Tag Transplant Center

We Tried

Michael 6 Comments

I wish I had a happier update to pass along but last Thursday we lost the kidney. We knew we were entering unfriendly waters, weren’t certain it was going to take and had the best team we could want, but the transplant was not meant to be. They all aren’t. Even something with a 97% chance of happening flawlessly has a 3% shot of not working at all. I suppose you could say the long shot came in. I can tell you what happened but people are still working on the why to go with it.

On the first implant, the donor kidney almost immediately picked up color indicating blood was flowing through it. By the following morning blood flow could not be detected and an ultrasound indicated a possible clot in the artery leading to new to me kidney. The decision was made to go back inside me, remove the kidney, clean things up, then return it. This is where we were at the most recent post.

For the next two days, various imaging tests indicated blood flow to be good, marginal, or inadequate – not consistently nor in that order any given time returning any of those results. But laboratory tests indicated an improved renal function. It raised questions. It can happen, in fact it’s not unusual that flow and function decrease or diverge in the first week after transplant. After a week though, results continued to show too much discrepancy between lab function and imaging. After much consultation and while considering risks versus benefits it was decided the only conclusive answer would be achieved by actually exploring the area and physically examining the kidney.

It was found that blood was flowing into the kidney but not through the kidney. The small veins inside the kidney were again clotted, turning the kidney into an anatomical water balloon. The danger of rupture resulting in peritonitis was too great and the kidney had to be removed.

Now that kidney is being examined by pathologists to try to determine the cause. Was there a defect in the kidney making it prone to clot, is there an undiscovered defect in my blood making it prone to clot, or was there a combination of immeasurable or unknown factors resulting in the clots.

The disappointment is huge but the potential is great. If there is something organically “wrong” with that kidney these events might have happened to it while it still resided in my sister potentially rupturing in her and causing her all sorts of untold problems. If there is a defect in my blood it could be that a potential life threatening condition might now be identified and treated. If there is a defect caused by the combination of my blood and her kidney it could that mean future donor and transplant candidates may undergo even more rigorous screening for compatibility.

Some consequences are more immediate. I continue to be hospitalized while I recover from these three operations. As an impatient I’ve received dialysis and my response here will aid in determining if upon discharge I return to dialysis at my pre-surgical order and schedule. My sister will continue her post-operative tests and appointments. I may not have been a successful recipient of her kidney but she was a quite successful donor and will now forever bear the scar of her sacrifice.

So the journey does not yet end. We’ve merely come to the inevitable fork in the road. It might be too early to tell which path to take or it might mean neither path is best but a whole new trail must be blazed. Something good will come from this. It might not be the result that we wanted but “good” and “want” are not guaranteed to overlap. 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)
Spare Part (May 22, 2019)

Close But No Cigar -Yet (June 2, 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)

Close But No Cigar – Yet

Michael 7 Comments

If things went according to plan this should be Day 5 for me as an official kidney transplant recipient. Actually I don’t know if that’s an official designation. I don’t believe it comes with a membership card or even a secret handshake although it is an ever growing cohort.

I started with that “If things went according to plan” because we have somewhat deviated from that plan. Sometimes things are going to go as well as a textbook procedure, maybe with a minor glitch creating a minor challenge that makes a learning opportunity for everyone. Then there are the things that happen to me.

Sometime last Wednesday a kidney was removed from my donor angel, walked into the operating room next door to that activity, and placed into my body. It was a moment unlike any other. Literally. The organ was a sewn into place, arteries and veins connected, clamps opened, “dirty” blood flowed in and “clean” blood flowed out one way to be recirculation while waste flowed out as urine to its ultimate elimination. It was working! And it continued to work for about 18 hours. Then the reason consent forms came to be came to be realized.

Without getting into the many reasons that could have caused it to happen, partly because specialists are still trying to determine all of the reasons that might have caused it to happen, the blood stopped flowing. I immediately was prepared to return to the operating room where the kidney was removed, arteries and vessels cleaned of some newly formed blood clots, the kidney bathed in an anticoagulant solution, new ties and connections again attached the new kidney to my old body, and then the cleaning process reestablished although at a less than optimal rate.

The kidney was saved, the kidney was working, but to exactly what degree and for how long is still yet to be determined.

As I am writing this samples of my blood are being sent off for examination into why it is clotting at a rate the would not allow the process to be without the corresponding infusion of anticoagulants. Perhaps in another week I can share the reason or reasons and some resolution for it. Until then I can tell you the good things that have happened.

The earth angel who parted with one of her kidneys for me is well and at home already establishing a new normal that remarkably resembles her old normal and doing it much faster than expected, waiting anxiously and praying devoutly for me to to do likewise. Her former kidney is doing its job well enough that I for the first time in almost 3 years lived through a full week without once being attached to a dialysis machine! And we made the right choice of transplant centers where I have never seen such coordination of care and research happening to see that her kidney successfully transitions to being my kidney in its new forever home.

I am walking and eating and generally being a pest to the doctors asking for more freedom of motion, less dietary restrictions, and answers, please more answers. In general, if asked how I am feeling I am clearly feeling better and stronger than a week ago. But I also know I am not yet out of the woods or out of the the weeds or wherever one gets out of when things are not working at their tip-top-pi-est.

I also feel closer to the donor than I have for not just a week but for almost 57 years. That was how long ago the girl who shared her kidney with me was brought home by my parents and introduced to me as my new little sister. Like most siblings particularly a middle and a youngest, we spent many childhood years fighting for attention. Now we are fighting together and discovering even after all these years, new reasons to get our way. Only now finally a common way! Someday soon we will have our answers and we will get our way. How can I let her down?

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)
Spare Part (May 22, 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)