OCR Text |
Show CHRONCJUE lhursdav, July 21, Jy?7 I MUKM hoM I AH Volume ho No. 8 d t-- ' .. ..... : ' CI" , kidney '. V . v transplant -- . I V. qr RRt C F. BAKFR Chronic le staff Tie just spent a most intense 10 hours. I saw a kidney transplant jwrformed by the I'niversitv Medical (jinn's Organ Transplant team. It's made up of luo sixcialicd surgeons, two sixe ialied nurses, a pump technician and a very busv secretary. The Transplant team erforms four it fie kidney 1 i: r:;-""nni.- !' Diary of a mad vr7 U by 1 Kidney, wrapiwd in gaue, gets its venous connection. Y- j - m - n x 1 transplants a month. This figure is both fortunate and unfortunate fortunate for the more than 25 patients the Medical Center has on the waiting list. But it is unfortunate for two reasons. One is that those patients who are waiting for transplants have to have their blood cleansed by a dialysis machine several times a week. Second, four to five kidneys a month is far loo few. Three to five prospective recipients are added to the list monthly. The more kidneys available, the more transplants can be performed. The team is very anxious to trv to help these people begin to lrad more normal lives. The staff knows everv potential recipient jKrsonallv and keeps iraek of I 10 people who have had transplants. The kidnevs most of these eoplr will eventually receive tome from deceased donors. The rest, a much smaller donors. So whv percentage, come from live, blood-relateshould a voting person, or anyone for that matter, think about signing a donor card, to he carried with them everywhere? F,spce iallv if you plan, like I do, to live to a ripe old age? For the same reason life is so interesting the unexpected. I'lirelaied donor kidnevs used in transplants - r-- ITT I f .1 ., "" m-m- MVi I) 1 d V come mostly from accident victims. The donor of the kidney I saw transplanted, died in an unplanned auto accident, at age three. Rut one of her young kidneys is still alive and will possibly keep another person alive, for a long time. Because of my experience, I now carry a donor card, which I got from Nancy Talboe, R.N.. transplant coordinator at the Organ Bank at the I'niversitv Medical Center. Talboe said from people she gets about 20 calls a day at 582-391- 4' h?-' 1, requesting donor information. 7 13 8 p.m. I'm at the hospital again to meet Nancy for a the to aiijMHt to pick up the kidney. It's aiming on a trip com mere ial flight with an attending pump tec hnic ian. horn San Antonio, Texas. After removal hoin the donor, a jxrfusion pump mac bine is hooked up to the arteiy and vein of the kidney, and chilled (7 degrees C), defibriginated plasma is c ite ulated through it to keep it v table. The pump, and the detachable sterile mexlule the kidney sits in. is light and portable and has its own jxnvei supply. A protective metal cove r keeps the kidney hidden from view. The mac hine flies in the seat next to the technician, making a soft thy thmie groan as it woiks. Curious passengers ask many questions and quite often, donor cards are passed out. 8:39: Nancy and I arrive in her yellow VW at Salt Iike City Airport. Walter Peter man. the team's pump tech, has driven out in his cat. carrying a spare pump in case a switch needs to Ik- made. It's a simple procedure, I'm told. The flight has aimed a little early and we hustle down to the arrival gate. The pump and precious captive await on a little pushcart under the watchful eyes of technician Lee Caniaro, a Texan, and Rick Serna, a new Walt lift the cover and lake a look at their new and Nancy arrival. They quickly wheel it to the waiting VV, illegally parked, naturally, on the circle. Nancy, Lee, the prwe passenger and I have a safe and swift ride back in the cool of - soft-spoke- n tech-in-trainin- imiiiiiinn Surgical team prepping the internal site for implantation. Weather Thursday south winds and warm, becoming mostly cloudy by evening with 40 percent chance of showers; high 92, low 65 Fridaywarm and windy, becoming mostly cloudy by evening with 50 percent chance of showers; high 93, low 68 Saturday partly cloudy with south winds and 30 69 percent chance of showers by evening; high 95, low Sunday partly c loudy, windy and warm with showers near mountains; high 96, low 70 late evening. 9:20 p.m.: Back at the third floor off ice of the Organ Bank. Walter draws a fluid sample from the kidney's output collection (Yes, it's still making urine!) and lakes it around the c orner to have the blood gases measured. This w ill give an indication of the kidney's health. Results are back in a matter of minutes: Excellent, considering the kidney has been separated from a human body for more than 30 hours. Walt will repeat this test every 15 minutes. Can functions change quickly, I ask. "Very," assures Nancy. The plasma terntxraturc and pump pressure and urine flow rate are also closely monitored. A decrease in flow and an increase in pressure would piotend the kidney's demise-- Out s is holding steadv. 9:35: Walt. Lee anil Ric k tiansler (he kidney container from the smallei transport pump to the I'niversity's larger hospital model. Sue ess. !J:37: N ine y is on the phone tiac king dow n a hote-- lot I ,ee . e l ."1 Dr. mac Maxwell hine-to-kielne- v snips th? con nection, as Alan Condceand Cindy look on. and Ritk, who'll lly back to Texas tome rt row motning. Nancy evidently does a little of evetything around here. Question to Nanc v: "Ate the te lathes of the dec eased donor told what happens to the kidneys?" "Yes, they're usually told the dispensation, but not the recipient's name." 9:50: 1)i Can Maxwell, hief of transplant surgery, gets his first look .it the new aitival. He's very pleased. Dr. Gary Thieme (an intern on rotation), and Nancy hi ief Dr. Maxwell on the prospective lecipient. Rusty, age 28. This is Rusty 's second transplant. The first one, about four months ago. was well tolerated by his Ixxly for the first month, and then epiit suddenly. It had to be temoved. This is not unusual, just one of the risks. The rejection rate for transplants from deceased donors in the first three months is alxmt 38 jxreent. And the whole time, the recipient is on immunosuppressant drugs, to lessen the natural rejection reaction. Dr. Maxwell performed Rusty's first transplant. 0:01 Nanc y c alls the tissue-typin- g lab to see if they're ready c tissue cells from the donor with hlexxl serum to from Rusty. The lab techs will run an antigen-antibcxlreac tion test. This is the final and e rue ial test. In fact, it's the last in a series of tests that took place both hours and months ago. More about thai later. Nancy and I walk the chilled tissue samples up to the lab. Results should be back in about . c 1 ross-matc- h y ninety minutes. 10:15 I get into the act and chive Lee and Rick and their pump to their downtown motel, freeing Nancy to lx with Rusty. Why out of 25 patients waiting for decease d donor kidney s, was Rusty chosen? The selection is much broader than that. Every prospec live recipient has Ixen bbxxl and tissue-typeresults ate entered next to their and the transplant-critica- l list. names on a computet Monthly, a revised list, by h center . For example, if our eac is transplant centers, sent to donor kidney suitable for transplant organ bank icceived a it and from our area, they'd tyrx compare the results against is h If a mate indicated, the luc ky our list of tec ipients. 21 hour call, the same as on c is alled, immediately. They Teall ihe transplant staff, and can usually arrive at the hospital in four to six hours. If a match doesn't look likely for our patients, they 'd check the list from other centers and call the first one where a match is indicated, and arrange tiansfei. A pump can keep a kidney alive for up to 70 hous. but the scxMiei the transplant is accomplished, the better. have gone to the 10: 10 Tin bac k. Di Maxwell and N.u t he What elxs ahead. A mav snack b.n loi eats. long inght 2 On! she olten is v houi these Nanc 's husband lb ink about d jx-rso- I continued on page 2 |