July 2009

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

My wife is not happy about the possibility of me traveling alone to Los Angeles and staying in a motel while recovering from surgery. She would much prefer me having the surgery at the Univ Washington Medical Center in Seattle and recovering at home.

I’m not sure it is possible to find a local recipient on the waiting list and am willing to travel to complete the transplant. So for now, I plan to continue to work with the UCLA Medical Center.

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

A transplant coordinator at the UCLA Medical Center has called me. The hospital is a member of the National Kidney Registry and I am contacted to determine if I am a match for a kidney patient who has become sensitized to foreign tissues (often caused by blood transfusions or a previous transplant). They are searching for someone with matching human leukocyte antigen (HLA) type to prevent organ rejection (see my earlier post on the role of antigens in transplants). I am surprised that they called me. It is unlikely that two unrelated individuals will have matching HLA-types. The closest matches are usually siblings. Maybe the patient is Japanese (as I am), which may make me more likely to match than just a random donor.

However, UCLA-MC cannot use the HLA-type test results that I have on file with the National Kidney Registry to determine if I am a match for their patient. That’s because the results are not detailed enough to determine if I am a match. So they will mail me a blood sample kit so that they can have their lab perform the HLA-type tests and present the results in the format they can use. They also want a second blood sample to conduct a serological cross-match test between me and the recipient. This is a simple but crude HLA compatibility test. A sample of my blood is added to the sample of the recipient’s blood to see if it agglutinates. If it does, then we are not HLA-type matched.

Drawing the two blood samples will not be covered by my insurance. I decide to save some money by asking the Puget Sound Blood Center to take the samples when I come in next month for a plasma donation. The Blood Center is also an organ transplant clearinghouse, so they routinely handle these requests.

I call the Univ Washington Medical Center and cancel my appointment with them since I don’t want them to go to the expense of doing all their tests if I end up donating my kidney through UCLA.

[Note: This entry was actually written in Sep 2009. I changed the posting date to keep my blog entries in chronological order.]

I just read another great article on kidney donations written by Virginia Postrel (another article by her is mentioned in a Dec 2007 blog post), The story appears in The Atlantic Jul 2009. She talks about on the creation of the National Kidney Registry, the benefits of paired exchange donations, how allowing financial incentives could encourage more people to donate kidneys, and the ethical problems facing transplant patients who choose medical tourism as an alternative to being on a waiting list in the U.S.

As I stated in a Nov 2007  blog post, I am registered to be a donor through two organizations, the NKR and the Alliance for Paired Donations (APD). I’ve been on both lists for over a year and am surprised how long the matching process is taking (more on how waiting lists work in a future post). Ms. Postrel describes some of the inequities created by waiting lists and the prohibition on incentives from the recipient’s point of view in a Forbes article in 2006.

[Update: My own experience with the MatchingDonors list is described in a Sep 2009 blog post.]