In the meantime, you may be put on a transplant list, and regular blood and urine tests will be done to determine the blood type and the compatability of any portential (normally relatives of immediate family, or friends) donors who would be willing to donate a kidney, and if all goes well and tests are positive, chances become stronger of having a transplant.
Once the transplant is approved and all arrangements (surgeons, hospital stays, discharge from dialysis treatment) have been made, the last thing to do is to determine whether you and the donor are strong enough mentally and emotionally for the operation and the recovery. This will be determined by an assessment by a Psychologist that specialises in renal transplantation. Once deemed fit enough in that regard, you can go and have the operation. All the tests and assessments are known as a 'work up'.
Once on this road to a new lease on life, there are questions that you usually ask:
"where will the new kidney come from?", the answer is this, there are two sources from which a new kidney can be taken- A living donor or a Cadaveric donor. The living donor is a person who has volunteered his or her kidney for transplantation. The Cadaveric donor, however, is dead, but in life has given consent to have his or her organs, in this case kidneys, removed once dead, and used to save the lives of others.
In terms of living donors, most people, such as my mother, have two kidneys, but sometimes they are born with only one or must have one kidney removed due to illness or accident. These donors live normal, healthy lives. That is why living donors have always been an important source of kidneys for patients in need of transplantation.
In my case, my transplant kidney came from a living relative, which means that, if taken care of properly, I can live a normal and relatively healthy life, without the need for dialysis. Having said that my kidney came from a relative, I now come to a sub type of donor under living donors- Related donors- this can be anyone over the age of 18 years old, who is a part of your family. In my case, my mother was my donor as she was ,the same blood type as me, she was my mother, and she was fit and healthy. Another reason for my mothers choice was that she didnt want to see her child on a dialysis machine and looking so sick for the rest of his life. For this I will be forever grateful.
A kidney from a related living donor gives the best chance, in my experience, of success. This is because the donor is more likely to provide a good tissue match. The better the match, the less chance of rejection. Lower the chance of rejection means less anti-rejection medication on a daily basis.
Non- related living donors are considered for volunteering a kidney if the intended recipient cannot find a suitable related living donor. Although these donors may not be closely matched to you, there are certain benefits to a living donor:
1. The transplant can be performed at any time.
2. The success rate is higher than that of cadaveric kidneys, whether the donor is related or not.
3. With a living donor there is no delay between the time the kidney is removed from the donor and transplanted into you as the recipient, whereas, with a cadaveric kidney, the organ has to be stored for several hours between recovering the kidney, a suitable recipient is selected, the kidney is transported to the recieving hospital, and finally transplanted.
The living donor will have to undergo an operation to remove the kidney. This will take up to four hours, and is performed under general anesthesia.
After this, the donor will have to stay in hospital for a period of up to 5 days. This time can varie from case to case.
In the case of my mothers operation and stay in hospital, the operation went well and she was only in hospital for three days. After discharge, the donor can return to his or her normal activities after 4 to 6 weeks. This being the done thing, my mother was "discharged" but stayed in hospital to be with me, which was a great comfort.
There was no risk to my mother during and after the operation. In other cases, however, there has been a risk of the possibility that the donor will injure the remaining kidney in some way, which would mean that he or she would not have a backup kidney.
In the case of Cadaveric donors, I have met one transplant patient who was called for a cadava kidney transplant. This patient, who was on dialysis, had had a transplant, the kidney had come from his sister. However, one of the major signs of rejection- fluid retention (caused by sodium build up)- started showing itself, and the patient began swelling, and he had to be drained via foley catheter. A few months later, he recieved the call informing him that a cadava was available. He was admitted for surgery, and the operation was a success and he is doing well at present.
In general, cadava donors- people who have died- has given consent for a transplant team to harvest his organs in order to transplant someone in the future.
Keep in mind, "even though living donor transplants have a higher success rate, at least 9 out of 10 kidneys are still working after one year" (OTIS Guide Book; P 4).
Before and during my stay in hospital, important tissue matching tests had to be done to ensure that the kidney that was going to be transplanted and the donor giving the kidney was right for me. "There are 3 important levels of tissue testing" (OTIS Guide Book; P 4) :
1. Blood type.
2. Tissue type.
3. Antibodies.
In my case, mother and I were a 97% match, which means that we could have the operation knowing that there was far less worry of any chance of rejection, however, there is always the risk that there will be rejection. In my case there wasn't any as the kidney started 'taking' (working) immediately.
Transplanted kidney procedure diagram (above)
Once your operation, which takes about 3 to 4 hours, is over, you will have a scar on the lower abdomen which will be around 20cm long, which is the result of an incision made during surgery where the surgeon will attach the donor kidney to your bladder as well as its artery and vein which are in turn attached to the nearby blood vessels.
.JPG)
My scar 7 months after my surgery (above)
At 7 months post transplant, your life should have returned to normal and you would have gotten used to your medication as well as not suffering the side effects of the medication. You are also not really required to wear a mask, however, my advice is to wear one when in public places or at least keep one on you just in case. Play by the rules and you wont suffer the consequences in what I have decided, and if you feel that something is not quite right then dont hesitate to contact your transplant team.
In my case, I feel nothing to contact my transplant team if I feel something is not quite right. You should also memorise the warning signs of rejection, which are:
1. flu like symptoms, such as chills; headache; fatigue; dizziness or vomitting
2. fever of over 38.7' C
3. any signs of fluid retention, such as rapid weight gain or swelling of the ankles
4. increased blood pressure
5. pain or redness in the area of your surgery
6. reduction in urine output
7. pain or burning in urine output
8. dark, bloody or bad smelling urine
9. dark or bloody stool
Having memorised these signs, I do a lot of self monitoring- looking out for any of these signs as well as doing research on aspects that do not appear in guide books that were given to me, namely are transplant patients allowed to take vitamin C after having a flu jab during the 'flu season'? The answer to this is yes.
If you experience any of the above signs, you are advised to contact your transplant team immediately!
*****
