Tag Archives: ethics of organ transplantation

“You gave me life”

This inspiring article comes courtesy of Tom Hayes of Global News.

Toronto kidney recipient celebrates 40-year anniversary

When 72-year-old Tom Mitrovski’s kidneys failed, he thought he had five-to-10 years to live. That’s what he was told 40 years ago.

“I was so tired. I didn’t understand,” said Mitrovski thinking back to the early 1970s.

Mitrovski said he was told by his doctor that his kidneys were failing. He would undergo three years of dialysis before a donor kidney became available in 1979. Nov. 27 marks the 40th anniversary of his new kidney and noted a special attachment has formed.

“I named my kidney Gerry, so we are Tom and Gerry,” said Mitrovski while laughing.

Dr. Jeffrey Zaltsman, the head of nephrology at St Michael’s Hospital, said Mitrovski’s success is remarkable.

Click here to read the whole article and the Global TV news clip.

Anyone interested in becoming a donor can sign up at http://www.beadonor.ca.

 

 

How Artificial Intelligence (AI) Changed Organ Donation

I received a kidney from a living donor in 2016. That this happened was a result of developments described in this article, a program run by Canadian Blood Services that would take all the available but incompatible donor-recipient pairs across Canada and seek to match them up. After going through that exercise multiple times with no success, the difference came about because an altruistic anonymous donor came forward. This resulted in a chain of paired donations and new lives for many people.

The following article, although specifically addressing the US context, describes these circumstances in great detail. The opening lines really grab you:

How AI changed organ donation in the US

By Corinne Purtill

There used to be only three ways off of a kidney transplant waiting list. The first was to find a healthy person from within one’s own pool of friends and family, who perfectly matched both the recipient’s blood and tissue types, and possessed a spare kidney he or she was willing to part with.

The second was to wait for the unexpected death of a stranger who was a suitable physical match and happened to have the organ-donor box checked on their driver’s license.

The third was to die.

Although algorithms have made a tremendous difference in matching up eligible donors and recipients, the medical ethics around organ donation cannot be resolved by a mathematical model. I’m sure you will find the included discussion of a “God committee” fascinating.

Click here to read the article.

And in a related note, I’ll be participating in the Kidney Walk this weekend. If you are interested in supporting those living with kidney disease by making a donation, click here to go to my sponsorship page.

The Globe and Mail. “No more secrets: Why I broke protocol as a kidney donor”

This “First Person” article originally appeared in The Globe and Mail on April 27, 2018.

 

 

Twice a year – at Christmas and in early June – I hear from a man whom I have met only once, who lives in a remote village far from my Vancouver home, but with whom I share something intimate: our kidneys. I’ve got one, he’s got the other. I’m not supposed to know this man. Protocols in the national Kidney Paired Donation program decree that donors and recipients who are strangers should remain that way.

Vern and I were part of a cross-Canada exchange involving multiple donor-recipient pairs that resulted in my daughter, Kasari, receiving a kidney from someone closer to her age and my kidney going to Vern, who is closer to my age and for whom my kidney will be a better match.

While for some, donor-recipient confidentiality in a paired kidney exchange makes perfect sense, for inquisitive people like Kasari and me (and, it turns out, Vern and his wife, Shirl), engaging in something as intimate as a kidney transplant ignites our most basic curiosity. Who is now walking around with my kidney? What kind of a person is she or he? How does she or he feel about it? How is my kidney working out for them? And who gave my daughter the incredible gift of her new kidney? I mean, this is a vital organ we’re talking about. This is shared DNA. This is important, life-altering stuff.

By putting two and two and two together and watching those shuffling the post-op corridors and the comings and goings during endless hours in post-op waiting rooms, Kasari and Shirl were able to figure out whose kidney went to whom. Because we are not supposed to know these things, they had to be tentative, discreet and sensitive to signals when exchanging pleasantries before my daughter could say, “I think my mum’s kidney went to your husband. What do you think?”

Click here to read the rest of the article.

