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Author Topic: High risk deceased donors  (Read 3487 times)
Tío Riñon
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« on: November 30, 2017, 05:43:56 AM »

I had my annual transplant clinic update appointment this week during which my coordinator shared that I'm pretty high on the list now and should anticipate receiving offers in the upcoming weeks and months.  She then shared that many of the recent donations are the result of heroin overdoses.  She went on to explain that many of the donors are young and are healthy (no other underlying medical conditions) besides the use of intravenous drugs.  When I am called, they would share with me that the donor is a "high risk" and I would have the option to accept or pass.

My knee-jerk reaction is to automatically pass, but evidently there have been successful transplants with no further issues.  I'd like to get input from others who are on the list and their thoughts?  Has anyone here accepted a "high risk" donation?  What has been the outcome?   Are there any pros or cons to the decision?

Thanks!

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iolaire
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« Reply #1 on: November 30, 2017, 06:14:30 AM »

I have nothing against the overdose donors.  I would have accepted one, but the higher risk received I took was a "donor after cardiac death" not a high risk lifestyle donor.  I did agree to be alternates on overdose patients, former IV drug users and someone who had been in prison recently.  I believe that its most likely that you would get an offer from a younger donor whose Kidney is probably in better health (from being young) than you would get otherwise.  Most of that type of donor I received calls on were in their 20's versus the donor I got that was about 40.
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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
Simon Dog
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« Reply #2 on: November 30, 2017, 05:21:13 PM »

Read up on nucleic acid testing.  It has reduced the gap between infection with HIV and detection from many weeks down to a few days, and has substantially reduced the risk of infection with this virus from "high risk" donors.
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KarenInWA
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« Reply #3 on: December 05, 2017, 12:07:36 PM »

I just received my high-risk donor kidney 2 weeks ago today! It took just under 3 days for my creatinine to go from 3.6 pre-op to 1.06. My recovery has been easy so far and I do notice a difference in how I feel.

KarenInWA

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1996 - Diagnosed with Proteinuria
2000 - Started seeing nephrologist on regular basis
Mar 2010 - Started Aranesp shots - well into CKD4
Dec 1, 2010 - Transplant Eval Appt - Listed on Feb 10, 2012
Apr 18, 2011 - Had fistula placed at GFR 8
April 20, 2011 - Had chest cath placed, GFR 6
April 22, 2011 - Started in-center HD. Continued to work FT and still went out and did things: live theater, concerts, spend time with friends, dine out, etc
May 2011 - My Wonderful Donor offered to get tested!
Oct 2011  - My Wonderful Donor was approved for surgery!
November 23, 2011 - Live-Donor Transplant (Lynette the Kidney gets a new home!)
April 3, 2012 - Routine Post-Tx Biopsy (creatinine went up just a little, from 1.4 to 1.7)
April 7, 2012 - ER admit to hospital, emergency surgery to remove large hematoma caused by biopsy
April 8, 2012 - In hospital dialysis with 2 units of blood
Now: On the mend, getting better! New Goal: No more in-patient hospital stays! More travel and life adventures!
iolaire
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« Reply #4 on: December 05, 2017, 01:12:46 PM »

I just received my high-risk donor kidney 2 weeks ago today! It took just under 3 days for my creatinine to go from 3.6 pre-op to 1.06. My recovery has been easy so far and I do notice a difference in how I feel.

KarenInWA

Congratulations!  I'm glad that it looks like you hit a good one with that creatinine!
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Transplant July 2017 from out of state deceased donor, waited three weeks the creatine to fall into expected range, dialysis December 2013 - July 2017.

Well on dialysis I traveled a lot and posted about international trips in the Dialysis: Traveling Tips and Stories section.
Michelle2016
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« Reply #5 on: December 05, 2017, 01:21:14 PM »

I’m very happy for you.

