Kidney Quest: Last Tests

In the last week, you will have the last tests. For us, the test came five days before the transplant. Alan and I returned to Mount Sinai for final testing. Since the HLA (Human Leukocyte Antigens) can change, within a week of the transplant, the recipient and donor must be re-matched to be sure we were still negative antigen reactive--i.e. he won't reject my kidney.

Alan had to have an X-ray and CAT scan. We both needed to be examined by an anesthesiologist. Alan had to be seen by the doctor who would do his surgery. I had to see mine.

So on surgery minus one week--you can expect:

1. an additional cross matching
2. and X-ray and CAT scan
3. a check-up by an anesthesiologist
4. a check-up with the surgeon

Site of kidney extraction:

Formerly, ribs had to be removed and the kidney was taken out from the donor's back. This left the donor in a lot of pain and often produced unsightly bulges in the muscles. Donors complained, so doctors began taking the kidney from the front. Still, ribs had to be removed.

Once laproscopic surgery became feasible, the kidney had generally been removed near the navel and no ribs were taken.

My doctor took it one step further. He would remove the kidney near the pubic bone. This would leave the scar hidden by bathing suits or underwear. I nice thought for a single, fifty-year-old!

It took us three months to complete everything. However, all the tests can be completed within three weeks. Most of the time and effort is spent before the surgery.

Kidney Quest: Save the Urine

Not a big enough bottle for the 24 hour urine test

Sunday, October 12, 2003, the day before the barrage of testing, I began the dreaded twenty-four hour urine collection.

Why must we collect a full day's worth?

This test is a more accurate measure of creatinine levels. Since creatinine is a muscle by-product, the more muscle one has, the more creatinine she produces. So weightlifters generally have high levels and babies have low ones.

That's the scientific end of the story. However, consider the logistics.

Mount Sinai mailed me a jug. It looked like a plastic half-gallon milk container. The opening was  about four inches in diameter. Have you, as a female, ever tried to pee in a milk bottle? (and I hope you males don't do it regularly).

Logistics:

1. How do you aim and get the pee into the bottle and not on your hands?
2. How do you hold a milk bottle under you and still fit over the toilet?
3. How do you go out anywhere, drink lots of coffee and not use the ladies' room?
4. How do you refrigerate it? Yes, you heard me right. The whole kit and kaboodle has to be refrigerated. (What if someone mistook it for apple juice?)
5. How do you fit a day's worth of urine in a half gallon jug?

Now isn't this juicy info for a blog? Tune in this weekend for the answers.

Related articles

• Kidney Quest: 24 Hour Urine Collection
• Kidney Quest: The Story of Organ Donation
• Kidney Quest: Initial Screening for Donors