My Journey Through a Kidney Transplant Procedure.

Abstract

My Journey Through a Kidney Transplant Procedure James Moran Polycystic Kidney Disease is hereditary. My grandmother died at home before dialysis was readily available. My mother, uncle, and great aunt all had dialysis treatments for extended periods of time and eventually died. My uncle was most fortunate in that he had a heart attack while on dialysis. My mother and great aunt suffered through the disease before it consumed them. The magic age for adult onset PKD requiring dialysis is in the early fifties. First diagnosed at age 25, I watched my creatinine levels increase over the years and knew what awaited me. I was 52 when my nephrologist said it was time for me to have the surgical procedure to attach a vein to an artery in my left arm. This arteriovenous fistula is the access point for dialysis. He said that I would probably need dialysis within about three months. It was about one year more before I really needed it. Even though it was an eventuality we had expected for over 25 years, my wife said: “I thought we had more time.” I considered myself fortunate to have dialysis available and so close. The center was about ten minutes from my house. The 5:30 AM appointment time was not my first choice, but it did enable me to continue working and still have evenings at home with my family. The initial few months are called the “honeymoon” period. Things were going well, I was tolerating the treatments, and I felt better. Why would I need a transplant? I attended a pre-transplant session at a hospital at my wife’s insistence. I really had reservations about the process. Except for the out-patient AV fistula surgery, I had not been “under the knife” and never had a hospital stay. A pre-transplant session at a different hospital was even more graphic and made me less enthusiastic. Eventually, dialysis became more difficult and I felt more fatigued. It was more disruptive and vacations always created scheduling issues. Both hospitals as well as the dialysis team, encouraged me to look for a live donor. They suggested that I contact family members and friends to tell them I was in need of a kidney donor. My oldest son who was 21 at the time offered immediately without being asked. Personally, I felt reluctant to put someone else at risk for me even though they assured me that the donor would remain safe and my outcome would be better. I reluctantly placed myself on the transplant list and received dialysis for about four years before a cadaver kidney became available. The story of the call from the transplant clinic was interesting. My transplant surgeon had told me that I would need a bilateral nephrectomy because my polycystic kidneys were large and infected. He said that they needed to be removed before the transplant, but the removal should be delayed until I was closer to the top of the transplant list as it would add extra stress on my body. After about three years on dialysis, I received my first call. I declined the kidney and scheduled the nephrectomy. This surgery was difficult and I was in a lot of pain. The following year was brutal while I waited for the next call. Without my native kidneys, I was no longer producing urine and I had severe limitations on fluid intake. This was most unbearable during hot summer days. The long wait between the first and second calls was exacerbated by a nearby transplant center being closed as people transferred their wait time to the center on which I was listed. In the ideal scenario, I would have received a call soon after the nephrectomy had healed. The second call came while I was on a Boy Scout camping trip. I had been involved in Boy Scouts for 25 years in varying capacities but many as Scout-master and frequently camping. I probably spent several hundred nights in a tent. On this trip, I had no cell signal inside the camp. My wife received the call at home and, after failing to reach me, drove to our camp and walked...