Neil: Transplant registrar

We had a trip to the hospital to talk about live kidney donation. The surgeon was still in theatre, so we met with the surgical registrar. We went through all the standard questions again, just to be sure. It is good that I don’t smoke and am not overweight.

Though my Glomerular Filtration Rate (GFR) is below average for my age at around 85, it is not that far below (98 plus or minus 39, from Epstein 1996). Although kidney function generally decreases with age in many cases it may stay constant for many years.

We got to see the results of my CT scan on the computer, so I had a good look at my liver, stomach, kidneys, intestines, etc. They all looked OK to me, and thankfully they all looked OK to the doctors as well. By this time Jasmine had got bored and was singing away loudly to herself, so Ruth took her back to the waiting room.

There was a woman in the waiting room who had donated her kidney three weeks before. She looked pretty well, so that was encouraging. She was showing her scar to the receptionist, so Ruth had a good look. Ruth tried to ask her some questions, but was too upset at the sight of a scar, even though it was nice and neat.

The surgical procedure would be to use key hole surgery to extract the kidney. The plan is to take the left kidney, as the ureter is longer. The artery and vein are sewn shut with titanium. They use multiple stitches instead of a single clip, so it cannot pop off.

The registrar went through the possible complications. Most common is excessive bleeding, at five percent, requiring a blood transfusion. In one case in a hundred the bleeding is so bad that they have to change from key hole surgery to open surgery to stop the bleeding, which would significantly increase the recovery time. One in 3000 cases they miss some bleeding and you have had it….

Then there is intra-abdominal infections. Physical injury to the bowel, spleen, etc. Most of these can be corrected and will be apparent while in hospital. Chest infections and urinary tract infections are also possible. A hernia may develop after leaving the hospital.

The surgeons seem to think it is fairly routine, as they do the surgery all the time. That is reassuring, but at the same time they have to tell you about all the things that could go wrong, which is not reassuring at all! As Jasmine is so young she needs the best chance of a transplant that will last a long time, and a cadaver kidney is unlikely to last as long as a live one. And you can only have a limited number of kidney transplants before you run out of plumbing to attach things to. Jasmine needs the best kidney as soon as possible, as one of our doctors said, “Jasmine needs a transplant as dialysis shortens your life…. Well, transplantation shortens your life too.”

2 Responses to “Neil: Transplant registrar”

  1. Jill Winslow says:

    Its all so scary, but she will feel better and that is a gift, it sounds as if you are in great hands…and scars a re cool right, very tough…and quite the story to tell after (: Hang in there guys, you are doing awesome!

  2. Jessica says:

    It is so scary how transplant and dialysis both shorten our children’s lives. My little one is on dialysis as well. He is 15 months old and 9.4 kg. I’ve been following your blog for a few months and thought I should introduce myself. I created a yahoo group for parents of children on dialysis and post transplant. It only has about 5 moms right now and soon to be one dad. If you are interested in chatting with some people who kind of know what you are going through–send me an email and I’ll send you an invite. I will be saying prayers and thinking good thoughts for your family.

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