Living Kidney Donation

Evaluation process to be a Living Kidney Donor – finding a recipient – laparascopic surgery to remove kidney – my recovery

Having donated a kidney – even though the process was not without its frustrations and last minute blips – I would not hesitate to donate a kidney all over again if I could.
For anyone considering donating a kidney, whether to a relative or friend or to a stranger, the majority of this blog would apply. I have been as honest as I can and not just put a glossy cover on it all.  The events are as they happened and my feelings and thoughts at the time. I hope this blog will enlighten some people as to the process of donating a kidney. It has been a great learning experience for myself as well. Spending so much time with people who have kidney problems and speaking to patients on dialysis or just having had a transplant, and speaking with their families ….. it has opened my eyes even more to the fact more organ donors are needed.  There was nothing in my evaluation or the operation or recovery process that put me off having donated.
I also want to praise everyone working at the transplant unit. Everyone was great and made this whole experience good. There was always a smile and more than that, everyone had time for me. I was never made to feel rushed. When it came time for the operation itself I was made to feel very relaxed and the after care was brilliant. Nothing was too much for the nurses to do to help. The catering staff also could not have been more obliging and friendly and the food was really very enjoyable. The NHS is the very best health system in the world and all the staff are truly wonderfull caring people. I have nothing but praise and thanks to everyone I met.

Here is a brief summary of the evaluation process to donate a kidney leading to HTA approval, finding a recipient, pre operation assessment, the operation and recovery.  You can either click on the links below or on the very left of the page are links to my posts or just scroll right down to the bottom of this page to start reading about my kidney donation from the beginning of the evaluation proceedings.:

Kidney Donor evaluation begins (Feb 3rd ’09)
Met surgeon – coordinator – chatted -  bloods taken – blood pressure – urine sample – ECG – chest xray.
Consultant Nephrologist (April 17th ’09)
Bloods – kidney ultrasound scan – consultant nephrologist – chatted.
Kidney Donor Evaluation proceeding (May 10th ’09)
Confirmation letter from consultant nephrologist. Have to lose weight – come off HRT nearer operation.
Psychologist Assessment  (June 30th ’09)
Chat about my emotions and how I would cope if things didn’t go according to plan etc.
Kidney Donor Evaluation Tests (July 3rd ’09)
Summary of process so far
Living with one kidney – Living kidney donation – risks explained (July 3rd ’09)
Self-explanatory
Emotions – being a kidney donor (July 9th ’09)
What made me donate? How emotions can dictate what we do.
Glomerular Filtration Rate (GFR) and NM Renal DMSA (August 18th ’09)
These are tests to see how well my kidney filters blood and to also visualise the kidneys (shape, size etc).
Psychiatrist Assessment complete (Sept. 10th ’09)
Evaluation to determine reasons for donating are genuine and above board etc etc.
CT Scan on Kidneys (Oct. 28th ’09)
Detailed slice-type pictures of the kidneys
Conclusion of Evaluation tests & HTA (Human Tissue Authority) approval
Exciting times
Trying to find a Recipient for my kidney
Not as straight forward as I thought it would be.
Living Donor Pre Assessment Clinic
Within 2 weeks of donation have to have various tests redone to ensure fully fit for operation.
Again not necessarily stress free.
Heart ultrasound prior to kidney donation
Talk about cutting it fine …..
keyhole surgery to remove my right kidney
Operation admission day. Preparing me for operation – quite a laugh at times.
Recovery Room after Kidney Removal
How I felt immediately after the operation
My Hospital Stay after Kidney Removal
Two day stay in hospital after kidney donation.
NHS is the best in the world. I have nothing but praise.
Recovery at home after Kidney removal
Nice to be home. Learned to listen to my body.
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My Recovery at Home

I was allowed home 2 days after the operation. The journey home was okay. Couldn’t avoid all the bumps and potholes in the road so had to support my abdomen during the journey. It was good to be home. Own bed, own bathroom etc. Couldn’t keep my eyes open so had not been home for long before went up to bed. Now of course, my bed does not raise up like the hospital one. So with great effort I got onto the bed at a sort of an angle and then couldn’t move, lol. The pain in my abdomen was intense. Oh well – I just stayed there on the bed sort of laying across it – and went to sleep. Woke about 5am feeling refreshed and wanting the bathroom, but quite a battle to get out of bed. took around 10 minutes trying to work out the least painful way.

Decided that the next night I would sleep with lots of pillows behind me so my upper half is already raised, just like the hospital bed was. It would then be much easier getting in and out of bed as would not have to use my abdominal muscles as much.