 

 

A Message from a Living Kidney Donor

A few months ago in the post, A Somewhat Oddly Timed Thanksgiving, I mentioned Gerald Neufeld, who donated a kidney on my behalf as part of the Paired Kidney Donation (a.k.a. Living Donor Paired Exchange) program. I had mentioned in that post that Gerald had been a missionary in Japan. These days Gerald continues to be involved in church ministries in two part-time roles, one as pastor of a small Japanese congregation in Surrey, BC, and the other as the music coordinator for Emmanuel Mennonite Church in Abbotsford, BC. On February 12, he shared the following message at Emmanuel:

Faith, Christian Community, and Kidney Donation

Galatians 6:1-10

I’d like to tell you a bit about my experience in donating a kidney a number of months ago. Most of this message will be about my experience. Many people think that it must have been a huge decision for me, but I really felt like it was just a number of small steps of faith. God has blessed me with great health, a supportive family, and a wonderful church community. In deciding to take steps to donate a kidney I felt like I was just responding to God for all the blessings I’ve received…

If you read the article I wrote in the Emmanuel newsletter you would have seen how I decided to donate. Rather than it being one huge step of faith, it really felt like a lot of little things, pieces of a puzzle that came together. As I reflect on this, I realize how much community has been woven through the whole process.

In Paul’s letter to the churches of Galatia he tells them to “Bear one another’s burdens…” Here, he’s likely talking about helping people who are of bearing the burden that results from sin and the consequences of sin, but the burdens that we can help each other with could be anything that takes away from the joy in living our faith – sickness, difficulty finding work, struggles in relationships, uncertainty about the future… I’m not going to get into a lot more detail here but I thought this passage fits well with the role of the faith community in everyday life. A big part of bearing one another’s burdens involves prayer, and as I look back on my experience it’s interesting how the prayers and support of our faith community played such a major role.

At a Vancouver pastor’s meeting, when I first heard a prayer request for a man who was dying because his kidneys were failing, I began to not only pray for him, but I also thought, “Would it work for me to actually donate a kidney?” I began praying to see if God may be leading me this way. Didn’t John the Baptist say “Whoever has two coats must share with anyone who has none”? I figured I have two healthy kidneys, I guess maybe I could share with someone who has none (at least none that are functioning well)! I remember my wife Rie’s initial reaction. “I hope it doesn’t work out for you to do it!” She was quite worried! But then, she also began to pray about it and soon she was strongly supporting me, I think because she sensed that maybe God was leading me in this direction. I did lots of research, and found out that most people who donate a kidney have no problems afterward and can live a normal life. You don’t need any special medication or anything, and the only restriction I have now is that they advise against skydiving. (I’ve never figured out why)…

I read in the Canadian Mennonite magazine about another pastor who donated a kidney, and had no problems, so I decided to take another step and begin the donation process. I had to go through many tests in order to make sure I was healthy enough to donate. If any tests showed a danger of health problems in the future, I would not have been allowed to continue the process. It was at this point that I heard the one to whom I’d possibly donate a kidney, was from the same family that had given me a guitar several months earlier! When my 12-string guitar had been stolen I had put out a prayer request during one of the pastor’s meetings, hoping someone may know about a good deal on buying another guitar, and one pastor suggested he could check with a church member who has a 12-string guitar that was hardly ever used. Right away, I heard that I could have it. Now, this was the same family praying for a kidney! I had already pretty much decided to start the process to donate, but this helped confirm my decision. If they gave me a guitar, I guess I could give them a kidney! Since I wasn’t compatible with the person who needed the kidney, I joined a special program where other incompatible donors and recipients are matched. So, between 2, 3, or 4 incompatible pairs people could be matched so that each person can indirectly donate or receive. It usually takes several months, but before we were matched, the other person actually received a kidney from a deceased donor. I then wondered if God was saying, OK, you don’t have to donate anymore. But by that time, I had heard about a different friend who needed a kidney, so I decided to stay on the list in order to donate for him. Why not? I was all ready to donate! Russ Sawatsky is a friend I’d met in Japan. We’d both been mission workers there, and had met several times. Now, Russ is living with his family in Ontario… After much waiting, we were finally matched and we each had surgery.

