DETROIT -- Stevie Wonder announced during a concert Saturday in London that he'll have a kidney transplant in September.
That means after his surgery, his fans will likely have to wait at least until the new year to see him perform live again, said Dr. Jason Denny, director of the Center for Living Donation at Henry Ford Health System and the director of living kidney transplant.
"I would expect that in Stevie's case, that he will not be doing concerts for at least a few months after surgery, assuming everything goes well," said Denny, who spoke to the Free Press on Monday about the general protocol for kidney transplant recipients.
"The immune system will be low; the lowest it will be is right after surgery. So you don't want him in large crowds because of the illnesses the crowds have.
"An example I give to patients is that it's like when you bring a new baby home. You could have family see the baby, but not everybody can be in the baby's face all the time."
The legendary Motown performer was hospitalized in the spring and has been traveling to his performances with a medical team ever since. He told fans Saturday that he already has an organ donor lined up.
Wonder, 69, is among 15% of U.S. adults who are estimated to have chronic kidney disease, according to the U.S. Centers for Disease Control and Prevention.
And when the Grammy Award winner receives his organ transplant, he'll join the roughly 21,000 Americans who have kidney transplants every year, according to the United Network for Organ Sharing, a nonprofit organization that contracts with the federal government to manage the U.S. organ transplant system.
The Free Press asked Denny to answer some questions about kidney disease and how the transplantation process works.
Question: What do the kidneys do? And how do you identify kidney disease?
Answer: Most people have two kidneys, which are vital organs that filter waste from the body and create urine. They also balance electrolytes in the body and play a role in maintaining blood pressure and blood volume.
Some people hardly notice when their kidneys stop working properly, Denny said. Others, he said, get quite ill.
"Half the patients will not feel well," he said. "They will get swollen legs and have fatigue, or not feel well and see the doctor. And the doctor will say, 'Hey, you have a kidney problem.'
"The other half of patients will feel nothing until the kidneys are almost gone. And they'll just get a physical ... and realize that the creatinine in their blood, which is a measure of kidney function, has increased.
"A lot of people don't feel anything at all, which is troubling because they don't always believe they have kidney problems. ... Those people will often have some chronic disease that they either have not managed well or has been really severe. You don't really feel hypertension and diabetes, and so sometimes they don't do anything about it."
Most people only need one functioning kidney to live a healthy life. That allows people to donate a kidney to a person with kidney disease.
Q: What causes kidney disease?
A: Hypertension and/or diabetes are the root causes for about half of all people with end-stage renal disease, Denny said. That's especially true among people in the African American population.
Other conditions, such as cystic kidneys, genetic factors, nephrotic syndrome and autoimmune diseases also can cause kidney failure.
Not all kidney failure is permanent. But for those who have end-stage renal disease, and whose kidneys are not functioning, they will either need dialysis to artificially filter the blood or they'll need a kidney transplant.
Q: What does dialysis do?
A: "When a person needs dialysis, they need their blood cleaned because their kidneys are not cleaning their blood," Denny said. "Typically, a person is hooked up to a dialysis machine for three to four hours, three times a week."
A person would go to a medical center or dialysis center so the machine can be connected through an artery-vein fistula in the arm or through a catheter in the neck to filter their blood.
Sometimes, Denny said, the dialysis machine can be connected through a tube placed in the abdomen, which allows for treatment at home. That's called peritoneal dialysis.
Q: What sorts of things might Stevie Wonder's medical team be doing for him as he travels prior to surgery?
A: "I don't have direct knowledge of what his medical team is," Denny said, "But that said, it depends.
"If he is already on dialysis, he may, because he has means, have a doctor or a nurse helping him with a mobile dialysis situation, where he's either doing it himself in his abdomen or they could be hooking him up to a machine.
"It could also mean he's close to dialysis but not actually on it yet and he is able to have his doctors come with him to check him on a regular basis ... monitoring his blood chemistry, those sort of things."
Q: What kind of preparation is needed prior to a kidney transplant?
A: For a person like Wonder, who is receiving an organ transplant, Denny said the main requirement is that the person be healthy enough to have the surgery.
"The main thing is, how strong is their heart? What is their risk for a heart attack?" Denny said. "How well do they get around? Are they still a relatively active person? One of the other big things is how well do they follow instructions, take their medications and how compliant can they be?
"Our goal is to get this person back to the life they had before the kidney doctor said you have a problem. So if a person is 95 and in a nursing home and not waking up, you probably are not going to be benefiting that person too much (with a transplant).
"But that said, age by itself is not a cutoff at our center. Some centers cut off at around 70. My oldest (transplant recipient) was 80 years old and is doing quite well. The surgery was years ago."
Q: How do people who need a kidney transplant find a donor? Some have speculated that because Wonder is famous, he's getting more swift treatment.
A: "You cannot pay anyone to be a donor," Denny said. "That's against the law.
"When you're on the (organ transplant) list, it's by wait time and a few other criteria, but it has nothing to do with money, fame or anything like that. Stevie cannot push himself up on the wait list. But he can find himself a donor. Anybody can find themselves a donor.
"You find a donor by sharing your story, by telling them it's a low-risk procedure, and that donors do very well. Optimally, the minute you find out you have a kidney problem, you should start trying to find a donor."