In myself I felt very well. Still bloated which was uncomfortable rather than anything else so hopefully the extra 4 kilos would go soon. I got tired very very quickly. In fact I had only been up for around 3 hours and was walking back from the kitchen with a cup of tea and almost dropped it as I found my eyes closing as I walked. The tiredness just came out the blue!! I know I was told I would feel tired, but I was not sure if that meant bodily tired i.e. no energy, or tired in wanting to go to sleep. Now I know. I had to go back upstairs and get some sleep. I arranged the pillows so they were like a backrest. I have a memory foam mattress which is bliss. I could get into bed a lot easier now with little pain. I got a good hours sleep and woke refreshed. Around 3pm the same thing happened and I found my eyes just would not stay open, so got another hours sleep. I must say the first four or five days was like this. Suddenly feeling sleepy when I had only been up a few hours. I didn’t fight it as I knew my body needed the rest. I was also going up to bed around 7pm or 8pm in the evenings. I actually felt more comfortable laying propped up in bed than sitting in the chair downstairs, which squashed my abdomen up a bit and was uncomfortable. I had very good night sleep for the first week, most nights not waking at all until the morning. Pre operation I would wake about 3 or 4 times needing the bathroom. I also found that sleeping with my upper half propped up I could breathe a lot easier as well which I am sure aided a good night sleep. In fact I have continued to sleep propped up and find it much better than laying flat in bed. When I have saved the money I may just invest in a bed where I can raise the back up. I am surprised at the difference in quality of sleep I get this way.
To read about the rest of my home recovery – Click here

After Kidney Removal – Recovery in Hospital

Same day as operation:
My bed in the transplant ward was going to be ready at 5pm so my family had been told to give it until 6pm to allow me to be settled etc. It was actually 6.15pm that we heard my bed was ready and as I was wheeled into the ward I saw my family at the nurses’ desk and called out a “Yoo Hoo” and gave them a big wave. They expected me to be half asleep and out of it I think, and they almost fell on the floor so see me so awake, happy and smiling … hahaha ….I was taken to my room. Very nice room. Just two beds, I was by the window overlooking the little garden area which had a bird table in it. Shared the room with another lady (who had a kidney/pancreas transplant) and we had our own bathroom. My family were told that I needed to be settled in and it would be a little while so to go for a coffee and come back in say an hour.

I was helped off the trolley into my bed. I couldn’t quite manage this on my own as for some reason my right leg would not bend properly and had not much muscle power. This did by the next day correct itself. The first night I was going to be regularly monitored. Blood pressure sleeve was put on and automatically every two hours it would inflate and do its stuff! Gone are the days when the nurse had to come and do it. I was constantly impressed by all the advancements over the years since I had last visited someone or been in hospital myself. I had boot wraps on my calves over the thromboses stockings. They were wired up to some sort of pump and alternatively each one would inflate and deflate so massaging my calves and thus helping to prevent any blood clots (blood clots are rare, but can happen). A “clip” was put on my index finger which was wired up to a heart monitor. I had a drip in my left arm giving me fluids (until they knew I was eating and drinking enough on my own). In my right arm was another drip which was for the pain meds…
To read about my recovery in hospital – Click here

Recovery Room after operation to remove kidney

Next thing I could hear a voice saying my name and asking me to wake up. It is strange but you can hear the voice perfectly but for a short while you can’t move or speak. It was not that I was even trying to. I was just listening to this voice but not reacting to it yet. I didn’t even try to open my eyes, I was sort of getting my bearings and remembering where I was. For a second I was confused and wondered why I had to wake up, why had I been asleep? I thought it sounded like the operation was over, yet I had only just gone down to theatre! Of course I soon twigged that it was indeed all over. For some reason I was totally surprised by the lack of “lost time”. How wonderful though. One minute feeling woozy, then next minute it is all over and I am back awake.  Sounds a bit crazy, but I sort of felt I had missed out on the best bit! I would have loved to have watched the operation and having lost a few hours seemed so strange as literally I felt like I had one minute said how woozy I felt and the very next second was being asked to wake up … with no gap in the middle.

I felt fine in the recovery room where you are expected to stay about a couple of hours and they keep an eye on your stats etc to make sure everything is okay before taking you to the ward. I was told the operation had started at 9.30am and was finished at 12.45pm, so just over three hours. I forget actually what the time was when I came around, but I was in no pain at all.  I was offered an oxygen mask but preferred the nose tube, which only just sits inside the nostrils. It doesn’t go right up your nose and into your lungs which I had previously thought. Duh! Oxygen is pumped through which aids recovery and certainly I felt I was breathing a lot better than I normally did. I felt slightly light headed, but not unpleasantly so and a very dry mouth. I anticipated this as had been under anaesthetic before and had both those feelings before – water seemed to be the cure back then and so I asked for a drink of water which I was given. Head cleared immediately and I felt fine and dry mouth went.