To have surgery, I wasn’t too scared because I felt that God had led me to this decision. Of course there was a potential that there may be some complication, but I felt that even if I ended up with some major problem, God would continue to lead me through. I sensed your prayers as well as the prayers of many others in my wider community of family and friends.

Through this whole process, I didn’t let myself think too much about possible things that could go wrong (‘cause I didn’t want to chicken out!) (even though the chances of anything terrible happening were quite slim). I expected everything to go smoothly, but there were a few unexpected things that happened, reminding me that this was a complex process. I guess one thing is that the whole process took longer than I expected. When I first called the number of the “Pre-Assessment Transplant Clinic,” I gave them my email address, and they then sent me all the information I needed to get started in the process. I was thinking in my head that once I called that number, I was committing myself to donate, and would probably have surgery within a few weeks. It could have happened in a couple of months, but in the end, it was over a year later that everything finally worked out. During the process there were many opportunities for me to decide to opt out if I wanted. The staff were very careful to make sure I didn’t feel obligated to continue if I suddenly felt uncomfortable about the whole thing.

After the surgery, I was a bit surprised that it was somewhat more challenging than I had expected. There was no time when I felt all that much pain. At home, though, I took the maximum recommended dosage of painkillers because I wanted to be able to sleep, but it had the opposite effect. My mind went into a panic and I was not able to sleep for over 30 hours! It was a strange feeling, and at times I thought I might die. I prayed quite a bit during that time, committing to God, but physically my mind could not stop racing. After that I didn’t take any more painkillers and I actually don’t think I needed them. I’m glad that the weird effects only lasted about a day, and I’m thankful for all your prayers during my recovery. It was quite meaningful for me to know that I am a part of a larger faith community. It wasn’t just my own prayers that gave me strength, as I’ve mentioned before. You have been participating as well.

In the scripture passage read today, Paul not only encourages the people to bear one another’s burdens, he also says that everyone must carry their own loads. This might seem to be contradictory, but the meaning is different. We are to support and encourage each other along the way, but everyone must also take responsibility for their own actions. Someday, we’ll each have to give an account of how well we lived with what God has given us. The good news is that we are already children of God, part of God’s Kingdom through the sacrifice of Jesus Christ for us on the cross.

Today’s passage from Galatians ends with the encouragement to do what is right, not giving up, and whenever we have the opportunity, to “work for the good of all, especially those of the family of faith.” We all have chances to take a step of faith in some area. It doesn’t have to be organ donation. Maybe God is calling you to commit to give a greater percentage of your money to help others. Or maybe you are being called to give of your time, or something else in a different area. It may be a bit scary, but if you take just a small step of faith, you will see what God can do! And the one step may lead to another and another! I actually did a lot of calculating before deciding to donate a kidney, but I’m trying to trust more and more in God’s leading so that I can take more steps in the direction I feel God leading, even if I haven’t calculated and weighed all the possibilities. Sometimes I end up waiting too long before taking a step of faith, but with the support and encouragement of believers around me I’m learning to trust our Lord, more and more. Our steps of faith may be wobbly like a baby learning to walk. We’ll sometimes fall, but like a loving parent, I believe God is pleased to see us keep trying.

The great thing is that we are not alone in taking our steps. We are part of a faith community. How do we bear one another’s burdens? Here in Canada, we value independence. We teach kids to stand on their own, and take their own responsibility. We make sure we are doing the right thing, and it doesn’t matter so much how others are doing. But, when I lived in Japan I saw a different culture where the emphasis was much more on the community. The needs of the group take priority over individual needs. In Japan people are taught to think about the needs of others before their own. I sometimes notice this cultural difference between my wife and me. She’s criticised my driving because I’ve often failed to let others into my lane. My driving style is to mainly make sure I am following the rules, and others can do what they want, but in Japan people are taught to consider others, even when driving. I think we can learn something from them in this area.