Q: How can you tell if someone is a match to donate a kidney?
A: "Basically, we need to do some simple blood tests," Denny said.
"We mix their blood in a test tube to do what's called a mini-transplant. That's a cross-match and that will let us know if they're compatible. At our center, even if they're not compatible, we'll do what's called a swap."
It's also known as kidney-paired donation. Denny explains it like this:
"So let's say (a person) came in and he had a friend who wants to donate to him, but they were not compatible. I would find someone else at my center who is in the same situation -- a guy comes in and he has a friend but they're not compatible -- and then we would swap. We always find a way to get the job done safely."
Among the factors that go into determining a match are the blood type of the donor and the recipient, age of the recipient, and size of the donor kidney in comparison to the body size of the recipient.
Q: Do people die waiting for a kidney transplant?
A: As many as 13 people die each day waiting for a kidney, according to the National Kidney Foundation.
Naitonally, more than 93,000 people are in need of a kidney transplant, according to Organ Procurement and Transplantation Network (OPTN) Data Reports.
"People used to say, 'If you have a kidney problem, get on the list! Get on the list!' Denny said. "However, what you should be saying is, 'Find a donor! Find a donor.' "
The average wait time for a donor kidney from a deceased donor is five years, according to the American Kidney Fund. The transplant waiting list is managed for the federal government by the United Network for Organ Sharing.
"Getting on the list presumes you're going to get transplanted," Denny said. "You may wait years on the list. What's going to happen to you in five years, especially if you're diabetic? Diabetics die at a significantly higher rate on dialysis.
"It's very important to seek a live donor. That is your lifeline. That is your golden ticket. You don't wait. You find a transplant center and you do your best to find a live donor. If you need help, you call us and we will try to help you with that. Live donors are the best options for you. They work the fastest, the best and they last the longest."
Q: Do you need to have insurance to be a living kidney donor?
"It's completely free," Denny said. "You don't need insurance. You go home from our center afterward in one to two days."
Recovery for the kidney donor is four to six weeks after surgery, Denny said.
"For a live donor, we evaluate you because we need you to live to 70, 80 90 with just one kidney," he said. "My goal when I see a donor is not just to get them ready for the recipient, but it's to make sure that they can be a donor. The evaluation is completely independent of the recipient.
"A lot of times I turn people down because they're not OK to give one kidney away."
Among the factors that are considered are a person's weight, pre-existing or chronic medical conditions and cancer history, Denny said.
Q: Stevie Wonder is African American, which puts him at higher risk for kidney disease, doesn't it?
A: "We know that the diseases that cause kidney disease happen disproportionately in a high amount in African American folks," Denny said. "That's why greater than 50% of the people on the waiting list are African American."
African Americans are three times more likely to develop kidney disease than caucasians, according to the American Kidney Fund.
"There are health disparities in the African American community for a lot of reasons, much of that relates to the social situation, economics, education, and access to care," Denny said.
"It's a very close-to-home topic. When I give lectures, I always ask people, 'What do you think about dialysis or kidney disease?' And they say, 'I don't know or I don't care.'
"And then I say, 'Well, how many people have a grandma with high blood pressure?' Hands go up. And then I say, 'Who knows somebody with diabetes?' And then I say, 'These are the people who are going to need dialysis.' Then they can see how close to home it really hits."
Q: How long does a transplanted kidney typically last.
A: "It could go 30 years," Denny said, "but they average 13-15 years or more."
Q: How long is recovery after surgery?
A: Henry Ford's Center for Living Donation is the only place in Michigan, Denny said, that uses Da Vinci minimally invasive robotic surgery for kidney transplantation.
The laparoscopic procedure is used to implant a new kidney in about 30% of kidney transplant recipients, he said, and to remove a kidney in about 15% of donors.
"At Henry Ford, the donor will go home on the next day or the day after and the recipient will go home on the third day or the fourth day after surgery," Denny said. "The donor will be able to go back to work in about four to six weeks.
"The recipient is on medication, so we generally don't have them go back to work for about 90 days. There's a lot more things that we need to do to get their medication levels right. The transplant nephrologists work diligently to get them back to where they're doing normal activity."
He said donor recipients are asked to take precautions to avoid infections after surgery.
"Doctors will tell you to avoid large groups, to wear shoes -- don't walk around barefoot, those types of things," Denny said, noting that there are some things most people take for granted that people who've had a kidney transplant can't risk.
"Stuff like the dangers of eating at a buffet," he said. "If you went to a restaurant and the buffet looks good, you might chow down. Transplant patients don't do that. If you get something from the buffet, you might just have a loose bowel movement, but you're OK. If they get something, it might be much, much worse. The same goes for walking without shoes on the beach. Sometimes, you can get a cut on the bottom of your foot from stepping on a shell or something, and then you get cellulitis. It could be bad for a transplant recipient.
"We tell them to live the healthiest life you can within reason."
Q: How common is rejection in kidney transplant surgery?
A: "Rejection used to be high," Denny said. "The rates now are significantly under 10% with the medications that we have. Certain groups might have slightly higher risks, but most rejections can be treated with medications. Just because there's been a rejection doesn't mean you're going to lose your kidney."
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