Recovery unit were waiting for a bed to be prepared for me in the Transplant unit but there was a delay with the discharge of the previous patient I believe, so I was actually in recovery for around 5 hours.   The nurse who stayed with me for best part of that time was great. We had a good laugh together and chat about all sorts of things. She said they had been discussing why someone would do what I did and she couldn’t get her head around why I had donated to a stranger and even explaining it as best I could, she was still a bit “confused” by it all. I can understand that perfectly. Another nurse asked me to explain exactly what altruistic was so I explained. She said that her husband donates bone marrow and had done so 4 times! Wow.  She said it was very painful for him to do but each time of course a life was saved.  What a courageous man. There are some truly remarkable people in this world.  I was offered a cup of tea and while thinking “did I or didn’t I feel like one” – the offer of some biscuits was made. Well – only one answer to that – Yes Please! I suddenly felt really hungry and did I enjoy those biscuits and that cup of tea.  I know the British are sometimes mocked for our love of a cup of tea but I have to say they can mock away all they like – I love my cup of tea, and that day it was the best cup of tea I have ever had! I was beginning to feel rather spoiled. A companion to keep me company for all those hours – cups of tea and biscuits – I have nothing but the highest praise for the NHS and the many many people I have had contact with over the months.

From what I could see there was only one other person in Recovery, next to me. He was still a bit “out of it”. 

My main recovery nurse said when she finished her shift the next day she would come and find me to see how I was. I would look forward to that. She had made my time in recovery go quickly and was very friendly and kind – it takes a very special caring person to become a nurse  and my brief stay in hospital brought me into contact with many very special people who enriched my life more than they will know. 

I was taken up to the Transplant ward around 6.15pm.

Laparascopic Nephrectomy  (Keyhole surgery)

Our journey to the hospital was a hoot. For the first time ever  we missed the turning off the dual carriageway.  Drove on to the next turn off … missed it!! I was not driving. I was sitting in the back keeping my lips very firmly glued together, taking slow deep breaths and Praying!  Today was not the day to get lost, be late or end up stressed.  A few minutes later and iphone to the rescue with its built in sat nav and my son got the directions -  and we got back on track! We did eventually get to the hospital about 10 minutes late instead of 15 minutes early as planned. I had to laugh. No way could I see anything but the funny side of this.

We went to Day Surgery and I filled in a basic form with personal details, next of kin, telephone numbers etc. A nurse took me through to another room and into a cubicle – my family was allowed to come and wait with me which was nice as I was now into  unknown territory a bit. I was weighed. had name bands put on both wrists having confirmed my name, date of birth and address.

At this stage my family went back to the Day Surgery room to wait. I was given some tablets and a heparin injection. My blood when originally tested for clotting, clotted very well, so the heparin will help to thin it slightly so as to help stop blood clots from forming. The nurse measured around my calf as I was to wear anti thrombosis socks. She asked me to get changed into the hospital robe. Why is it that the ties that do up around the buttock area are always the ones that are broken, so you walk down the passage with with your bum sticking out! lol  The anaesthetist came and said hello. Checked the forms and got my weight. We had a little chat and off he went.

I then tried to put the stockings on the nurse gave me. They are special ones that help stop blood clots forming. Oh my!!! They were so tight I could hardly stretch them to get them over my toes let alone up my calf and over my knee!  Took all my effort to stretch it partly open. I managed to get the first one on, but not without grunting, groaning and generally going red in the face and feeling exhausted and throwing a mini tantrum – lol!!
…. to read more about my operation – click here

Sorting out last minute hitches i.e. Heart ultrasound

I had to wait a few days before an appointment was given to me. Before I heard, I emailed my co-ordinator a couple of times, flapping around a bit with meaningless questions! lol … Finally the ultrasound department rang me with an appointment for 2 days before the operation. I emailed my co-ordinator to tell her, although I am sure she would have already been told. I also asked when we would get the results? Could I come straight over to her department and sit and wait for them? She responded saying she was not sure if they would give me the results straight away but she had given the anaesthetist my phone number so he could ring me asap once he heard.

The anaesthetist actually telephoned me that evening to put my mind at rest. He reassured me that there was nothing major wrong with my heart at all, that he was just a very very thorough person and wanted absolutely everything covered. I was not to worry. I very much appreciated not only his phone call which did put my mind totally at rest over this, but I very much appreciated him as well. I had 120%+ faith in the whole transplant team. If I was not, I would not be doing this. I was really more concerned for the recipient and how they would feel should the operation have to be postponed until this “wiggle” was sorted. It was the time scale I think that got me anxious. Had all this happened with plenty of time to spare, then it would have been just one more test I had to have. But only 2 days from the operation was not leaving much time to spare should any further tests be required.
click here to read more about the last minute hitch!

 Living Donor Pre Assessment Clinic

By law you have to have some medical checks done within 2 weeks of the operation. This is to ensure that you are fit and healthy just prior to the operation. Some of the evaluation tests were done a few months ago, so up to date ones would be required. 