It’s so easy to go through life with blinders on (like a horse). Sometimes horses have blinders on each side of their head so they don’t get distracted and can focus straight ahead. Instead, I’m trying to take more notice of what’s happening around me. It’s not good to just focus on my own situation all the time. Is there some area where you’ve noticed a need? Maybe it’s time to step into the situation in order to offer help in bearing another’s burden, so to speak.

All through the process of my experience, I’ve sensed the work of the wider faith community — after losing my guitar, in my request for prayer at the pastor’s meeting, the request for prayer when someone needed a kidney, the prayers and support from you as well as family and friends in other places, as I underwent surgery, the prayers and support as I took time off work. Community played a role as I learned through the Canadian Mennonite magazine about the other pastor who donated a kidney. And, my connection with Russ Sawatsky through mission work and the wider Mennonite community was another area where community played a role. It’s good to hear that Russ is now doing well, and also the person who directly received my kidney here in BC. I also feel pretty much back to normal.

So, what about each of us, in our lives? Where might God be leading us to take a small step of faith? Jesus said we only need faith the size of a tiny mustard seed. The reason is, God recognizes our little attempts to be faithful, and brings us the rest of the way. Each of us are called to really just take a small step. It usually involves some risk. Maybe God is calling you to take a step. Many people have already signed a donor card. It can easily be done online, and even kids can sign up. A link is provided in the bulletin, but you can also just do a search for “BC Transplant.” Someone who has registered a decision to donate any organs needed, after death, could potentially save the lives of eight different people. Or, some of us may feel a calling to sometime become a live donor. Recently, I was amazed to hear that if you donate a part of your liver, it grows back! If I’d known that, maybe I should have done a liver donation rather than kidney! No… I have no regrets. Maybe someday I’ll consider the liver. But, one thing is becoming more and more clear to me. I think I may never have experienced donating a kidney if it hadn’t been for the supportive community and the encouragement I experienced in the small steps along the way.

Let’s pray.

Almighty God, you have blessed us with so much! Thank-you for all you’ve given us. Thank-you that through your Son, Jesus we have perfect peace and joy. Thank-you for the gift of your church. Each day, you lead us, O Lord. Thank-you that no matter what happens around us we need not fear, because you walk with us. Help us to trust that you always provide us with everything we need to do your will. Increase our generosity, that we may rely more and more on you and less and less on ourselves. Grant us the courage to step out in faith. Help us to notice those areas where you call us to step in and help bear another’s burden. May we recognise the opportunities you give us to take those small steps of faith, through the power of Christ at work within us, Amen.

It is to weep…1 in 5 willing organ donors have their wishes vetoed

How disappointing it was for me to read this article in the National Post. Even more disappointing for me were all the comments perpetuating myths about organ donation.

Even so, articles like this bring organ donation to the forefront, and encourage people to do two important things: 1. Register as an organ donor; 2. Tell your family that you have registered as an organ donor and that you want their support in the event you suffer life-threatening trauma.

One in five willing organ donors in Ontario have their wishes vetoed by family — and doctors don’t argue

No transplant doctor in Canada has ever gone against a family's wishes despite a signed organ donor card.

No transplant doctor in Canada has ever gone against a family’s wishes despite a signed organ donor card.

Blair Bigham, Special to National Post | November 25, 2016

Toronto — When Heather Talbot saw a police cruiser park outside her home, she braced herself for terrible news. After explaining her 22-year-old son Jonathan was involved in a car crash, police officers rushed Talbot to the intensive care unit at Toronto’s Sunnybrook Hospital, where doctors told her he was brain dead.

“I remember wondering if they would ask about organ donation,” recalls Talbot, who was against the idea.

It wasn’t until a nurse asked about Jonathan’s own wishes that his sister Emily spoke up. The two had gotten their drivers licences together, and she recalled Jonathan signing the organ donor card that came with it.

“I wanted to respect his decision,” says Talbot.

Talbot came to accept her son’s wishes, but often, families feud over whether to respect previously declared wishes around organ donation.

Click here to continue reading.

