by George Taniwaki
Today, I have a series of presurgical consults at the University of Washington Medical Center. This is my eleventh visit to UWMC related to my donation and only two days before my scheduled surgery date.
Ramasamy Bakthavatsalam. Photo from UWMC
The visit starts with another trip to the lab. I get several blood samples drawn for a final HLA cross-match test with the recipient and for another complete blood count. They also get a urine sample to test for protein and sugar levels (a check of kidney function and infection). The tests are ordered “stat”, meaning the surgeon wants to see the results before meeting with me in 30 minutes. Given how slowly everything else has progressed, it’s interesting to see that today’s test are so urgent.
My meeting with the urologist, Ramasamy Bakthavatsalam, starts with him showing me the CT scan of my abdomen again. He mentions again the possible complications resulting from performing a donor nephrectomy when there are multiple renal arteries. Thus, he says he is now strongly in favor of open surgery rather than laparoscopic. He will consult with the radiologist again later today before making a final determination.
Ouch, this is an unpleasant surprise. Open surgery will require an incision that’s twice as big as for laparoscopic, about 15 cm (6 inch) long. And it will be in the side through a lot of muscle rather than in the front. This means more pain, more time in the hospital, and a longer recovery time.
However, Dr. Baktha explains that open surgery provides a better view of the renal arteries, which will reduce the chance of bleeding for me and will make it more likely that the artery can be cut before it branches. This increases the probability of success for the reattachment to the recipient during the transplant surgery. As Dr. Baktha says, “I’m sure you want to feel good about the donation. But you may not feel your best if your surgery is successful but we end up not being able to use the kidney.”
He’s right. I would feel pretty disheartened if the transplant failed. So I’m willing to put up with a little more pain, discomfort, and longer recovery time if it improves the chance of success.
I sign a new patient consent form authorizing him to perform open surgery for my donor nephrectomy. He adds the form to my medical chart and tells me to take it to my other meetings.
For more information on becoming a kidney donor, see my Kidney donor guide.