Yesterday I spent the day at University of Pittsburgh Medical Center (UPMC) going through what amounted to the human interaction aspect of the screening process. I had done a lot of tests and lab work locally prior to this appointment so they had all that to review.
The day started with a general class about kidney transplants with several other candidates. There I learned that for someone 60-64 (my age group) dialysis will extend life expectancy 5 years while a transplant will extend it 12 years if you can get one. The waiting time at UPMC for a deceased donor kidney averages 22 months though other factors can affect one’s specific wait.
For example, because I have already had a liver transplant my immune system is considered sensitized and it narrows the parameters of which kidneys might work for me which may extend the waiting time.
Of course with a living donor you move to the top of the list.
Compatibility is not just based on blood type it also has to do with the antibody profiles of the donor and recipient. Everyone has a personalized palate of antibodies in their body based on past experiences and exposures and this is more crucial for kidney transplant than for liver transplant as it turns out.
I meet with a nurse practitioner who grilled me on my medical history, dietician, a pre transplant coordinator, a pharmacist who reviewed current meds and gave a glimpse of post transplant meds, a representative of a research study that wants to enroll and track me ( I agreed), a neprologist (kidney doctor) , a social worker, a financial person (yes Dorothy death panels already existed before Obama care — no insurance, no transplant) and even the potential surgeon.
It was basically sit in a room and one after another they came in, it took hours. The day ended with blood work being drawn, a total of 23 tubes worth but who was counting.
Because I had previously aced my cardio stress test amongst other things, I was told I was an excellent candidate for a transplant but they needed some more testing.
Because I have a history of skin cancers I need a clearance from a dermatologist, I need a colonoscopy, and a clearance from a heptologist. The clearance from the heptologist will need to include a liver biopsy and ultrasound. These can all be done locally if I can get them done timely but they warned if it takes too long then I may have to repeat previous tests. If I can’t get timely work done in Wheeling, then UPMC can do them but that of course involves trips to Pittsburgh, a lovely town but time consuming to visit.
The liver biopsy may be the kicker because if there is too much fibrosis they won’t waste a kidney on me. Mean time to cirrhosis post liver transplant with chronic active hepatitis C is 5 years and I am 6 years out so the possibility of damage does exist.
Anyway, more waiting for more tests seems to be my lot. At least the bulk of it is out of the way.