A somewhat oddly timed thanksgiving

Two months ago, in September, Gerald Neufeld donated a kidney to a person in need in British Columbia, closing the loop on the Paired Kidney Donation program that we had entered into, he as a donor and me as a recipient. This is the first time I have mentioned Gerald’s name in any of my blog posts. The transplant coordinators generally want to keep these matters confidential for the first several weeks following the actual transplant. Sadly, sometimes if direct donors and recipients find out about each other, the altruistic nature of the donation can become a bit weird. But, enough time has passed that I have been released from this constraint.

Gerald Neufeld, my donor in the Paired Kidney Donation program.

Gerald Neufeld, my donor in the Paired Kidney Donation program.

Rie Neufeld, Gerald's wife and among many other things, caregiver following Gerald's kidney donation surgery.

Rie Neufeld, Gerald’s wife and among many other things, caregiver following Gerald’s kidney donation surgery.

 

 

 

 

 

 

 

Before I go on, I want to mention once again another person in British Columbia, someone I had known for many years, who had also volunteered as a donor for the paired exchange program. Ultimately, I only need one kidney to thrive and therefore only one donor, and so this other friend did not become a donor. Nevertheless, I wish to thank him for his willingness, along with his wife for her support. The encouragement I received, the depth of emotion I felt whenever I spoke with him as he accompanied me on this journey across thousands of kilometres, will remain in my heart forever.

Back to Gerald. Gerald’s connections with me and Etsuko are perhaps not quite as old, but they are every bit as significant in a different way. We shared some years together as former missionaries in Japan. As with me and Etsuko, Gerald also met his wife Rie on the other side of the Pacific. And although we didn’t have a whole lot to do with each other at the time, several years earlier we even spent a year together as fellow students at Canadian Mennonite Bible College (now Canadian Mennonite University) in Winnipeg. Who would have thought that so many years later (we returned from living in Japan a final time in 2000) we would establish a new life-transforming connection like we have experienced in 2016.

In the caption below Rie’s picture, I mentioned that Rie was Gerald’s caregiver following his surgery. Although Gerald was discharged from the hospital in a timely manner, recovery is something that still takes a number of weeks before a return to work is possible. For that reason, Gerald received support from his employers, Emmanuel Mennonite Church in Abbotsford, BC, where he is music coordinator, and the Mennonite Japanese Christian Fellowship in Surrey, BC, where he serves as pastor.

Thank you, Gerald and Rie, thanks to your three children, and thank you to your church communities for all that you have done, not just for me, but also for raising awareness of the need for organ donation.

I will add a small note about my situation these days. Recovery from the blood clot in my right leg continues but I hope to have that fully resolved by December. Last week I went to the kidney clinic as I have been doing every two weeks for quite some time. After reviewing the results of my blood test, the nephrologist I saw that day pronounced me fit and said that he wanted to see me next in two months! And then he told me that he would have suggested three months except that he was concerned it would “freak (me) out.” It almost did. Wow. By then it will be just short of the six month anniversary since my transplant.

I really am making progress. This past Friday, Etsuko and I went to Sarnia (about an hour west of London, ON) for an overnight stay at a hotel and a very pleasant walk along the waterfront. Friday was apparently the last nice day before winter began to settle in, but one of the main reasons we went away on this little trip was because we had to burn up some Air Miles before they expired at the end of this year (yes, we are among the many Canadians forced to use our points whether we want to or not). It turned out to be a great day, and it was my first time away from home in two years without having to haul along a bunch of equipment and supplies for dialysis. What a sense of liberation that was.

So, lots of reasons to be thankful! But today I want to say I am mostly grateful for people like Gerald, people willing to be living donors, as well as those who support them. Not everyone is willing to be a living donor, or even if willing, able to take such a step because of health limitations, but today you can register as an organ and tissue donor following your death. Here is the URL that provides links to all of the provincial and territorial donor registration sites: Canadian Transplant Society. Please register and make a difference. Thank you.

 

A Follow-Up: “I donated a kidney. I have no regrets.”

A few days ago I reposted an article from the Washington Post written by Michael Poulson, who had regretted donated a kidney at age 18. Here is a “Letter to the Editor” from a living donor, Macey Henderson, who at age 24, donated a kidney to her 36-year-old cousin. To what might we attribute the difference in their attitudes?

