Andy Garcia and...

Yeah, I don't remember who else. Was it Jennifer Aitton? Yeah, it's a good movie. I think it's out there still. Or I'm thinking of the movie where the guy got the hand transplant. Encino, man. 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 hey, Jeff Fahey was the lawnmower man. Okay, I never saw that one. I mean, it might have been called something as basic as like bad hand or something. Was it called idle hands? No, that was different. That was not good. I'll look it up and we'll...

How about this? So if folks stick around for listener mail, we'll look it up in the interim. Oh, okay. We'll announce it at the beginning of the listener mail. Finally, year 14, we got a new hook for the show. Or maybe I can just make up an email that fake Jeff Fahey sent in. Okay. Okay.

Remember me? We need a fake Jeff Fahey sound effect, like our colon sound effect. All right, 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 a 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. If you're talking kidney transplants, you got to go back to 1902, was when they did a dog kidney transplant in Austria. The dog did not make it, of course, but it did produce urine for a couple of days. The kidney, not bad. I know, and that really just kind of takes you back to some... 1902. Really unsettling black and white view of like some terrible

experiment. Yeah, let me see. In 1909, apparently there were efforts to transplant kidneys from humans, dead humans to monkeys. As you do. 39, the first deceased human donor, I think was performed in Russia, but the organ didn't take, the organ never worked, but they tried it in 39. They tried their best.

From human to human. 53, you finally had your first successful temporary human kidney transplant in Paris. It was twins, right? 16, your boy received one from his mother as a living donor. And then 54, 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 62 was the first non-related, no genetics involved whatsoever. So it's only been since the 1950s, 1960s that we've been able to successfully transplant kidneys, but once we got it, we got it pretty good. Yeah. We have it down pat. Let's do this a lot, guys. This is fun. If you are a living donor and you do donate your kidney, I think that 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. Yeah. Three quarters of the time, it's you're related. Right.

But that still means that 25% of 25% of all kidney donations. So that means however many thousand kidney donations 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 is anonymously, sometimes it's a friend, sometimes it's a spouse, sometimes you hear about someone in your community. But yeah, sometimes you don't even know anybody and you're just like, you know what, I'm going to save a life.

Yeah. I'm at the DMV. Right. I don't want to save a life. Yeah, I'm going to do it. So if you do do that, you're a living donor and there's a lot of advantages to a living donation compared to a dead deceased donate donation, you know, an organ taken from somebody who's died.

Yeah. Right. So if you donate your kidney, there's like the chances of the kidney being rejected are lower compared to a deceased donor. The kidney will probably start functioning independently, like on its own much more quickly than a deceased donor one because the deceased donor one is going to be basically put on ice for a little while while it's transported. By Cheech and Chong.

Kept, you know, kind of, you know, yes, exactly. There's also 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 lasts between 15 and 20 years on average from a living donor. It's only about a decade from a deceased donor and you also have a better chance if

you are genetically related of avoiding rejection. Right. So living, genetically related living donor is like the creme de la creme of getting a kidney. Right, exactly. There's also more convenient too. If you are a living donor, you can say, let's do this like a week from Tuesday. Right. That works best for me, not this guy just died, we need to get this into a recipient

like as soon as possible. It was fine somebody kind of thing. Yeah. You know what I mean? So 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. Yeah, from a relative, ideally. So let's take a break because there's actually ways to maximize how kidneys get donated,

Chuck, and we're going to tell everybody about it after this. Let's do it. Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation?

If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh, man. And so my husband, Michael. Um, hey, that's me.

Yeah, we know that Michael and a different hot, sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Oh, just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. I'm Mangesh Atikulur. And to be honest, I don't believe in astrology. But from the moment I was born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're going to get secondhand astrology. And lately, I've been wondering if the universe has been trying to tell me to stop

running and pay attention. Because maybe there is magic in the stars, if you're willing to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop. But just when I thought I had to handle on this sweet and curious show about astrology, my whole world came crashing down. Situation doesn't look good. There is risk to father.

And my whole view on astrology, it changed. Whether you're a skeptic or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart radio app, Apple podcast, or wherever you get your podcasts. All right. So on the kidney exchange, it's pretty cool how they've worked this out over the years. There is something called paired exchanges and it goes a little something like this. You want to donate a kidney to your relative, 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 niece's blood type. So let's just get together and make this all work out. Chris Cross is Alfred Hitchcock put it. Paired exchange. But then that is multiplied exponentially by the donor chain, right?