I arrived early in the morning at the hospital, knowing I would be there most of the day. Here is a list (as presented to me at the hospital) as to what the day would hold. I was at the hospital for around 5 hours and the following took place but not necessarily in this order:

Tests I had done:
1. Blood and urine samples (they took 20 tubes of blood! yes .. 20!)
2. MRSA swab (gave me a loooong q-tip I had to wipe the inside of my nose with)
3. Chest X-ray
4. ECG

I was seen by:
1. Consultant Surgeon
2. Anaesthetist
3. Pharmacist
4. Transplant Co-ordinator

1. Consultant Surgeon:
My Consultant Surgeon explained that he would not be available to do the operation.  There would be two other surgeons. He told me a bit about them. I was a little unsettled about this, as familiarity of people/faces goes towards a relaxing atmosphere and I felt I knew my current  Surgeon and felt very relaxed in his company. But then I thought I am going to be out of it anyway under anaesthetic, so won’t really matter, so I was okay with that.

My Consultant went through the procedure from admission to after the operation. He drew a picture showing where the incisions would be and why. There would be a small incision just above the belly button, through this the camera would go.  Two more would placed to the right of the camera incision – one just under the rib cage and the other same distance below the camera one. Through those two the surgical instruments would go. My surgeon comically called them “chopsticks”. Another small incision would go to the right of the one just under the rib cage. Through this incision an instrument would go that would move the liver out of the way which is very close to the right kidney. Those four small incisions would be around 1-2cms. The final incision is along the bikini line and would be around 6 inches. It is through that the kidney is extracted.  He also explained that it would be hard to move around in my abdomen as not much room, so they inflate me like a large balloon with carbon dioxide. An after effect of this could be that some gas could escape up into the shoulder blade area and afterwards cause some discomfort for a few days (it did! lol).
Read the rest of this entry »

HTA approval given to donate a kidney – Finding a recipient

My transplant coordinator asked if there were any dates I may not be available for the operation and when was best for me. Once I was registered at UK Transplant things could happen quite quickly so it was important I was not registered at until we were ready. I had a couple of dates that I wanted to avoid otherwise a clear calendar. My family were fine for things to proceed also. My details were then registered at UK Transplant.

The recipient is selected for blood type matching, tissue match, age, length of time on waiting list and various other medical / non medical factors, all of which are there to make the system as fair as possible and also to select the best match to reduce any chance of rejection.

Do not think that once you get to the stage of HTA approval that everything will be straightforward.  It may not be. It was not for me. I made the mistake of assuming it would all now be plain sailing but we still had a few hurdles to get by.
Read the rest of this entry – finding a recipient

It has been  some time since I posted re my final evaluation test, the CT Scan (October 2009). Following that I got HTA approval and I donated my kidney.  Here is an account of that and the operation and my recovery.  There is quite a lot to comment on so I will do it in separate posts. It may take a couple of days to fully post.

Independent Assessor Report and HTA (Human Tissue Authority) approval to donate my kidney.

My last and final evaluation test was the CT Scan in October 2009. That all went well and an appointment was made for me to see the Independent Assessor (IA). The IA is totally separate from the medical teams that have dealt with me, he acts as the HTA (Human Tissue Authority) representative and sends a report to the HTA for approval.
read more about the Independent Assessor Interview

Following several emails asking why I have stopped the evaluation process I just want to say it didn’t stop, I just stopped posting about it back in October as it was important to keep the confidentiality of recipient and donor.  I will post again after several months have passed when I will describe the rest of the evaluation and the donation - in the meantime please scroll down to the bottom of the home page of this blog to read the evaluation process from the start.  

There are also plenty of good (I hope) links and pages on this blog to offer information regarding kidney donation.

If anyone is considering becoming a living donor and would like any information from a donors perspective then please get in contact with me via the contact page or just post a comment and I will get back to you.

“I can’t bring about world peace, I can’t eliminate world hunger, but I can get one person off dialysis”, Dr. Susan Hou had said in 2004

What an amazing and wonderful person and her comments sum up totally the selfless person she is and her desire to help anyone she can.

Chicago based doctor Dr Susan Hou is  in India on the occasion of World Kidney Day on March 11. If you are wondering what’s special about Dr Susan Hou, it is the fact she saved her patients life in a true sense by donating her Kidney seven and a half years back . Dr Susan Hou would be speaking on renal disorders in pregnant women at an event organized by Tanker Foundation on Monday.

We have all known of family members or friends donating kidneys to one another.  But organ donations to unrelated patient was not really heard of.

Dr Susan Hou set up a noble example in this regard and proved that one need not be related to donate organs.

 ”If we believe in the brotherhood of men, then there should be no second thought in donating your kidneys to anybody as no donation is unrelated,” Dr Hou explained.

Dr Susan Hou, an expert on renal disorders in pregnancy describes her transplant experience as great. Her husband Mark Moli, who is an expert doctor himself, was apprehensive about her decision but was fine post surgery. In fact every nephrologist should donate his kidney for the cause of health care, Dr Susan Hou noted.

It is not all roses with Kidney transplants. The donor’s intent and health condition is of utmost importance. The donor must not be suffering from cancer or any other infection. The donor’s kidneys should be healthy. Not many people are convinced of organ donation. “If we have the feeling a donor doesn’t really want to donate, then we tell them they cannot do it.” Dr Susan Hou said.