I donated a kidney. I have no regrets.

When I was 24, I gave a kidney to my 36-year-old cousin who had been on dialysis for two years, and I have no regrets.

I respect Michael Poulson’s lifesaving kidney donation and his desire to better understand the risks of donating, but aspects of his article were misinformed.

As a research scientist who actively studies risk after living donation, I can report that data show that more than 95 percent of donors are satisfied with their donation decision.

I am not scared about the risk of kidney failure after donating. Mr. Poulson stated that we do not know how many people donate and how many of them develop kidney failure, but that was incorrect: There are national data sources for both of these, and research has been published based on almost 100,000 donors showing that kidney failure risk after donating is a tiny 0.3 percent.

I spend my days thinking not of my remaining kidney but of ways to design a better transplant system, in which live donor care is optimized.

Macey Henderson, Gaithersburg

The writer is a member of the national
transplant network (United Network for
Organ Sharing) Living Donor Committee.
The views expressed are her own.

At 18 years old, he donated a kidney. Now, he regrets it.

This article  was originally published in The Washington Post on October 2. This is not an article I am particularly fond of. A living donor now regrets the decision he made at age 18. As the recipient of a kidney via living donation, and knowing of at least a couple of people who were willing to donate a kidney anonymously (sometimes referred to as an undesignated or altruistic donation), it troubles me that Mr. Poulson now regrets his decision. It also troubles me that living donors may be putting their lives at risk beyond the immediate risk of the surgery itself. Even so, I think this is worth reading the perspective of a young living donor. Please note that this is article is particularly applicable to the US context.

You may or may not want to read the comments following the article, however. Some are disheartening and mean-spirited. Others are encouraging.

By Michael Poulson
When I was 18, my stepfather’s brother had been on dialysis for just over a year. He was thin, he exercised regularly and he seemingly was in perfect health, but inexplicably his kidneys began to fail him. Although I was just about to leave for college, I’d heard enough about the misery of dialysis to decide to get tested as a possible donor. In the back of my mind, I knew that the chances of our compatibility were incredibly low because we were not related by blood. Perhaps that made it easy for me to decide to get tested.

When we received the results, I was stunned to find out that he and I were a match. The transplant team gave me plenty of opportunities to back out of the donation, and it put me through countless evaluations, physical and psychological. Much of my family was steadfast against my becoming a donor. Looking back, who could blame them? Their son-grandson-nephew was going to undergo a major operation with no benefit to himself.

However, I continued to be confident in my choice. I relied on the one fact that would be repeated to me many times: “The rate of kidney failure in kidney donors is the same as the general population.” Why wouldn’t everyone donate a kidney, I wondered.

My mother was the only one to — reluctantly — support my decision. She accompanied me to San Francisco, where the surgery took place, and we settled in for the weeks that I would spend recovering. On the day of the surgery, anesthesia flowed into my arm and the world swiftly slipped away. Then, just as quickly, it seemed, I awoke, nauseated and confused. So much preparation for such a short nap. The anxiety I’d felt about the surgery was now gone — as was one of my kidneys.

An uneventful recovery came and went. I returned to college and resumed a normal life. Likewise, my step-uncle did very well and is living a full and healthy life, as is my donated kidney.

Michael Poulson regrets giving that kidney away. (University Photo)

Michael Poulson regrets giving that kidney away. (University Photo)

Five years after the surgery, when I was 23 and getting ready to go to medical school, I began working in a research lab that was looking at kidney donors who had gone on to develop kidney failure. For that research, I talked to more than 100 such donors. In some cases, the remaining kidneys failed; in others, the organ became injured or developed cancer. The more I learned, the more nervous I became about the logic of my decision at age 18 to donate.

Click here to read more…

 

Three Weeks Post-Discharge

Wow! Three weeks already. Time for an update.

My life during these three weeks can be summarized by the following: diminishing pain and discomfort, semi-sleepless nights compensated for by afternoon naps, an improved appetite, gradually increasing walks, frequent visits to the nephrology clinic, and reliance on others.