Wish you the best.
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kickingandscreaming
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« Reply #6 on: December 05, 2017, 05:13:27 PM »

I must have missed something as I had assumed you already had a TX.  Well I guess I was wrong.  Congratulations on your new acquisition.  I hope you have a good life together.
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Diagnosed with Stage 2 ESRD 2009
Pneumonia 11/15
Began Hemo 11/15 @6%
Began PD 1/16 (manual)
Began PD (Cycler) 5/16
KarenInWA
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« Reply #7 on: December 05, 2017, 06:37:55 PM »

I must have missed something as I had assumed you already had a TX.  Well I guess I was wrong.  Congratulations on your new acquisition.  I hope you have a good life together.

Oh no, you are correct. I had my first transplant 6 years ago on 11/23/11. It was from a non-blood related family member. It was slow but steady in lowering creatinine, so by March it hit 1.4, then went up to 1.7. My Dr at the time decided to do a biopsy to rule out the slight possibility of rejection. That was a very big mistake.

To shorten up the story, everything was fine unti a few days later when I woke up w/no urge to pee. Went to the ER, found out the biopsy had caused an obstructing hematoma on my kidney. Had emergency surgery to save it. Lost a lot of blood, so had to have one round of HD and 2 units of blood the next morning. My creatinine got as high as 9.9.

It took months for my kidney to settle in the low 3's - good enough to keep me off of dialysis, but low enough to put me back on the list. I was re-listed in Summer 2013. They even put me back on the list before I completed my testing. I went back and forth with being Active/Inactive, due to being stable. I went back to Active last summer, but then Inactive this past February due to pneumonia. I then decided to stay Inactive because I decided to travel to NYC for a week in September. Del from IHD joined me!

I then saw the pre-transplant ARNP in October about going back to Active. I did not need to complete any tests. My official Re-Activate date was 11/15/17. I got a back-up call on Saturday the 18th. I decided to take it. That back-up call turned into an offer on the 20th. My transplant happened on the 21st. All in all, it was a pretty crazy ride! And the one thing I kept saying was "I'm not in any hurry to get a kidney" but I had been taking more naps lately. My goal was a pre-emptive transplant this 2nd time around, and that is what happened. It's still bittersweet with what happened to my first one, but what helps is this recovery is going along just fine. One reason why I decided to take it is it sounded like it would be a good kidney. Brain-dead donor in their 20's. High-risk, but I understand what that means. I adopted the attitude of 'if it is meant to me, I'll get an offer. If it isn't, well, that's fine too'. I also went in with the mindset that this is going to be an easy recovery. My nurses kept telling me I was the rockstar of the ward, so that was nice to hear. My tx nephrologist is always happy at my appointments, so that's a good thing. So long may this continue!

Oh, and an interesting thing - I had the same surgeon for all 3 of my surgeries. He is a kidney-transplanting machine!

KarenInWA
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1996 - Diagnosed with Proteinuria
2000 - Started seeing nephrologist on regular basis
Mar 2010 - Started Aranesp shots - well into CKD4
Dec 1, 2010 - Transplant Eval Appt - Listed on Feb 10, 2012
Apr 18, 2011 - Had fistula placed at GFR 8
April 20, 2011 - Had chest cath placed, GFR 6
April 22, 2011 - Started in-center HD. Continued to work FT and still went out and did things: live theater, concerts, spend time with friends, dine out, etc
May 2011 - My Wonderful Donor offered to get tested!
Oct 2011  - My Wonderful Donor was approved for surgery!
November 23, 2011 - Live-Donor Transplant (Lynette the Kidney gets a new home!)
April 3, 2012 - Routine Post-Tx Biopsy (creatinine went up just a little, from 1.4 to 1.7)
April 7, 2012 - ER admit to hospital, emergency surgery to remove large hematoma caused by biopsy
April 8, 2012 - In hospital dialysis with 2 units of blood
Now: On the mend, getting better! New Goal: No more in-patient hospital stays! More travel and life adventures!
Michelle2016
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« Reply #8 on: December 05, 2017, 07:59:30 PM »

Hi, Karen:

Thanks for sharing your experiences. Now I realize that we all should avoid biopsy if we can. It’s a invasive procedure. And it’s not safe.

I heard other bad stories of biopsy.

Wish you the best.
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