Kidney/Pancreas: 20 years later, a life worth celebrating

[okarol]

Kidney/Pancreas: 20 years later, a life worth celebrating

BY HARRY JACKSON JR.
ST. LOUIS POST-DISPATCH
12/17/2009

An organ transplant is a treatment, not a cure, says Dr. Daniel C. Brennan, a transplant nephrologist at Barnes-Jewish Hospital.

So generally a transplant will last about 10 years before the recipient needs another.

But Annette Weber, 48, recently topped 20 years with a transplanted kidney and pancreas. On Nov. 15, 1989, she was among the first women to receive a kidney-pancreas transplant at what was then Barnes Hospital. The procedure was in its infancy.

To celebrate two decades, Weber recently had an anniversary party. "I've been blessed with 20 years," she said. "They're amazed that I've made it this long. I took care of myself, I drink a lot of water, I don't eat a lot of sweets ...


"And people pray for me."

In transplant circles, 20 years on one transplant "... is good, very good," said Brennan. Transplanted organs often last about 10 years because they endure the stress of the anti-rejection drugs as well as the person's body trying to reject the organ.

The kidney-pancreas transplant has been the answer to people whose kidneys failed because of type 1 diabetes — juvenile diabetes. Type 1 diabetes results when the person's pancreas stops working, often in childhood.

DISEASE STRUCK EARLY

Weber learned she had juvenile diabetes when she was 6 years old. She lived a normal life, playing organized softball, soccer, and other sports in school, all of the things that went with being a girl.

But the wear and tear of the diabetes medicines and stress on her kidneys because of the failed pancreas brought about kidney failure when she was a young adult.

Before the transplant she lived 10 months, three times a week, on kidney dialysis. Dialysis was making her sicker.

"I was coughing up blood; I developed ulcers," Weber said. "At one point they said I had two months to live."

Her condition made her more eligible for the transplant. Pancreatic transplants in those days were extremely risky and were done often when the choice was the risk or death.

Members of Weber's family were eager to donate a kidney, but she was the only member of the family with an O-positive blood type.

Then, as she recalls, in the autumn of 1989, an 18-year-old young man in Jefferson County suffered a fatal head injury.

"He saved a lot of lives," Weber said, "his eyes, his tissue, his heart, lungs." She got a kidney and his pancreas.

'NO NUTS, MEAT'

The working pancreas ended her diabetes, she said, but she still had to live on a restricted diet to protect her new kidney. "I don't eat protein," she said. "No nuts, meat. I eat a lot of vegetables and drink a lot of water to keep my system flushed."

Brennan wasn't Weber's physician in the beginning but is now. He explained that in the early days, doctors still looked for a combination of treatments that would ensure longevity for someone with a kidney-pancreas transplant.

In most cases, the pancreas is the first organ to fail, not the kidney, he said.

ANOTHER TRANSPLANT

In Weber's case, she has had to go back on the transplant list because her kidney is beginning to wind down.

"We believe she'll get another transplant," Brennan said. "But we've learned so much from her."

Indeed, said Brennan, the time to perform surgeries for the transplant has been cut in half; doctors have learned that lower doses of steroids and anti-rejection drugs are as good as the massive doses they gave 20 years ago, he said.

So why has Weber done so well? "She was a great patient," Brennan said. "She did everything she was supposed to do and kept up with all of her labs and (doctor visits).

"That's very good considering 30 to 40 percent of patients don't comply with doctors' instructions," he said.

Send submissions to:

Jackie Hutcherson, STL Health editor

St. Louis Post-Dispatch, 900 North Tucker Boulevard

St. Louis, Mo. 63101-1099

E-mail — jhutcherson@post-dispatch.com/

http://www.stltoday.com/stltoday/lifestyle/stories.nsf/healthfitness/story/82CE62A6371E0B048625768F00071211?OpenDocument

[Chris]

No protein is odd to me. Books I have read pre and post k/p transplant from the time era never mentioned that diet restriction. Did it make her transplant last this long though is the question.

[cariad]

What? No protein? Is that even possible? Your brain does need protein. I don't get that advice at all.

To my knowledge, I was never on low protein post-transplant. I can only thank my lucky star that my parents did not hear about any of this, because they would have imposed it on me without a doubt. I was on a low-salt diet for a year or so post-transplant for some bizarre reason, and I hated every second of it. It left me with what appears to be a lifelong craving for salt, which I use whenever I want. My sodium levels were one point below normal at my last lab. (My gp said the number is meaningless anyway.)

The secret to her success, in my humble opinion: luck. How diet affects individual health is one of those things that doctors have always pretended to understand, but they don't really know the full story, even today.