I’m happy to report that the discomfort and tiredness that are normal following major surgery, have subsided a great deal. Healing is happening. I am much more mobile. Even so, something as minor as a shower feels like a major event that tires me out quite thoroughly. Still, enough discomfort remains that I don’t sleep all that well at night yet, although in compensation, I have a nap in the afternoon. (Wow! What an exciting report, eh?)

On the plus side, my appetite is improving. At first, I really didn’t want to eat that much. Between the mandate to drink a lot of water and the residual pain from my surgery (the scars on my abdomen might be quite a topic of conversation the next time I go swimming; that, or the response will be hastily averted eyes) I wasn’t very hungry. That’s changing now, which is fortunate, because I was losing weight and probably not eating enough protein to support the healing that my body wanted to do.

Another factor in improving health is getting exercise, primarily in the form of walking. In the first week I was back home, I could barely put one foot in front of the other, and I was exhausted after a 10-minute walk. At this point, I’d say my gait looks more or less normal, albeit significantly slower than pre-surgery, and I’m able to walk up to 30 minutes at a time. I’ll walk outside during the early morning and the evening, but I’m behaving a bit like a vampire these days, actively hiding from the sun so as to keep my now cancer-susceptible skin as healthy as possible.

The inimitable Bela Lugosi, vitamin D deficient from avoiding sunlight

The inimitable Bela Lugosi, vitamin D deficient from avoiding sunlight

A big part of each week has been visits to the Nephrology (kidney specialists) clinic at University Hospital. It’s almost like a club in a way, as I was meeting other transplanted “outpatients,” some of whom had transplants in the same week that I had my own surgery. And since the time in the waiting room seems to go literally goes on for hours, we have gotten to know each other a bit. As it turns out, it seems quite likely that I have met my donor! A married couple had been coming in to the same clinics as I have been, and as we got to talking, I learned that she had received her new kidney on Wednesday, July 27, and that her husband had donated a kidney as part of the Paired Kidney Donation program on Friday, July 29, the same day as my surgery. He had donated his right kidney. I received a right kidney. His blood type is type O; mine is type O as well. I came into the hospital at 5:45 AM in order to avoid meeting the donor. He came into the hospital at 6:15 in order to avoid meeting the recipient. To my knowledge, there were no other kidney transplant surgeries that day. These things happen…. Interestingly, they had found out who her donor was as well, on the very day of her surgery. I will still send a thank you card “anonymously” via the hospital, but it’s quite something to look into the eyes of someone who gave you an organ out of his own body that is making a significant difference in your life.

Another graphic explaining one way that the Paired Kidney Donation program works.

Another graphic explaining one way that the Paired Kidney Donation program works.

As much as I have been getting good news at these clinic appointments, no one really likes to spend a lot of time at the hospital as a patient. Initially, I was going in twice a week. Yesterday marked the first appointment that was at the once per week level. I expected that to go on for a few more weeks, but the doctor who saw me said that I was doing so well I didn’t need to come in until two weeks later. If they’re happy, I’m happy.

None of this would be possible without a lot of help from a lot of people. At my first clinic appointment, Etsuko accompanied me the whole time, something like 4 1/2 hours. Since then I’ve gotten stronger, and we haven’t felt it necessary that she be with me through the whole appointment. She arranged for a number of people from church to pick me up after my appointment is done, so that she can make her way to work after dropping me off at about 7:30 in the morning. I’m grateful for rides from Enos K., Tim F., and Jake F. these last few weeks. Of course, Etsuko has had to pick up slack in other ways, too. I don’t have much energy to cook these days (I never realized how taxing it was to stand in front of the range until now), so after coming home from work, Etsuko makes supper, too, something that I have generally done. The same goes for any of the other household tasks that I have generally contributed to.

Our oldest daughter, Rika, even came in from Toronto one weekend to look after me while Etsuko and our son Aaron went down to Virginia with our third daughter, Aisha, to help her move in as she begins her Master of Architecture program at the University of Virginia. Rika, in addition to being a brilliant junior associate lawyer is also a pretty good cook. She even made kale tasty (my opinion about kale has been significantly warped shaped by comedian Jim Gaffigan’s rant about kale in his Obsessed video — here it is from Youtube!).

