The Miracles Continue

I have always been a fan of medical shows on television. You can go all the way back to “Marcus Welby, M.D.” and “Medical Center”. Then there was “St. Elsewhere,” “E.R.” and “Chicago Hope” in the ‘80s and ‘90s.  More recently “The Resident,” “The Good Doctor,” “New Amsterdam” and “Chicago Med.”  Of course, my all-time favorite was “House.” “House” was a true curmudgeon. Still, he was brilliant, solving disease mysteries that no one else could. I truly believe that I am smarter today because of these medical shows.  When I get my blood tests back, I feel informed because of what I have seen on TV.

Thank goodness I have gained this knowledge because I have had enough tests these last two months to sink a battleship as I get ready to hopefully receive a kidney transplant.  So far this month I have had the following: CT Abdomen Pelvis without IV Contrast, NM Cardiac Perfusion Rest and Stress Spect, DX Chest Anterior Posterior or Posterior Anterior and Lateral X-Ray, 6 Minute Stress Walk, ECG, Urinalysis with Microscopic, Echo Transthoracic (TTE), Abdomen MRI, Colonoscopy plus 16 vials of blood that turned into 40 results. Don’t feel bad if you don’t understand most of this. I did all of those tests and still don’t understand it all. Julia had her own series of donor tests.

In addition, we each had a series of meetings to speak to those on the transplant team - a social worker, surgeon, doctors from Infectious Disease, Hematology, Nephrology, Cardiology, and a coordinator Physician’s Assistant.  There have been meetings with the National Kidney Foundation to help us find donors and caregiving training. Unless I can use Julia’s kidney, Julia will have to care for me and I will care for her.

The process of receiving a kidney varies. There is the most traditional path of receiving a kidney from a deceased individual. This can take an extended wait time and typically lasts about a third of the time of a live organ. It could take a decade to get such a kidney. Second, there is the process of receiving a kidney donated directly from a relative or acquaintance. Lastly, there is the possibility of getting a kidney from someone that you don’t know in an exchange of kidneys – each recipient secures a donor who donates to someone in exchange for a living match.  This is the type that we will likely pursue if Julia and I are not a good enough match.

Julia has agreed to give me one of her kidneys. If we are not a good match due to factors other than our blood types, she could donate a kidney to someone else that is waiting for one. For this person to receive a kidney, they also have someone willing to donate a kidney. Chances are that there may need to be several people in this chain. The Mayo Clinic is well known for its ability to create these chains and matches. After a match is found, surgery will be scheduled but likely at different times.

Julia has gone through her own set of tests and learned that she has been accepted as a donor. If she wasn’t accepted, I would have had to go to plan B.  Plan B is the process of finding another person to donate. Amazingly, I have a few individuals that have volunteered to go through the process. It is amazing having support like this. I didn’t even have to ask. They just generously volunteered to be tested as a donor. Luckily, we will not have to go this route.

There are certain criteria for finding a good match between the donor and the recipient.  They are as follows:

1. 
   The same tissue type—aside from identical twins, no 2 people have the exact same tissue type, though a match is considered the “same” if tissues match 12 certain protein markers.
2. Compatible blood type—certain blood types are compatible, meaning their antibodies won’t attack each other. An antibody is a blood protein formed when the body recognizes another substance as harmful.
3. Negative serum crossmatch tests—this series of blood tests looks at the reaction between a kidney donor’s and a transplant recipient’s blood or organs. Negative test results mean there are no antibodies from the recipient’s blood that would destroy the donor’s.

Should I get lucky enough for all of this to happen, I will spend a few days in the hospital after the surgery. Julia will spend a night if all goes well. We will then have to take it easy for a couple weeks and should be back to normal in three months. I will be on a regimen of medications for life to keep from rejecting the organ, but I will no longer be tethered to dialysis many times a week. Through the years of battling Multiple Myeloma, I knew that my kidneys would eventually give out. Fifteen years ago, there was no option for a kidney transplant because of Myeloma. Now due to the remarkable recovery from my time in the hospital in 2022 and medical advancements, it is possible and even recommended by my medical team.

At this point, all looks well with just one procedure outstanding. We will likely know sometime in early September if we can move forward. The miracles continue!