I’ve been terribly inconsistent posting but I have a very good reason for that. I’ve been making room for a new kidney!

In the last kidney update from a couple weeks ago I said I was starting the annual testing to remain on the transplant list. Just as I was starting those we got word that we had a live donor match! In fact we had two!!

Since you’ve come along this far on the journey, please join me for this step.

From some posts on a support group page I took it that multiple matches although not common are neither rare. I suppose there could be two absolutely identical donor candidates. More common is the possibility of multiple “perfect marches” with cadaver donors. That would be because with a cadaverous donation only the organ is considered. With live donors, although multiple kidneys might match they are attached to people still using them and their lives rarely perfectly match. Considerations for age, family obligations, location, post-op support, and probabilities of future health issues not uncovered in the donor evaluation must be made. If there still is no decision then they have decide how they will decide. I suppose in the extreme, say if the potential donors are identical twins, they may go as far as a flip of a coin or rock paper scissors. Our donors aren’t twins and they were able to make a determination without resorting to playground games. They got together, made their decision, and notified the hospital.

That decided, pre-op testing began. For the recipient this is the same as the annual testing with some additional lab studies. For the donor, pre-op tests include only a chest x-ray, EKG, a complete metabolic panel lab study, and a complete blood count (CBC). All these can be done within a 30 day window leading up to surgery except for a “last minute” final blood and tissue typing. Last minute would be within 10 days or so of the tentative transplant date.

At this point that date indeed is still tentative. All these tests and studies will be reviewed again by the transplant team. Only after an affirmative from that review is the date finalized. Even then the surgery can be “unscheduled” by any member of the team, the recipient, or the donor.

The surgeries themselves aren’t difficult procedures considering the lifesaving result. The donor operation begins up to an hour before the recipient. In our transplant center this a robotic procedure controlled by two transplant surgeons in attendance. Long before this the decision was made which kidney will be removed. After its removal the renal arteries and veins are shunted to the remaining kidney, the unused ureter is tied off, and the donor goes to recovery.

While the donor’s surgeons are finishing their procedure the recipient’s receiving location is prepared by a second surgical team. The recipient surgery is performed through an open incision and two attending transplant surgeons, in my case one of them also a urological surgeon, will operate. Unless there is a medically necessary reason, the recipient’s native kidneys are not removed. The donated kidney will be placed in an abdominal lower quadrant, usually the right although in my case because of previous surgeries and that space already occupied, it will be placed in the left lower quadrant. The renal vessels and ureter from the native kidneys are transpositioned and the recipient is closed up and sent off to recover.

Typically the donor remains in the hospital 1 to 3 days, often ambulatory the same day of surgery. The recipient’s stay is usually 3 to 6 days, hopefully walking and building up an appetite on post-op day 1. When they go home there are lots of other things that have to happen for both to live healthy, full lives. After all, that is the point of that.

When we get to that point I’ll be sure to keep you up to date in just as excruciating detail as you have become used to. After all, that’s the point of this.

Oh, when will all that be? Well… our presumptive surgery date is next week! I’ll have my last pre-transplant dialysis on Tuesday then eat ravenously because I am ordered nothing by mouth after midnight, every surgery’s first order.

Then, if all goes well I’ll get a new, slightly used spare part. Stay tuned!

——

Transplant Journey Posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)
The Journey Continues (April 16, 2018)
More Steps (May 31, 2018)
Step 4: The List (July 12, 2018)
Step 1 Again…The Donor Perspective (Sept 6, 2018)
And The Wait Goes On (Oct. 18, 2018)
Caution: Rough Road Ahead (Nov. 19, 2018)
And The Wait Goes On (Jan. 24, 2019)
A Worldbeater of a Story (March 14, 2019)

Other Related Posts

Walk This Way…or That (March 9, 2017)
Looking Good (May 18, 2017)
Technical Resistance (May 25, 2017)
Those Who Should Know Better (July 24, 2017)
Cramming for Finals (May 3, 2018)
Make Mine Rare. Or Not (Feb. 28, 2019)
Parts is Parts (May 6, 2019)