Sunday, December 26, 2010

Because You Asked

Here a few more answers to some questions I am getting from people as they learn about my "kidney thing" or who have had questions come to mind after thinking about it for awhile.

Will you still be able to drink?
I don't know what is funnier-the frequency of which this one is asked (i.e almost everyone) or the fact that it usually is in the first three questions people ask. I had the same question (perhaps even in my top three) when I first started looking at this.  The first answer I found was on the blog of the FBI agent who donated a few years ago in the states ('Kidney Chronicles', as found in my "Interesting Sites" links on the right hand side of the page).  He said: "I can think of a million reasons why people shouldn't drink, but this is not one of them".  Why I don't share his disdain of festive beverages, I think it might be a good excuse for me to continue drink less and avoid overdoing it.  A coworker who shared with me that she had only one kidney (reasons unknown to me) said her hangovers are worse as a result.  However another co worker's husband donated a kidney about 10 years ago and he "still drinks like a fish". So I think the short answer is you can still raise a glass as well as the next person, but like they say, everything in moderation.

Would I want to know about who got my kidney?
Yes I think so.  It's not a "must" for me but I think it would be nice. It's a piece of the story right?  That being said if I didn't like the person or their family or worse if the kidney didn't work, I am prepared for that.  I knew going into this that I have to make the decision because its a good ting to do, not because I have a specific outcome and recipient "type" in mind.

How will they choose who gets my kidney?
That I don't know 100% but I will ask. But here is what I know based on the assumption that they'll ask if I am willing to go into the national program (I am even though it may mean travel). My understanding is that they will come up with a short list of people my blood type can help how likely have been waiting the longest and are the sickest or harder to match. They will perform cross matching tests which are used to identify the presence of preformed antibodies that would damage the kidney (cause rejection). The basic test involves mixing the liquid portion of the recipient’s blood (the part of the blood that contains antibodies) with my cells. If their blood tries to kill my cells (or does kill my cells) that is bad and it won't work out between us. I will likely have to give a bunch of blood for this purpose once cleared for donation and then from there they will test against the short list, schedule surgery etc.  If I had been donating to someone I knew, this test actually would have been done at the start to rule me out as a compatible donor for that person, then again right before surgery to make sure nothing changed (pregnancy, transfusions and transplants can change the antibodies in your blood).

What is a Domino or Paired Exchange?
A "paired-exchange" is a technique of matching willing living donors (who had planned to donate to a loved one but weren't a match) to a compatible recipient who also has a loved one willing to donate who is not a match. For example a spouse may be willing to donate a kidney to their partner but cannot since there is not a biological match. The willing spouse's kidney is donated to a matching recipient who also has an incompatible but willing spouse. The second donor must match the first recipient to complete the pair exchange. Typically the surgeries are scheduled simultaneously in case one of the donors decides to back out and the couples are kept anonymous from each other until after the transplant.
When a non-directed donor (like moi!) enters the Registry, they have half the conditions required for finding a match. In other words, because the transplant of their kidney is not conditional on my friend or family member receiving a transplant in return, I have a greater possibility of being involved in whats known as a domino exchange. The largest so far I think has been 16 transplants, involving 32 people (in the US). There are some pretty intense logistics to it (including travel, OR scheduling etc) but its pretty cool.  The Canadian Registry going national in November was a huge step for this as it centralizes the planning a bit and makes the who "matching" process far less manual.  Here is a diagram of how a domino exchange would work:

Keep the questions coming-it's a great learning experience for me and also on some occasions has given me some added food for thought!

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