On Monday Dr Susan Hou was honored by Georgi Abraham, founder-trustee of Tanker Foundation. But one would be surprised to know that seven and a half years back her decision faced strong criticism. In a male dominated society that India is, there was a fear that women would be forced to donate kidneys to their husbands.

“I can’t bring about world peace, I can’t eliminate world hunger, but I can get one person off dialysis” Dr Susan Hou 2004.

What a noble and inspiring thought indeed!

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The kidney CT Scan appointment only took 30 mins and I was in and out in a jiffy. 

I had to make sure I was not wearing anything metal so necklace and bra came off. Trousers stayed on as elasticated instead of zipped.  So wearing t-shirt and trousers I lay down on the CT Scanner bed. It was explained to me that first of all they have to “plan” the scan. The scanner will take some x-rays to determine exactly where my kidneys are then the main scan will only scan that part of my abdomen instead of all of it – all clever stuff.  To do this I had my arms stretched out behind my head and about 7 times the bed passed through the scanner stopping over my abdomen. There was a little screen on the outside of it with two “pac man” type faces – quite amusing. This recorded voice would say “breathe in” and the little pac-man on the left would light up. He had his mouth partly open as though he was about to go chasing his lunch … lol … then a voice would say” hold your breath” and the little pac man on the right would light up. His mouth was closed and his cheeks puffed out! …. Holding of the breath lasted between 3 and 5 seconds, so hardly any time at all.  The bed you were on moved out of the scanner as the voice was saying “breathe” – you could see a countdown in seconds also. 

Have to admit when the bed first went under the scanner (check previous post to see image of the scanner, like a doughnut), I didn’t think it was going to stop until it had passed totally over me. Being rather claustrophobic I felt a bit of panic start, but then felt silly when it went no further than it had to so as to cover my abdomen!! It stopped with the outside, that was slightly angled, level with my chin, so that was fine.

Once they had “planned” the scanning area on my body, I then had a canular put into my arm. First salt water was injected in (felt a bit cold) to make sure the canular was inserted correctly. Then they attached the machine that was going to dispense two different amounts of radioactive mixture.  This travels through the body highlighting the kidneys etc so the scanner picks it up and can form the image.

I was told that as the fluid went through me it may feel warm also I may feel like I am doing a pee but I wont be! lol !

When the “warmth” was felt, it was hardly anything, I felt my hands feel lovely and warm, but only fleetingly then the feeling disappeared.  I now know what he means when he said I may think I am doing a pee (not sure if this applies to men also…) but I felt a sort of “warm flowing” sensation as though I was weeing, but I knew I wasn’t because no bladder feeling happened. It was just like the feeling of warmth flowing through my hands. I had a joke with him and said I thought I had actually wet the bed! He said he wasn’t bothered as it would be the student with them that would have to clean it up!! We had a laugh ….

Had to wait a few minutes for the mixture to travel round my body. Then a second dose was injected and this would show up the veins and arteries.  Again felt my hands warm up and the feeling that might be having a pee. I hasten to add this was not an embarassing or unpleasant feeling  and was only a fleeting feeling. Not sure how else to describe it except for how the nurse described it!

With my arms stretched out above my head under the scanner again.  I did twice have to hold my breath.  I was under the scanner I suppose maybe 10 minutes. Was not long at all.  There were some see-through sections in the scanner and you could see the “workings” whizzing around. It also sounded very much like my washing machine when on spin cycle, it even increased the revs just like my machine does! Then it was all over. 

So the whole thing was very quick and totally pain free. None of it was unpleasant and was back home before I knew it.

Now I believe the next stage is that my Consultant will review all the test results to make sure they are all okay. He may order other tests, that would be up to him and he may also wish to see me … or may not!  This is always the hard part – the waiting to hear something.

CT Scan now booked – 28th October 2009

CT stands for Computerised Tomography. This will be in the Radiology Department.
The CT Scanner is a machine that takes detailed slice-type pictures of the body using x-rays and a computer. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent simultaneously from different angles. In my case it will result in detailed image of the kidneys, their location, size, the arteries and veins connected to the kidneys. From this image the surgeon can decide which will be the safest kidney to remove.  Although we have two kidneys they are not necessarily identical. One can be larger (my left one is) and they can each have a different number of veins. The fewer the better as far as surgical procedures.

I will be asked to lay on a couch which then moves through the CT machine which will scan my abdomen.  The machine is an open ring-like structure – rather like a doughnut!   I will feel nothing, but will be able to see lights on the machine.  I may be given an injection of a colourless dye which will help to show up the blood vessels.

This is what a CT Scanner can look like.

CT Scanner

The hospital are great, they promised they would manage to fit in this CT Scan before I went to London and they have. I did not want my time away from home to hold up procedings any more than they had to.

