My Kidney Transplant Update

My Kidney Transplant Update

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.