Yes. So like if you have a good computer handy to run an algorithm for you, because apparently it's very difficult to do, you can take a bunch of these mismatched pairs rather than four people. You can take, I think, up to 70 people. Yeah. 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 70, 70 recipients. Yeah. So cool. Through a combination of one person donating it without any, you know, just saying take my kidney, put it in somebody and then a bunch of paired matches, all like 70 people. So it makes it really difficult to say like, I don't really want to donate my kidney. When not only you're saving one person's life, you're setting off a chain reaction that allows

for 70 different people to get their kidney because you donated yours without, without directing it toward anybody in particular. Yeah. And if that's not the first thing you say on every first date you go to for the rest of your life, then you're doing it wrong. Yeah. We should mention that the, there was a Nobel Prize winning economist named Albin Roth who, who came up with his donor chain idea.

And I don't think we said you, you have to be 18 to donate a kidney. You have to be in good health and you have like rocking kidneys basically and also in good health otherwise. Yeah. Like a 16 year old can't donate a kidney. 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 going to do it. And by the way, 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.

Right. But if you do this, you are going to undergo surgery. 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 50s or 60s. And now they can usually do it laparoscopically. Yeah.

How does that work? I think they just squeeze it real tight into this really long pencil like. Really? No. How do they get the kidney out? I don't know. I have no idea. That's the one thing that flow makes me and I almost like

Google to see if I could find, you know, a surgery I could watch. Mm-hmm. Laparoscopic kidney removal. Because laparoscopic means it's like a very small incision. Yeah. You're 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, incision. Yeah. This is a widow maker right here. And here to me is the fact of the show. Never knew this. They don't take out your bad kidney. Yeah.

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. Yeah. And they didn't do any harm and maybe more dangerous to take it out. I can see that. Then 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. Well, 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 attach 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 so that it can transport waste to your bladder. And supposedly it's actually a pretty effective surgery. And with minimal 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 got to come in at six, 12 and 24 months for checkups. Like we said, you lose 25 to 35% of your kidney function, but that's not 50. So your one kidney must like ramp it up. And then you said pretty good outcomes. There, I think this is between 2006 and 2008 of the 17,000. Oh, there's your number right there. If the numbers hold, that would be 17,000 over three years.

So about 5,000 and change a year. At least back then. Yeah. Unless there's been a rush. Yeah. Only 12 donor deaths out of the 17,402. And only one of those was from the surgery, from like hemorrhaging, hemorrhaging, hemorrhaging. It's close.

Hemorrhaging. Hemorrhaging. God, that sounds weird. Hemorrhaging. Hemorrhaging. Yeah. Okay. It was purposely weird.

During surgery. Yeah. Bleeding too much. Don't forget to complete the sentence. That was very porky pig of me. So yeah, that's a pretty good track record. 12 deaths out of 17,402 transplants. They also studied people for long-term effects and found that somebody who had donated kidney

had about the same chance of suffering end-stage renal failure as the general population. So it didn't increase their chances one bit. And I was like, okay, all right, internet. Let me go a few more pages deep. Like where's the real talk about the long-term consequences of donating a kidney? And from what I can see, study after study, it shows like there's really not any long-term effects. That after about six or eight weeks of recovery, you can go back to normal life. Mm-hmm.

During that time, you're going to feel very fatigued. Yeah. Your function is going to be decreased. But if you say, I'm donating my kidney, I'm just going to take two months off basically of life, like stressful life. 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 65% of the original function. Yeah, like if you work from home, you have no excuse.

Exactly. Dave did put in here, and I looked into this a little more, that a drawback might be, it might affect your life, insurance or disqualify, you will increase your rates. Yeah. So I poked around that because that sounded like a horrible thing, 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're not booted from your life insurance policy because you donated a kidney, or your rates aren't going to skyrocket because you donated a kidney. Gotcha. It's against the law. That should be. Yeah.

So 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 despite all the tests, despite all of the care given into matching you and your kidney with a recipient, it still might get rejected. But they have developed 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, and there were basically four different kinds of maintenance agents. And the way this one website I saw put it, I think it was at kidney.org or whatever. That sounds made up. 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 the induction agents 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 prednisone, the steroid. Yeah, I didn't either. I saw the most common combination of drugs is three things. One called tachrylimus, which is a calcinevrin inhibitor. One called mycophenolate mofetil, which is an anti-proliferate and then prednisone. And I saw that you're generally on these for life, but they can scale down.

I don't know if you're ever off of them completely, but yeah, I think 30% of kidney recipients experience some sort of rejection, so those are key. But it doesn't mean that it didn't work back to square one necessarily. Yeah, I think in a lot of those cases, you can keep that kidney if the drugs are working. So the entire thing, this entire thing, whether it's a dead donor or deceased donor, sorry, I keep calling it dead donor. I know it's not quite right, even though it's accurate. Or living donors of kidneys, all of this is based on altruism.