Tues, 6th October

One more evaluation test to come

I thought I had finished all the physical tests but apparently there is a CT scan of the kidneys still required. The CT scan will show the veins and arteries leading to and from the kidneys. It will show everything in much greater details. It takes about an hour and a half. The result of the CT scan will then be discussed at a consultant meeting and this will determine which kidney is to be donated and whether laparoscopic (keyhole) surgery can be performed. Hopefully soon the letter will arrive with my appointment date.

Once it is determined which kidney is to be used, then the consultant nephrologist will review all my results to date. He may or may not wish to see me. If he is satisfied that I have had all the necessary tests and he is happy with the results then I will be referred for my independent assessment.

The Indepedent assessment is a legal requirement set by the HTA (human tissue authority) in order to gain approval for me to donate and for the transplant to take place.

Once approval has been given by the HTA that will be the finish of the assessment and the next stage would be for my details to be registred with UK transplant so that I can be matched with a suitable recipient. This last stage must not be rushed and I will only go onto the donor database when it is totally convenient for me i.e. no committments to get in the way etc. Once a recipient is found which will be almost straight away, then things could happen very fast, so would not want anything to hold things up. But all this will be discussed with the hospital when approval to donate has been given.

I sit back now and wait to hear when my CT scan is. I hope it is before beginning of November as I am then away for about 2.5 weeks.

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The purpose of this interview was to make sure that I understood what I was offering to do and that I was not doing this under any sort of coersion. Was not being offered money or any incentive to donate. They also needed to know there was not any underlying mental conditions that could adversely affect my decision making . That I was donating for the right reasons and my life was stable etc etc.

The interview lasted around an hour and basically we just chatted. The doctor asked me about my childhood and schooldays … also about my time while growing up and then questions about my family life past and present. I was also, of course, asked why I wanted to donate. She probed further and asked me how I would feel if say the operation presented problems … if something went wrong – how would I cope. How did I feel about never knowing who the recipient is? Would that bother me. I explained to her that just knowing they were living a better life and enjoying doing things again was plenty to make me smile. I think at the end of our chat she could see that I was a strong person mentally, knew my own mind and had made my decision freely with no coersion from anyone or payment and with full understanding of the whole procedure and risks etc etc.

It is a bit nerve-wracking knowing you are going to be quizzed by a psychiatrist. All one can do is say things as they are.

The doctor had no more questions and asked if I had any. I said I just had one … “Had I passed!” …. lol …. she said there was nothing untoward in our discussions – nothing that would make her query my decision. She would write up her report and send it to those concerned and a copy to me.

Couple of days ago I wrote to the Transplant Nurse Specialist and asked her to remind me of what happens next. We are so near now. I did chat with her a few weeks ago about what happens once the evaluation tests are done – but I never wrote anything down, so I am in a muddle as to what order things happen next. So look forward to her response.

A Glomerular Filtration Rate (GFR) measures how well  kidneys filter your blood.  A lovely radiologist called Sarah greeted me. My weight and height were taken. Sarah put a  canular into my left arm. It is from this that the blood samples will be taken.  A small amount of Heparin was used to stop any blood clotting in the canular which would interfere with the drawing of the samples.

In my right arm she put a “butterfly IV canular” into which she injected a very small amount of special radioactive tracer (probably less radioactive amount than having a normal x-ray).   The canular in my right arm was then removed. Read the rest of this entry »

I was challenged recently to try to explain what drives me to donating to a stranger and what is in it for me. If I were paid a large sum of money, then that could be understood as to the motives behind this. But with no apparent benefit – then why do it? Very good question and not always easy to answer.

Why do people decide to sail around the world or climb the highest mountains in the most atrocious of conditions? They are hailed as Explorers and record breakers and daring and brave! Who have they benefited by doing those things? Don’t get me wrong, they are courageous and brave and have pushed the boundaries of what the body can endure to the limit and beyond and I have great admiration for them. Why then when we decide to help someone lead a better life, we are often viewed as … crazy!

Why do we do anything though? Emotions drive us either to do something or not do something. Emotions that just seem to spring from nowhere.

Sometimes the drive inside us is so strong we just can’t ignore it. I had such  a desire inside me to offer one of my kidneys to someone who needed one. That desire just grew over time. I knew it was something I really wanted to do.

What do I get out of donating? I do agree that whenever we give, we do also receive, whether it is a great sense of satisfaction or disappointment should something go wrong.
Read the rest of this entry »

It is important that anyone considering donating a kidney is aware of the risks involved. 

Firstly let me say that altruistic donation (the operation and recovery etc) is no different to someone donating to a loved one. Here are some statistics *.

