Journal Entry 6: Donor Counseling, Part I

In January 2010, Kay decided to donate a kidney and began a life-changing journey. She chronicled her experience in detailed journals, which she is now sharing here.

Feb. 2, 2010

So it was off to San Diego for two days of meetings with the Sharp Memorial Hospital staff and labs. The transplant center reserved a room (and paid for) a nearby hotel. Shuttle service was available between the hospital and the hotel, so it was very convenient. Driving over in the morning, I had plenty of time to check into my hotel and make my two afternoon counseling appointments.

I met first with the nephrologist/donor advocate, Dr. B. I had a list of questions for him and any others who might listen. He reviewed all my test results and pronounced me quite healthy and appropriate for kidney donation, except for my creatinine levels that differed on two tests. One test showed acceptable and the other borderline so he ordered the test for a third time to break the tie.

Creatinine is a protein in the muscles and blood that is a waste product that should be eliminated by the kidney. High creatinine levels may indicate kidney damage, which would render me a poor donor.

Then we discussed my list:

• Is my insurance involved (no)
• How is the tissue match achieved (today's blood test will be sent to determine the genetic markers, which takes about four weeks, then another sample will be taken and mixed with that of a potential recipient to see if they fight with each other)
• Laparoscopic surgery or regular (99.9 percent sure it will be laparoscopic)
• Do I donate blood for myself prior to surgery (no, not necessary)
• Will the anesthetic cause depression (probably, but short-lived)
• Does a family member need to be present at the time of surgery (not necessary)
• Length of surgery (2 to 3 hours)
• Length of hospital stay (1 to 2 days, maybe more)
• What is the length of recuperation (after about a week I should be able to drive, thus return to my home and take it easy for a few weeks)
• Timeline for the surgery (genetic markers determined by Feb. 15, surgery in March)
• What medications are needed after surgery, what are to be avoided (none, no problem)
• What dietary restrictions are necessary after transplant (no dietary or alcohol restrictions)

We talked a lot about growing old with one kidney. I had read a lot but Dr. B's take was that my life span would not be significantly jeopardized. They have already screened me for major health problems — heart, lung, circulation, hypertension, etc. — and I'm healthier than most. Most data show that donors actually live longer than nondonors, as they have already been selected for good health and lifestyle. Smokers and alcoholics, for example, are never potential donors.

We also talked about my meeting the recipient. Remember the article in The New Yorker? About donor/recipient expectations of each other if they share names, addresses, phone numbers, email addresses, etc.? I told him I only wanted to know gender, age and length of time on dialysis. And how long the kidney lasts (assuming I outlive the recipient).

He said it would be hard to NOT run into the recipient, since we will be in close proximity. On the same surgical floor, etc. He also pointed out that many recipients are not totally wonderful people. They could be grouchy or mean or angry or have mistreated their family. Was I willing to give my nice kidney to an SOB? Hmmm. My response was, that even SOBs have loved ones who worry about them, and who depend on them for emotional or financial support. Even an SOB deserves to live, as they are not 100 percent bad, probably. Also, a person whose health is really poor (besides the kidney) or who has an unhealthy lifestyle would not even be a candidate to receive a transplant. (Someone later pointed out that sometimes SOBs have a fresh outlook on life after a lifesaving experience, and maybe they will turn over a new leaf...) Anyway, I don't pick the recipient, and I won't get to know him or her that well in our brief encounter.

For More Information
To learn more about Sharp's transplant services or to find a Sharp-affiliated physician, search for San Diego doctors or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about transplant, visit Transplantation in Adult Health or read the Transplant News archive.