Friday, 28 September 2012

HTA Meeting

Shortly after our meeting with the surgeon, we had our meeting with Dr. Matthew Buckland, the Independant Consultant for the Human Tissue Authority (HTA).

I was seen first, then Pieter, then both of us together. The point of the interview was to ensure I knew exactly what I was signing up for, what the risks and procedures are of being a living donor and that I wasn't coerced or reimbursed. I also had to provide my passport as proof if identity. The meeting was very long but thorough, and I'm glad that these checks are in place to keep the process legitimate.

While Pieter had his interview I typed the previous post and let my family know about the good news. I was too excited to wait!

After about 40 minutes Matthew returned for me. He told us he was happy with our stories and motivation, but because I offered the donation to Pieter at the very start of our friendship, and the bond grew strong because of it, the donation will be classed as Altruistic instead of friendship. Altruistic kidney donations means to donate to a stranger or to the hospital who then give it to someone on the donors list.

I don't think this will be an issue, the only difference is that the final decision will be made by a panel of independant consultants, instead of just one. We are confident this will be agreed within a week or two.

Pieter also had some blood taken to test the level of immune suppressant in his system. This level will determine exactly how long before the operation can take place, and will be discussed in a meeting on Monday 1 Oct. 2012 by the Renal team.

Apart from the longer than expected wait, we're extremely happy and relieved to have been given the all-clear by the surgeon.


It's an anatomical match!!

I'm still reeling from the wonderful news as I sit here in the hospital reception room!

We just had our meeting with the consulting surgeon Dr. Roberto Cacciola about our tests. He was very happy with them and told us Pieter is extremely fortunate to have a non-related living donor with such a good match. He discussed everything with is in fine detail, down to the actual procedure and incisions.

Long story short, Dr. Roberto showed me die CT scans of my kidneys and was very pleased. He told us that they prefer to remove the left kidney because it has a longer artery and is easier to access. It wonderfully turns out that my left kidney is slightly smaller than the right one by 1.3cm. They will always remove the smaller or weaker one leaving the best one for the donor. My left kidney is connected to my main artery by only one artery, exactly the same as Pieters! Where the one on the right has two.

This means an easy an smooth operation because there are only these two arteries to connect. It's common to have up to 6 arteries, and connecting those to an odd number is very complicated.

So all my tests have been concluded and the surgeon is happy to do the operation!!!



There is one bit of bad news though; he noticed that Pieter is still on anti-rejection medication for his non-functioning kidney, even though his doctor should have told him to stop it once I started my tests. The medication prevents Pieter's body from producing new cells, which means that the new kidney won't be able to attach to his body. He is very upset about it because we were preliminarily scheduled to have the operation at the end of October, and now we have to wait another 3 months. I feel his anguish, but at least we know it will definitely go ahead!

Monday, 24 September 2012

Update


Spoke to John this morning and after I contacted Sister Lilly and happy to confirm that or meeting with the Surgeons are scheduled for Friday, 28th September at 11:30 and our meeting with the Human Tissue Authority (http://www.hta.gov.uk/) at 13:00.

Thursday, 20 September 2012

Confirmation of results


What seemed to be a long time has suddenly arrived and today we are all going to see the Renal Consultant to review our final results. We are not expecting any significant news as we have all been doing a lot of research and finding answers to our questions up to now.

We were looking forward meeting John and Natasja and arrived just before 13:00 where the two of them were already waiting. As always it was good to catch-up and share our excitement on the progress being made. Unfortunately we were waiting for a while before we saw Dr. Ravi but as always had lot to talk about and also looking forward to our Spur event afterwards.

While we were waiting Sister Lilly also came to introduce herself to John and Natasja and was good to see her again. She briefly explained what can be expected for today and also confirmed the next steps. Sister Lilly has already arranged for us to see the Surgeons next week Friday, 28th September which will go into the finer details of the operation and would confirm at least a tentative date for our operation. Sister Lilly also informed us of the independent consultant review from the HTA and would aim to schedule this for the same day in order to save us some time and before John leave for holiday on Friday evening - wonderful!

John and Natasja were seen first by Dr. Ravi and before we knew it they were back happy to confirm that all went well. Lizelle and I were next and Dr. Ravi confirmed that the results are all in order (all negative results) and also had a quick check-up. We further discussed recovery period and also the type of medication that I had to take for the rest of my life. Furthermore Dr. Ravi scheduled some further test for me just to confirm that all is in order. I managed to go for the X-Ray while John was attending to his procedures and also have an ECG and stress test scheduled for Friday morning at 9:00am before we see the Surgeons etc.