In the UK between 1 April 2008 and 31 March 2009:

• 3,513 organ transplants were carried out, thanks to the generosity of 1,854 donors.
• 977 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney, liver/pancreas, heart/kidney or liver/kidney/pancreas transplant.
• A total of 2,536 patients received a kidney, pancreas or combined kidney/pancreas transplant.
• A further 2,711 people had their sight restored through a cornea transplant.
• A record number of donors were living donors, 954 people donated a kidney or a segment of their liver or lung, representing more than half of all donors.
• The highest number of non-heartbeating donor transplants took place- 579 transplants, a 35% increase on 2007-2008.
• Living donor kidney transplants are increasing – 589 in 2005-2006, 690 in 2006-2007, 831 in 2007-2008 and 927 in 2008-2009 and now represent more than one in three of all kidney transplants.
• At the end of March 2009, 7,877 patients were listed as actively waiting for a transplant.
• Almost a million more people pledged to help others after their death by registering their wishes on the NHS Organ Donor Register, bringing the total at 31 March 2009 to 16,124,871

As you can see from the above, more than 1 in 3 kidney transplants are via living donors.  There may only have been a small amount of altruistic donors so far, but the law allowing that is only a couple or so years old.
Read the rest of this entry »

I thought it might help to just go over what has happened so far, and the evaluation stages left.

I had an initial consultation with the surgeon and a Transplant Specialist Nurse. Various questions regarding my health, past and present and my families health as far as any illnesses they may have had.  My weight and height were checked.

Blood pressure
This gets taken as high blood pressure can cause damage to the kidneys.  Blood pressure is taken more than once during the evaluation period. 

Urine sample
Urine sample is taken and checked for underlying problems such as glucose, protein, bacteria, etc.

I have had blood taken three times and  checked for a variety of things. Blood group, tissue type …. infections, all sorts of things are checked for to make sure you are quite healthy.

Blood tests
Blood samples will be taken which is checked for blood group, tissue type, can show if there is anaemia, various infections etc etc . Various checks on the blood are done to make sure you are quite healthy and the kidney and liver are functioning okay ….

X-rays
A chest x-ray was taken.

Electrocardiogram (ECG)
I had an ECG (Electrocardiogram) where you have electrodes placed on you and your heart is monitored and the electrical impulses of the heart are recorded onto a graph and from that they can tell if there are any weaknesses in the heart.

Renal ultrasound
This is a non-invasive scan.  It  checks that there are two kidneys. Some people are born with only one kidney but are totally unaware of the fact.  The ultrasound can show the size of the kidneys, if there is any scarring or obstructions.   I had a small scar on the top of the right kidney which was probably due to an infection as a child.  It did not affect my ability to donate.  For those who have never had an ultrasound (most pregnant mums have) – then for a kidney ultrasound they wanted it done on a full bladder (that was the hardest part ..lol…). A gel is put onto your abdomen/side and then the technician moves a probe over your abdomen and sides and the probe can “see” your kidneys.  Once she had done the part that required the full bladder I was allowed to go and pee ! Then came back for the rest of the ultrasound. It is totally painless, not at all uncomfortable. The gel was a bit cold but that was all.  None of the tests I have had have been at all uncomfortable.  

A doctor was assigned to me to make sure that everything was being done that should to ensure I was healthy and fit enough to donate.  He checked my weight and height.  Asked me a few questions.   Listened to my heart which sounded okay. Blood pressure was 138/81. Peripheral pulses were present.  His opinion was that I was fit to proceed for further evaluation.  Ideally though I should lose some weight (being 89kb with a height of 1.6m). I also take HRT and was recomended I come off that for the donation. 

(Note: I do not take any form of  HRT which is derived from pregnant mares - such as Premarin etc.  I take kliovance which is plant based.  Speak to your doctor about switching if you are concerned about how the medication is produced).

I am working on the weight loss …. !

I saw the psychologist (see previous blog entry) and that is all fine.

Still to come ….
Psychiatrist Assessment
I am waiting to hear my appointment date for this.  They need to make sure I am fully aware of what I am committing myself to; that I am mentally okay and freely consenting to this procedure.

DMSA
This I have yet to have. It This is where they have to check the anatomy of each kidney. Arteries and veins have to be identified. It is not unusual for a kidney to have more than one artery.  These results go towards making a decision as to which kidney will be removed.   

GFR Test (Isotope Glomerular Filtration Rate).
I also have this to come. I believe I will be having this same day as the DMSA. The GFR is a test to assess the capability of the kidney to ’clear’ the blood of a substance. A small amount of dye is injected into a vein and blood samples are taken at hourly intervals for three/four hours, to measure the renal clearance of the dye. 

Finally I have to see the Consultant Nephrologist again  as he gives the final decision as to whether I am medically fit enough etc to donate a kidney.

All the information is given to an independant Assessor and I have a meeting with him. He  needs to make sure I understand everything etc etc. He then makes a report and presents to the Human Tissue Board and seeks their permission for the donation to go ahead.  The producing of the report and seeking permission can take up to a month in total.

It was explained to me that there was no guarantee that it would be keyhole surgery.  The surgeon would make that decision once both kidneys had been evaluted etc. It is not unusual for a kidney to have more than one artery and vein and if it turns out that there are two or three arteries and/or veins etc, it maybe that the operation would easier  with open surgery.  So that does affect recovery time.  Keyhole surgery – the stay in hospital is shorter by a couple days I believe and the recovery time  is much quicker.

