back to square 1

We got a call yesterday at about noon about what sounded like a good cadaveric kidney that mom's nephrologist recommended we accept, but no further instructions. Initially, it sounded like the kidney would have less than 12 hours of "cold time" which is very good. However, we called the transplant division back at 6 and at 9 pm, and they finally told us to come to the hospital at 11 pm, and the surgery would either be overnight or first thing in the morning.
We waited, and waited and waited. We waited at home, in the admitting waiting room, and finally in a telemetry bed on 3D. At about 9 am the OR transport team showed up to take mom to the PACU, leading us to believe everything was ready. However, as mom was being wheeled out on a stretcher, they got a call not to bring her. No explanation. The only person who ever knows anything is the attending, who is almost never available. Finally at about 10 am Dr. S arrived. It turned out the initial biopsy of the cadaveric kidney was insufficient but had signs of significant long standing hypertension, which could significantly shorten the useful life of the graft. A this point there was still a few hours left until the kidney was 24 hours old, so we elected to re-biopsy the kidney while Mom had an ultrasound of the iliac vessels where the kidney would be attached.

The repeat biopsy came back with some signs of hypertension, although with much less severe damage than the initial biopsy had suggested. However, at this point, Dr. S had told us that the medical history of the patient was not very comprehensive, and there was no way to get more information. At this point, Mom, Nathan and I talked and we decided to pass on the kidney and continue with our original plan for a living related donor transplant on 7/2/08.

It was not an easy decision for any of us because there isn't a crystal ball to tell us what the future will hold as a result of our decisions. Lots of tears, especially since we hadn't eaten or slept all night. In fact, it was Wednesday and I hadn't slept for more than two hours since Sunday, because I was working nights. After our last all-nighter in the hospital, I bought a Coleman air mattress and a pump and stored it in my car. It was definitely more comfortable than a chair or the floor, and I would definitely recommend it.

Now, I'm reviewing my schedule to see when I can pay back the fellow who kindly and generously covered my Tuesday and Wednesday night shifts.

The only outstanding issue prior to our transplant 7/2 is whether or not the transplant surgeon will require mom to get an MRI followed by dialysis prior to the surgery. I truly hope not, because I believe that benefit of the diagnostic information does not outweigh the risks of the study.

Well, take care blog readers, and we'll update again as soon as we know more.

Sarah

Here's Mom on the phone with the transplant division. Looks like we have a possible match for a cadaveric kidney. We're going to UMMS at 11 pm to be admitted for heparinization, and to start immune suppression. As soon as we know more we'll post. We love you all!!

Laura and Sarah