Bill Was Accepted to the Kidney Transplant List

Credit - IP Closeup

After all of the physical tests have been completed, Bill met the criteria to be placed on the kidney transplant list. We had to return to the transplant hospital in Denver to take a class on next steps. Bill also had to meet with the kidney transplant surgeon and the dietitian. As well as take a chest X-ray and DNA tests in order to wrap up the initial process. 

The class was quite informative as it was made up of everyone who also met the criteria to be placed on the transplant list. The class members included all ages, ethnicities, and those who were on dialysis and not. Bill is not on dialysis because his kidney function has stabilized. He is at 18% and his kidney doctor said he didn't see a need for Bill to be on dialysis for now. So, Bill is postponing because once you start dialysis, you have to remain on it until you receive a transplant.

Bill and I learned that he has to get blood drawn once a month to monitor his Panel Reactive Antibody. This blood work will help with finding a cross match with a potential donor. Bill is open to receiving a deceased donor kidney even though the kidney won't last as long as getting a living kidney donor. Regardless of a deceased or living donor, the donor needs to be A or O blood type for Bill. The antigens as well as the cross match being negative has to match for Bill to receive the kidney. According to Wikipedia, antigens are toxin or other foreign substances that induces an immune response in the body, especially the production of antibodies. The matching will help in preventing Bill's body from rejecting the donor kidney. Kidneys from the same family will be best the cross match. But, other criteria, family living kidney donors still may not be the best match. Bill has to do the Panel Reactive Antibody blood draw monthly and send to the hospital as they continue to search for a match. 

Presbyterian/St. Luke's Hospital will work with the United Network for Organ Sharing to find Bill a donor kidney. There is a process where they will look for a donor kidney in Colorado, then region 8 that makes up Colorado, Wyoming, Nebraska, Kansas, Iowa, and Missouri. If the hospital can't find a kidney in this regional, they will do a nationwide search. The search will be for a deceased kidney donor. If there are living donors who are willing to be tested, the searching process will happen concurrently. If deceased kidney donor search is found, the hospital will call Bill and let him know of the availability. The transplant coordinator let us know that her 30-year tenure at the hospital that these call happen late at night. So, she stresses that we put the hospital's 800 number in our phones. When they call, they will let Bill know the deceased donor's age, sex, cause of death, and if he or she had high-risk behavior like getting Hepatitis C or B or HIV. The hospital tests the donor kidney for all of these diseases. According to the hospital, there a minuscule chance of these high risk diseases being passed along to the recipient. Once Bill receives this information, he has one hour to say yes or no to the kidney being offered. If he says yes, the hospital will do more testing for the cross match. It will take 5 to 6 hours. If cross match is a go, they will let Bill know that he needs comes to the hospital in Denver for surgery. Our new normal means that Bill and I cannot travel now out of Colorado or the country because Bill needs to be prepared to go into surgery at a last minute notice. If Bill declines the kidney, he has start the process over again to find a new one. He doesn't drop down on the list for his refusal. It may take longer to find another one. 

When Bill arrives to the hospital, he will be seen by the transplant doctors and have a X-ray and blood work done. If everything is good, he will go into surgery because the donor kidney has been on ice for 24 hours. Surgery takes 3 to 4 hours. If surgeon sees that the kidney will not work, surgery could stop and Bill has to go through the process again. We are hoping that this doesn't happen. If kidney is okay, surgery will happen. Bill has to stay in hospital for 4 days. He will feel good right away. 

After surgery, Bill will come home and have a 3 month recovery. He has take 9 to 12 different medications with up to 30 to 40 pills a day in the beginning so his body doesn't reject the new kidney. We have to go the hospital in Denver once a week for one month so he can get evaluated to see if kidney is working properly. The main concern is rejection. It is important that Bill doesn't get a cold or flu virus because it is harder to treat. So, we have to keep him quarantined at home and monitor his temperature. The visits to the hospital will decrease after the first month including the dosage of his medication. Bill has to take the medications for the rest of his life. 

The kidney transplant will not cure Bill's diabetes. It will help with his high blood pressure due to diabetes. Unfortunately, the diabetes will cause problems to the new kidney and Bill will have to get a second transplant. If he gets a deceased kidney donor, that kidney will last about 7 to 10 years. A living donor kidney will last about 12 to 15 years. 

So, we are in the stage of the journey that we wait for the phone call for his new kidney. We are accepting the new normal in our life. We ask that loved ones and friends accept this part of the journey too because it means no travel now. And, it also means that quarantine has to happen post-surgery for 3 months. We will be happy to Facetime with you. But, no visits until Bill has been given the greenlight from the hospital that everything is good. Thank you for your understanding!