Aaron, currently living at home following the completion of his M.A. in History here at “Western” (University of Western Ontario) has also been helpful, often doing errands for me that I simply can’t accomplish these days. For instance, today, he picked up a prescription for me. Really, I don’t know what I’d do without the support of my family.

This photo's a few years old now, but it's the most recent "formal" photo we have.

This photo’s a few years old now, but it’s the most recent “formal” photo we have.

Jumping Through More Hoops

Yesterday, Monday, July 25, was round two in my series of appointments in anticipation of my kidney transplant surgery on Friday, July 29.

As University Hospital is, as the name indicates, a teaching hospital, I have been asked to be involved in a research project. We’ve probably all heard about the good bacteria in our gut, routinely promoted in yogurt commercials. This research project will investigate the impact of a transplanted kidney, with its own bacteria, into the transplanted person’s gut.

Good-Vs.-Bad-Bacteria

This research project of course meant more blood work, so I once again had blood taken from me. And once again, the bloodletting started in one hand and finished in the other. After a couple of hours in the air conditioned hospital, my veins were not terribly accessible. One nurse saw me coming in and said that she was happy that she was busy at the time, thinking that she would therefore not be the person to attempt to draw my blood. However, by the time the requisition was processed, she turned out to be the lucky one, and got the first crack at me. To quote another nurse, I’m a “nice enough person,” but I guess drawing blood from me doesn’t often happen very easily.

It's a joke! The women who take my blood are always kind to me!

It’s a joke! The women who take my blood are always kind to me!

I heard that drawing blood will not be that difficult once the surgery is done. Speaking with a nurse in the living donor program, I learned that a “central line” will be established in my neck(!) which will allow blood to be drawn and meds to be injected without repeatedly poking me with a new needle. I have this image of myself as looking like some kind of Frankenstein’s monster. As long as they don’t have to bring me back from the dead, I’ll accept a bit of a monstrous look for a little while. In fact, I saw a young woman at the hospital a few weeks ago who was there for a post-transplant clinic appointment. She had been discharged from the transplant unit just the week before and looked not at all monstrous.

One of the most interesting and sensitive things that I learned about living kidney donation has to do with the confidentiality of the donor and the recipient. I have friends in British Columbia, known to me, who are willing to donate to me but who are incompatible blood types. One of them will therefore donate to someone in need locally but they will not know or meet that person. Likewise, I will not know or meet the person who donates to me. In fact, the hospital will take some pains to maintain confidentiality. For example, my family and the donor’s family will be in separate waiting rooms in the hospital. If discussing the surgery with anyone else during the day of the surgery, I will be undergoing the more generic “abdominal” surgery rather than transplant surgery.

So, what can I do to say thanks? I can write a letter. The social worker with whom I spoke suggests that I write a letter to the donor, keeping everything anonymous and without any personally identifying information. Then, with the social worker having my name and the date of the surgery, she can deliver the letter to the donor.

'Okay, Mom. I'm sorry I re-gifted one of the kidneys you gave me.'

‘Okay, Mom. I’m sorry I re-gifted one of the kidneys you gave me.’

This is actually a fascinating area, apparently. Apparently, some families of donors and recipients have chatted casually while getting coffee at the Tim Horton’s in the hospital and have almost inadvertently made connections. At other times, especially in the case of deceased donors, some recipients or their families have combed through the obituaries of area newspapers in efforts to identify their donors.

Finally, I want to mention the intended schedule. I have to be at the hospital at 6 AM on Friday morning. However, I won’t actually have my surgery begin until about 1 PM. I do have to be there early in the morning, though, because the surgeon will not begin operating on the donor until my health has been determined to be adequate for surgery that day. If I show up at 6 AM with a fever, they are not going to proceed. It’s going to be a long day.

'How's that kidney transplant going?... I need him back on the field - pronto!'

‘How’s that kidney transplant going?… I need him back on the field – pronto!’

Three days to go! Thanks for all your support.