Tuesday, March 30, 2010

I’m looking for a kidney!

This is not meant to be funny! It’s no joke! I’m out looking for a kidney for a friend.
by Charlie Leck

I have some wonderful old friends who go way back. Unfortunately, the old part is truer than I would like it to be. Let’s call them Liz and Sandy. We’ve been doing things together for almost 40 years. We have kids who are close to the same age. For a time, when they were wee ones, they played together on those occasions when we joined up for a picnic or a family evening.

You ought to hear this incredible story about their daughter, Lisa. It may pluck some at your heart strings. It does at mine.

Lisa soared to great heights and we’ve always been proud of her and her accomplishments. She earned her medical degree, and then a string of other degrees: MSPH (Master of Science in Public Health), MBA (Master of Business Administration), and FACP (Fellow of the American College of Physicians). It’s more than ironic, as you’ll soon see, that one of the specialties in her work is high risk pregnancy. She is a physician of extraordinary achievement out in Denver.

She’s a single, professional woman who, somehow, never had the time to get married as her career rocketed forward. Yet, for years and years, Lisa wanted to know the joy of having children and being a mom. She tried, pretty desperately, to adopt kids from China. She waited patiently for several years. China, frankly, is a bureaucratic nightmare and, at every little turn, there seemed to be an additional cost. It's such a shame for a nation that has so many orphaned young girls. For a while it seemed it would work out, but there was one disappointment after another and, after many years, Lisa lost patience. However, she didn't lose her determination to have children.

Well, my goodness! A bit over a year ago, Lisa became pregnant with twins through a process of in vitro fertilization. If you, like I, are baffled by this procedure and don’t really understand it, read here for a good explanation of in vitro fertilization. She flew up to the Twin Cities to proudly tell her parents the good news. She brought with her the ultra sound photos. Naturally, the expectant grandparents were as excited as Lisa.

All of us were thrilled. Grandma and Grandpa (Liz and Sandy), her brother and his family, Aunt Adrianne and Uncle Bill (down in Tucson), and, of course, we (and all our family spread around the country). All of us watched the dramatic developments closely and got more and more excited as the day of delivery approached.

Of course, none of us were as excited or as joyful as Lisa herself. She was about to become a mother who would have her children with her for many, many years. Now, Lisa also knew there were plenty of risks in what she was doing. She was on the plus side of 40 years. Remember, she’s a doctor and a damned smart one, so she understood.

The pregnancy was completely normal. Everything was going well. Lisa kept up her travels for work right into October. Delivery was planned for the end of December. Well, somewhere toward the end of their term, things started going wrong and the earth seemed to tremble a bit. Some of Lisa's labs didn't look so good. The doctors decided on a premature delivery. So, the children came early (November 30) and the doctors had their hands full. I wrote about this marvelous and trying time in an earlier blog.

The initial fight seemed to be for the children because of the premature delivery; yet they were in terrific condition at about four pounds. Our initial worries about them were misplaced and soon messages arrived telling us that we should be concerned about Lisa. Slowly, like heavy clouds creeping in over the landscape, and most unexpectedly, the point of interest shifted to the mother. Lisa was not recovering properly. Those of us who were concerned, who loved her, who were interested in her brilliant career, hung on infrequent notices from the hospital. They were not positive and hopeful. Prayer groups formed – both Christian and Jewish. Hundreds prayed for her – hoped for her and wondered what they could do for her.

The beautiful little babes, quite unbelievably, flourished and grew strong and healthy. Photographs of them sent us all in to fits of celebration. Just in the last few days they weighed in at 13.8 pounds (Daniel) and 12.13 pounds (Sophie). They’re about to switch off the special formula for premature kids to a regular, ordinary mixture. They sleep through the night now and their smiles are constant.

Yet, we waited for good news about Lisa also and such news was slow to come. She had gone straight from delivery into intensive care. Her bleeding wouldn't stop. She required enormous amounts of blood -- more than 100 units. Her platelets were alarmingly low. Emergency surgery was performed to stop the bleeding. It didn't seem to help. Dialysis and plasmapharesis was done daily. She had approached death's door several times. Now the sense of worry had shifted fully from the children to the mother. Heroic doctors, led by Doctor Michael Schwartz, struggled to save her life. Physicians all over the nation were consulted.

What was going on with poor Lisa? Renal failure! Her kidneys are not filtering.

Now the doctors don’t expect Lisa’s kidneys to recover. She receives constant dialysis treatments. She needs a kidney transplant and it’s critical that she gets one. The dialysis is not a good, long-term option. So, Lisa’s been placed on a waiting list for a contribution from a deceased donor. The projections are for a wait of at least two years.

A much better option – better by far – would be a living donor. Such transplants have become commonplace and extremely safe. We can function, without problems, on one kidney.

Here’s the report that comes from the transplant evaluation team out in Denver. There are three components to matching a kidney: (1) blood type; (2) human leukocyte antigen (HLA), and (3) panel reactive antibodies (PRA).

Because her blood type is AB+, Lisa can accept a kidney from individuals with any blood type. There are 6 different antigens that make up the HLA. Anti-rejection drugs are so good today that HLA matching is less critical than in the past – the life of a transplanted kidney that is a 0/6 match is not that different from a kidney that is a 6/6 match. It is far better to have a living donor kidney that is a 0/6 match than a deceased donor kidney that is a 6/6 match.

The recipient’s PRA score is based on his/her history of blood transfusions, pregnancy and other things that expose the recipient to blood antigens. Once a potential donor is identified, the transplant center will do a cross match between the donor and the recipient's blood to see if this is a problem.

Who can be a donor?
The donor needs to be between 18 and 60, healthy, and with no history of diabetes or high blood pressure. If there is a family history of diabetes they will do an oral glucose tolerance test to see if the donor has pre-diabetes and they will do an evaluation to make sure there is no unknown kidney disease or other condition. As far as costs go, there is no cost to the donor for anything. If a potential donor lives out of state, when they contact the donor coordinator, she will arrange for them to get the testing done locally, and have the bill sent to the University where it will be forwarded to Lisa’s insurance company.

As far as the transplant itself, the kidney will be taken out with laproscopic assistance. There will be two small holes for the instruments in the upper and lower abdomen on the left (they will take the left kidney) and a small incision around the belly button to take the kidney out. The donor will spend 2-3 days in the hospital and will be able to return to normal activities in 1-2 weeks on average.

For Lisa, they will make a small incision in her right pelvic area and put the kidney in there. They will not remove the old kidneys.

I’m not trying to pretend here that this isn’t a huge decision for a potential donor. It’s a major commitment. If someone out there wants to think about this kind of life-giving and loving gift, there are many places to get information. One web site to check is www.transplantliving.org. Or, if you would like to talk anonymously to the transplant coordinator about what you would need to consider before making this decision contact Vonnie Bagwell at 720-848-2261 or email her at vonnie.bagwell@uch.edu

I’m hoping that this blog – this desperate search for a kidney for a new and excited mother – could be sent along, by everyone who reads it, to their friends and the people on their email lists.

We understand fully the challenge here. This search is not an easy one and the odds are likely against us, but we’ve got to try for Lisa, Sophie and Daniel.

A 2007 photo of Lisa...

Thanks for your kind attention.

1 comment:

  1. I do not know how I ended up on this page.. preparing my lecture !
    I am a nephrologist and a MOM before anything.. my heart and prayers goes to you..