Yeah. The entire organ procurement, organ donation system, everywhere in the world, say for one country, is based on the kindness in generosity of donors who do it for no money whatsoever, just out of the goodness of their heart. Yes. And that's the way that a lot of people think it should be. That's the way that it's enshrined in law, that that's the way that it has to be in the United States. There's a law called the National Organ Transplant Act of 1984 that says you cannot gain financially. I can't remember exactly how they put it, but you can't make any kind of gain from donating your organ. And I was like, where did that law come from? What prompted that?

Well, probably the black market for organs, huh? It turned out there was a guy, so that was the actor in 1984. In 1982, 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. He's like, there's no federal law against it. 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 their 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 going to 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 private non-profits that can also help cover travel, and if you're a low-income donor, help pay for stuff like that, but you're still not getting paid to do it. And the idea there is ethically is that the dystopian science fiction plot, which is there's a class of wealthy people who harvest the poor on organ farms. And 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 take place. Black market, human trafficking again, like you mentioned. And then another one I didn't think of is that the motivation for someone doing it, if you're getting paid, like you may fudge a little bit on your questionnaires and fake something to make money to get an organ taken out of your body. Yeah, it's almost like they've identified it as such a valuable thing that you can't assign any kind of monetary value to it. 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. No matter how many generous people are

donating organs, the demand is still not there. I mean, you said it yourself, like 5,000 people die on organ transplant waiting lists every year in the United States alone. That's just in the US 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, 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 lobbying for this, but they have floated things like a $50,000 tax rebate that you can absorb over like a decade or wipe out your student loans or something like that. They're not literally just cutting you a check. Things like that are interesting because donating a kidney

saves taxpayers close to $150,000 in medical costs paid out by Medicare for dialysis and things like that. And there was another analysis that found that paying donors $45,000 for a kidney would result in a net gain of $46 billion in lowered medical costs and better overall health 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 for Medicare, better health outcomes. I don't know. Something 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 10,000 kidneys a year are procured and transplanted on the black market. Wow. But then Chuck, ultimately you have, there is one country, Iran, that allows payment for organs. It's like $4,500. Something like that. And then also like you're right. It's a pretty insubstantial amount if you're selling a kidney compared to say like the 45 grand the US is considering. Right. Or I shouldn't say the US is considering. Americans have come up within a study. Right. But there is one stat that stood out to me that I think kind of suggests, you know, not applying money to organ procurement is that 85% of a 2001 study of 300 Iranian paid organ donors, 85% said that if they could go back, they would not have sold their kidney.

No, there you have it. There you have it pretty much. Got anything else about kidney transplants and donations and all that? No. Well, again, if you want to donate your organs and you aren't going to the DMV anytime soon, go to register me.org. And since I said register me.org, it's time for listener mail. I'm going to 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. I 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, I was at a small family gathering

at my grandparents and we were sitting around chatting about different topics and memories. And my grandma casually says, Oh, that's just like the time when the FBI tapped our phones because they thought grandpa was DB Cooper. Wow. I of course did a dramatic double take slam both of my hands on the table exclaimed, What? I mean, I was floored at the time I was in my late 30s and never heard this story in my whole life. That's the thing with grandparents. You hear this stuff and like, How did I not know this? I know. I of course had to dramatically turn to my grandpa with narrowed eyes and say, Who are you? My grandma was very nonchalant 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. 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 2021. But I'm happy to report that my grandpa is still doing well, even though I could never picture my cowboy boot, loving, heavily starched wrangler, jean-wearing grandpa in a skinny tie from JC Penney, although he does enjoy his daily bourbon. Oh, there's a clue. Maybe that was it. Yeah. So that's from Holly. And that's a great email, Holly. That is 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 from the shed out back. Yeah. We always got unmarked $100 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 stuffpodcasts.ihartradio.com. Stuff you should know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite shows. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help and a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody

about my new podcast and make sure to listen. So we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcasts, or wherever you listen to podcasts. I'm Munga Chauticular, and it turns out astrology is way more widespread than any of us want to believe. You can find it in major league baseball, international banks, K-pop groups, even the White House. But just when I thought I had a handle on this subject, something completely unbelievable happened to me, and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes, because I think your ideas are about to change too. Listen to Skyline Drive on the iHeart Radio app, Apple podcasts, or wherever

you get your podcasts. Here's to the great American settlers. The millions of you have settled for unsatisfying jobs because they pay the bills. Of course, there is something else you could do if you got something to say. Start a podcast with Spreaker from iHeart, and unleash your creative freedom. Maybe even earn enough money to one day tell your old boss, hey, I'm no settler. I'm an explorer. Spreaker.com, S-P-R-E-A-K-E-R. That's a lot over today.