MY KIDNEY TRANSPLANT UPDATE

by Ed Bryant

 

My cross to bear in life is diabetes. I found out how insidious the disease can be in 1978, when my physician told me I was undergoing renal failure, "End Stage Renal Disease (ESRD)" and that soon, when my kidneys could no longer filter waste from my system, I would have to go on dialysis.

I began dialyzing in December of 1979. My treatments were three times a week, and each lasted about four hours. I continued this regimen for the next 3 1/2 years. I was a lucky diabetic at first. I usually felt great after dialyzing, and unlike many, could continue my normal daily activities. I traveled quite a bit during this period, and dialyzed at centers in other communities. I found that many dialysis patients felt nauseated and weak after treatments, requiring the remainder of the day to regain their strength.

After about three years on hemodialysis, my luck started to run out; I began to feel ill. I lost weight and had a constant pale look. I was not doing well at all. The somewhat gentler alternative forms of dialysis, continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD), were in their early stages, and were not often presented to diabetics as available options.

When I attended the 1982 convention of the National Federation of the Blind, I heard a presentation by Dr. John Najarian, Chief of Surgery at the University of Minnesota Hospital in Minneapolis. He covered the topic of kidney transplantation in diabetic patients. Hearing Dr. Najarian speak, I was inspired; was this an alternative for me? I knew I needed more information before I could consider transplantation as an alternative to the dialysis treatments that were causing my health to fail.

My research supported the viability of transplantation. I found that the life expectancy of kidney transplant recipients is significantly longer than that of diabetic dialysis patients. Although some individuals might not qualify for a transplant because of other physical factors, I was lucky--the doctor considered me an ideal candidate. I weighed the evidence, considered the odds, and decided to "go for it."

For a number of reasons, I chose the University of Minnesota Hospital (now Fairview University Medical Center) for my transplant surgery. Although there are more than 239 transplant centers in the United States, the University of Minnesota pioneered transplantation for diabetic kidney patients. To date, they have performed more than 4,000 kidney transplants, and they do an average of 200 per year. Their success rate is above the national average.

The transplant center offers an information packet, explaining kidney transplants, to interested consumers who call them toll-free at 1-800-328-5465. Upon entering the hospital, patients are provided a manual explaining transplantation before, during, and after surgery. Blind patients may receive this manual on audiocassette.

My sister, Debbie, volunteered to donate one of her kidneys to me. I will be eternally grateful for this generous act of love. It is a wonderful gift and my feelings for this act are indescribable.

My first step was to start taking the immunosuppressive drug Imuran, which would protect my new kidney against my body's efforts to reject it. But something went wrong, and on the day I checked into the hospital to prepare for the transplant, the doctors found the drug had caused my white blood cell count to fall to a dangerously low level. Surgery was postponed until my body could replenish its white blood cells. The Imuran was stopped, and I went back home.

While waiting for my white blood cell count to rise, I learned about a new immunosuppressive drug called Cyclosporine. The Food and Drug Administration (FDA) had not yet officially approved Cyclosporine, but it was being tested at various transplant centers, and the results to that point had been extremely positive. The "kidney survival" (non-rejection) rate greatly exceeded that of any other drug of its type.

Two months later, in August of 1983, my white blood cell count finally returned to a normal level. When I returned to the transplant center, I asked the doctors if I could be a "guinea pig" in the Cyclosporine tests. The surgeons told me I could, and that they foresaw no problems with the revolutionary new drug.

A new kidney, like mine, is placed in the lower abdomen, where it is best protected. Kidney recipients receive only one kidney, which is all that is needed to handle bodily functions. A newly transplanted kidney will grow or diminish in size as needed to best serve the body into which it is placed.

I received my new kidney on August 9, 1983. My surgery went very well. I was amazed and pleased at how quickly I recovered and how minimal the discomforts and complications were. Because I experienced no rejection episodes, I was able to leave the hospital after only eight days. Some recipients have "rejection episodes," and although they probably won't lose the kidney, they take longer to stabilize and heal. I was lucky.

Like all other transplant recipients, I was placed on immunosuppressive therapy, which I will continue for life. My first prescriptions were Cyclosporine (now FDA-approved) and the steroid Prednisone. Several months later, the hospital began "triple therapy," yet another University of Minnesota innovation, a mixed-dose regimen of Cyclosporine, Prednisone, and Imuran. I continue this same triple therapy today.

My transplant made a tremendous difference in my quality of life. Almost immediately I felt more energetic, no longer tired and drained as I was on dialysis. My spirits were high, my mental processes sharp, and I was ready and able to handle a busy schedule. Today, almost 15 years later, my transplanted kidney is doing fine, and I remain as active as ever.

I strongly endorse kidney transplantation. I am a living example of the improved quality of life after a transplant. I say "go for it!" Check out the possibilities and get answers to all your questions before you make a decision. Ask different doctors. Talk to someone who's had a transplant. Consult a transplant center or a transplant surgeon. Your nephrologist should be able to help. Your quality of life, and in fact your life, may hang in the balance.

I hope my experiences will provide you with food for thought. If you have any questions, please feel free to contact me at the VOICE editorial office.