I saw the Consultant first, he was a nice chap, but spoke so slowly... the appointment seemed to go on forever. I had a full work up, listened to my heart and lungs,took my blood pressure, felt my glands, examined my abdomen and even gave me a breast exam!!
We discussed my medical history, previous surgeries and my current lifestyle, my smoking, my drinking and my diet etc...
Then onto the kidney stuff, he went over all my results from the tests I've had so far and everything is looking good. We then discussed my brother's condition, I was told that according to the last test he had done, he had approximately 21% kidney function, which is actually pretty good. According to the Consultant, my brothers kidney function needs to go down to about 7% or 8% before the transplant is absolutely necessary. If my brothers function continues to deteriorate at it's current rate, then it could be anything up to 5 years before he needs the transplant. However, should he contract an infection or virus then it could be quicker.
We discussed the risks involved for donors, the main issue I will face is the risk of major surgery. All surgery carries risks, no matter how big or small. The most common risks associated with my surgery (a nephrectomy) are usually relatively minor and can be treated appropriately. These Include:-
- Wound, urinary tract & chest infections, which occur in approximately 1 in 3 donors.
- Bleeding that requires a blood transfusion or blood clots, this occurs approx 1 in 50 donors.
- Death - this is very rare occurring in 1 in 3,300 donors.
At this point it was also made very clear to me that I am free to change my mind at anytime and if I didn't want to tell my family I had voluntarily withdrawn, they could help me with that.
It was also explained to me that as my brother has opted to go for an ABO Incompatible transplant, a riskier type of transplant, he would also have to undergo further treatments. These will remove the antibodies against my blood group in order to allow the transplant to take place. This involves administering a drug which suppresses antibody production and a treatment called Plasma Exchange. This procedure involves plasma (part of your blood) being removed and replaced with new plasma. However, he'll only need these treatments in the run up to the transplant.
We also discussed my future and whether or not I'd like to have children. I said "yes, I would one day. But not in the immediate future."
I know that I can still have a healthy pregnancy with only one kidney, but i would be a high-risk pregnancy and I'd be monitored more closely. However, what I hadn't thought about was, If the timing of my decision to start a family conflicted with my brothers need for a transplant, and if I had a child prior to my brother needing a transplant, my antibody's would change and may render me unable to donate. This was something I hadn't even thought about. To be honest, it totally blew my mind and left me feeling kinda crappy! How does someone make that choice? Knowing that if you choose to start a family you could be letting someone down, and not just someone your OWN brother!! It's a toughy!!
In the gap between, the end of my appointment with the Consultant and seeing the counsellor, I had to give some more blood samples to be sent to Guy's Hospital to be tested for cross-matching and I had to give another urine sample.
The urine test revealed a trace amount of blood, yet again!! Which now means that the tests I'd hope to avoid, the cystoscopy and renal biopsy, are now necessary!!
As soon as I stepped foot inside the counsellor's office, this huge wave of emotion washed over me, and i burst into tears. The discussion I'd just had with the Consultant had sunk in, along with the need for the tests I've feared and the enormity of what lies ahead hit me like a 10 tonne truck!! Obviously, my meeting with the counsellor was private, so I wont be giving you a blow by blow account of what we talked about, but we did discuss my family and my relationship with them, my support network, my history of depression and how i feel about my decision to donate my kidney. After a few tears and plenty of tissues, she told me that she saw no reason why I shouldn't donate and that she thought I was strong enough to deal with the psychological side of donation. Whoopee!!
The next test needed is a Renal CT, which will look at the anatomy of my kidneys, the position of them, how many veins go to them and which kidney is gonna be the best for them to take. I'm not entirely sure when I'll have to have the cystocopy or renal biopsy but I shall as always keep you posted.
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