I have some personal committments late Autumn  that are a must to keep and may involve physical activity. So allowing enough time for the donation and full recovery, it may be difficult to make the actual donation any earlier than late November/December.  That is fine and allows plenty of time for the rest of the tests and assessments to take place. Approval for the donation will be sought once my committments are over.  I certainly don’t want to be under any pressure during my recovery especially as I don’t know if keyhole or not – so need to be sure  there is plenty of time afterward to get back to normal.

30th June

Met with the psychologist today, a very nice lady, felt immediately comfortable chatting with her.  She needed to know that I fully understood the risks involved and that I was not under any pressure to go through with this. Also that I was aware of the mixed emotions that I may go through.

She asked why I wanted to donate to a stranger.  Various personal experiences over the years I know have contributed towards the way I feel about other people.   We had a long chat about certain aspects of my life that I believe have influenced me over the years and made me the person I am today. Certainly my faith in God has played a large part over the years.  Read the rest of this entry »

10th May

Great news. Got a letter from the Consultant Nephrologist advising that I am fit to proceed to further evaluation although I should lose some weight and come off HRT before being a donor.  The former I am working on! The latter will be fine over the short term and who knows maybe wont need to go back on it.  He is still waiting the results of other blood tests but they should present no problems.

Had my second appointment.  Had several more blood tests including a fasting one. Luckily I was first in the queue for that one, so could then go and have breakfast before before my next test. I had a kidney ultra sound scan. There was a small scar on the top of my right kidney but apparently that is not unusual and more than likely meant I had an infection as a child and was probably never even aware that I had. It should not affect my ability to donate.

I saw the Consultant Nephrologist who checked blood pressure, weight, height and general fitness. Again the question of my weight came up. 

I understand it could be another 2 months before the evaluation is finished.

I am not sure what is next on the list … I wait to hear…

Kidney donation – altruistic

February 3rd 2009

My first appointment at the hospital to meet the surgeon and have some initial tests done. It was during the heavy snows we had but luckily once I had got a few miles out from home, the snow thinned and travelling wasn’t a problem.

There had been some mix up with the appointments and I was in the book for 30 minutes after the time in the appointments letter. The hospital was also  running 1.5 hours late and I had arrived 30 minutes early!! No matter, it gave me time to read up on literature there and just watch and listen as to what was going on in the reception area. I was struck by the assortment of people there that had kidney problems … young, old, mothers, fathers, youngsters … it was a reminder than anyone, any age can be seriously ill and need help. I had time sitting there to think about the struggles some people have  to try and lead a normal life. It made me realise I have been very lucky in life as regards my health. Whatever I have had wrong with me has easily been treated. Not so for thousands of people. I am so glad I made this decision to donate.  Sometimes being kept waiting for an appointment has its advantages as in this case – it opened my eyes even wider.

I saw the surgeon first, very nice guy. Very friendly, smiley face and good sense of humour. I immediately felt relaxed in his company.

He made sure I knew exactly what it was I was offering to do and explained that a Doctor would be assigned to me to look after my interests.  I would go through a very thorough medical assessment.  I would also have a psychologist and psychiatric report made. The whole team needs to know that I fully understand what I will be doing. That I understand the procedure and what could go wrong etc etc.  Once I pass the medical tests and the psychiatric report, the details are then sent for approval. If I am approved as a suitable kidney donor, then I will be put on the database and once a suitable recipient is found, arrangements will be made for the transplant.  The evaluation process can be between 3 and 6 months, but they anticipate that once accepted it will be a very short time before they locate a suitable match.  

They would remove my kidney in this hospital and then safely transport it to whichever hospital the recipient is in.

The surgeon asked me about my medical history and my families. We have all been clear of major illnesses that might affect the donation.   The only down side was that I am overweight. I thought that might get mentioned!  lol ! I was weighed and although my BMI (Body Mass Index) was just within the acceptable limit, the surgeon did advise I try to lose some weight.  My current weight would not hold up the operation, but if I could lose some then that would assist the  surgery and also my recovery afterwards.

I then saw one of the transplant nurses. She asked more questions re medical history etc and then organised some  tests:

Blood pressure
Blood taken for tests (about 8 tubes used)
Heart Trace
Chest X-ray.

  It was also explained to me that during the very strict and thorough evaluation process, at any stage they could find out I am not suitable as a donor, so I also have to prepare myself for the disappointment of not being able to help someone.

My biggest worry at the moment is losing weight. I have an under active thyroid which piled the weight on a few years ago and losing it  is extremely hard – I never used to have a problem with being able to control my weight, but now it is a real battle.  

Please Pray that I pass the evaluation process with flying colours.

My next appointment is April 17th when I see the doctor … regarding what exactly not too sure, will have to wait and see.