A donor kidney

A donor kidney

By Mary Zunt
SPECIAL TO THE STAR
Thursday, November 08, 2007

The bottom line for the 300,000 people on dialysis machines is that thousands of kidney donors are needed.

In my case, I have been on the list for 22 months.

In transplant language: that is a short time. During those months, I have had dialysis three times a week. Dialysis is a process by which a machine filters toxins and unnecessary fluids from our blood, cleans the blood and returns it into our systems. This takes about five hours including driving time. But the process removes only part of the toxins from our bodies as compared to 100 percent or close to it with perfectly working kidneys. So, I am anxious for a new kidney.

5 a.m. Monday — UC Davis Transplant Center calls offering me a kidney.

Three weeks prior to this call, my estimated waiting time for the transplant changed from the original three and a half years to eight. The reason for the extension was in my A+ blood. The complex set of microscopic A2 antibodies sneak into a mother’s blood or transmit during blood transfusions. With this condition, I have an 82 percent rejection rate for all transplants.

On Monday morning, I am shocked to get the call. In my case, there are three potential candidates. I’m number two. The nurse from Davis asks 24 questions to see that I have no infections or open sores, no reason not to go into surgery. Barely awake, I try to respond to their offer.

In January 2006, shortly after kidney failure, my doctor counseled me. First, she encouraged me to get on the national transplant list with approximately 70,000 Americans listed. I registered at both UC Davis, Sacramento, and at UCSF, San Francisco, two separate districts. Second, she warned me a female kidney is usually smaller and weaker than a male kidney. And although they accept kidneys from persons up to 50 years old, the older ones are less reliable, making longevity a factor.

The kidney I am offered is 58 years old from a small female.

I say, “I need to discuss this with my nephrologists.”

“Are you telling me you might reject this offer?”

“I’ll call you back in 15 minutes. Yes, I do need to speak to her.”

Time is essential, I know. From the moment the kidney is harvested from the cadaver until it is transplanted must be less than 24 hours. During that period, it remains on a pump that recreates body function while the kidney is either brought by ambulance or flown to the transplant hospital. The hospital performing the transplant compares and tests blood samples to confirm a recipient. And they need to prove as well as they can that the recipient’s body will not reject the donor kidney. Up until the time the match is on paper it has not been tested against the actual kidney.

5:35 a.m. — My doctor reaffirms what I know, and says, “This is the worst of the best offers. But do you want to be on dialysis for five or six more years? There are risks in this business, big risks. Those are the facts. How do you want to live?”

I call the hospital back and say, I’ll take it. The nurse urges me to find a ride to Davis. If the match is positive, I need to leave immediately. The surgery might begin as early as 4 o’clock that afternoon. They will call back in approximately seven hours, earlier if possible, after blood samples, which they collect monthly and freeze, are tested against the donor kidney. After that, the hospital will select the candidate whose body has the greatest chance of accepting the kidney.

In the U.S. approximately 70,000 of us are listed for a kidney. Only 17,000 are donated each year. That is the reason for the long wait — three to eight years. There just aren’t enough kidneys.

6:30 a.m. — My daughter is en route from San Francisco. I have found a driver to take me to dialysis early, at 7 a.m. I am nervous, thinking of going into surgery that day. On top of everything else, I remember a recent article stating that a high percentage of transplant recipients contract cancer due to the strong anti-rejection medicines. Again, I call my doctor. In a kindly voice, he says, “Mary, this is a high risk business. Decide how you want to live.”

My stomach is groaning. I have a cup of coffee, a small bowl of cereal. But, when I arrive at dialysis, I am told to fast. Surgery may not be that far away.

Because of age, some end-stage renal patients are not eligible for kidney transplants. St. Helena dialysis participant Jane St. George, 87, sits patiently each week in dialysis, reading. “It doesn’t bother me,” she says. “I’ve got a weak kidney. I play bridge every week; get my hair and nails done. Read a few books.” She gives me a smile, “Someday, my kidneys will stop. I’ll die.”

10:30 a.m. — Dialysis is ended. My daughter arrives to pick me up. We head home to wait. At this point, I figure it’s as if I was going to Vegas, a toss of the dice. No, I don’t want to go to dialysis three days a week. Do I want to risk cancer? No. My brother died of it. It’s a painful disease. For the most part renal failure is not painful. It’s debilitating. It creates a war within yourself, challenges you to compete against it every day.

12:30 p.m. — The nurse calls. My A2s are at a 140 measurement. The highest this donor kidney can withstand is 50. The nurse is sorry about my disappointment. My daughter and I shed a tear.

Jane St. George and I meet the day after to begin dialysis, again.

To become a donor, you can go to any DMV or call the American Kidney Foundation in San Francisco. There are 70,000 of us waiting.

(Mary Zunt a longtime St. Helena resident and freelance writer.)

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