By now all our stomachs were growling and I was very happy to see that John, Natasja and Lizelle were waiting as I exited the X-Ray room. We were looking forward to getting to the Spur were we could have a wonderful evening and discuss the day’s events further.

As we arrived at Spur and heard that they had an eat as much as you like Ribs event we were convinced that Spur would probably incur a loss after all four of us decided to go for the special. We concluded after a wonderful evening of company and full stomachs heading back home.

Nephrologist meeting and CT scan

Today both couples had a meeting with the Nephrologist, Ravi Rajakariar to discuss all the test result to date. Our appointment was for 1pm, but we had to wait about an hour to be seen. But at least we had good company!



In that time Sister Lilly came over to introduce herself to me. We had spoken on the phone may times but never met in person. She wanted to know how we were and how all the tests were going. We told her that we thought things could be done a little faster, and asked if the meeting with the surgeon to discuss the CT scan and the meeting with Human Tissue Authority (HTA) could be scheduled for the following week before I go on holiday for two weeks. She was extremely understanding and went off to make arrangements. She came back in a short while, and confirmed that the meeting with the surgeon will be on Friday 28 September 2012 at 11:30am. She said she would  try to arrange the meeting with the HTA for the same day, which would conclude all the tests, meetings and consultations. We will then be booked in for the operation!

Natasja and I were seen first by Dr. Ravi to discuss my results to date. The meeting was very informal, and over in about ten minutes. Dr. Ravi told us what we already knew, that all the tests results were good. It's the best possible news we could have hoped for! What are the odds that two strangers match so well? Then there was a quick routine checkup and medical questionnaire just to tick a few boxes, and we were done! It was a bit of an anti-climax as we thought it was going to be a in-depth meeting to discuss every aspect of the transplant, but excellent news nevertheless. We already know all there is to know about kidney donation due to all the research I did before deciding to donate a kidney to Pieter.

While Pieter and Lizelle went for their meeting, Natasja and I made our way down to the 1st floor Imaging Department for my CT scan. It was so comforting to have Natasja with me and for her to see the hospital as well.


  

 The purpose of the CT Scan is to get a detailed look at the size, shape and health of my kidneys, as well as how they are connected to the arteries and veins. The less arteries that connect to the kidney, the easier the transplant will be. We know that Pieter has one large artery connecting his kidney, so the best scenario will be if mine is exactly the same. This is what we are hoping for.

After checking in at reception and waiting some time, I was called in by a very friendly technician named Neil. Neil took me down the corridor to the preparation room. It was quite daunting because I didn't really know what to expect, but Neil explained the procedure that was to follow which put my mind at ease. He asked me some questions about my health and allergies, and I had to sign a form to confirm everything we discussed. Neil then started prepping me by inserted a canular into my arm into which the dye would be pumped later. He told me that it was quite a long needle so he needed a good vein. It was at that point that I decided not to look at it while he inserted it!

Once inserted, Neil directed me to the waiting area, where I had to drink 3 glasses of water to help circulate the dye through my system. I waited a good 15 minutes before I was called in as there was someone being scanned. I was greeted by a very friendly nurse who asked me to confirm my name and date of birth. I had to remove all metal objects, and lie down on the bed. I also had to pull down my trousers to my knees, with my privates covered by the nurse with a towel. Shame on you nurse for sneaking a peek and thinking I didn't notice!


Above is a generic photo of a CT scanner, I didn't get to take a photo. I had to lie on the table with my arms raised above my head, hold my breath, and the scanner passed over my abdomen to take the first scan. Then the nurse came to attach the tube to my arm which was used to inject the dye. I was asked if I was allergic to Iodine, but I didn't know. So I was told to wave my arm if I felt any pain or discomfort as it went into my bloodstream. Fortunately it was fine, and all I felt was a warm sensation as it passed through my body. She disappeared into the control room again, and I was told to hold my breath while the scanner passed over me. This happened 3 times. I had to lie there for 5 minutes while they analysed the images, after which they decided to do one more for good measure. The nurse then told me we were done, and I could pull up my trousers. This time I made sure there was no room for peeking! She removed the canular from my arm, stuck a plaster on the hole, and I was released.

Natasja was relieved to see me as she was told it took 10 minutes, and I was gone for 45 minutes. They obviously didn't take all the preparation into account. We went up to the second floor imaging department to meet up with Pieter and Lizelle, and Pieter finished with his X-rays as we arrived. 

Ravenous from not eating all afternoon we went to the Spur restaurant at the O2 Arena in North Greenwich for dinner. To our delight we were told that there was an "Eat all you can" special on ribs and chicken wings - just what we needed! And what a wonderful way to end another day of test; great food and great conversation. We talked for hours about how far we had come in the past 3 months, and all the wonderful times that lie ahead.