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  • Help with decision as to when to get transplant

    I am a male 58 1/2 yrs young. My gfr is 22. I have found a donor and the medical team has verify the kidney match. I would say my health is good, but tired easily. What advice can be provided about when to get a transplant. When I reach 20 or less or wait until gfr is as low as possible. My decay rate is about 3 units per year. There seems so many pluses and minuses, I wish I knew what the right time was to be operated on. Thanks, for your inputs.

  • #2
    Can't really advise you on when to do it, since you currently have the luxury of picking the time. But there are some things you should think about.

    If your transplant evaluation revealed any health issues that need to be addressed before the transplant, or you have procedures you wanted to have done, you have to be completely healed from those and be infection-free before you can move forward with the transplant. In my case, they found a non-critical gallstone and advised that I should have my gallbladder removed before the transplant. I ended up having an acute gallstone attack so it was removed, anyway, but I'd have had to do it at some point. Better before you are immunosuppressed than after. I also had a hernia repair and some dentistry done to clear the decks.

    Your donor will likely have a longer surgery and recovery than you, so the impact on your donor's home and work life and the timing are key, since you have a choice. Allow for complications. My donor contracted C diff post-OP in the hospital and was bedridden for several weeks longer than anticipated. If you and/or your donor are employed, you need to have everything arranged for leave, FMLA, and securing your position, beforehand. Remember that you will still have frequent labs and clinic visits for months after the transplant. Some of that as you resume your normal lifestyle.

    People frequently postpone starting dialysis until the last minute. There's no reason to do that if you are having a transplant you can plan ahead. Mine wasn't elective, but I wasn't on dialysis yet, either. I was relatively strong, my recovery was quicker than average, and I was able to transition back into the world much easier than if I had waited until I was almost too sick to tolerate the surgery. I also (barely) avoided losing too much muscle mass to remain eligible for transplant.

    There are many things to consider, and many facets to look at. If your transplant team has a staff psychologist, it might be worth a little counseling time to discuss the issues and your feelings about the timing.

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    • #3
      I agree with what ThomasM posted, I would also add that most of my nephrologists have always said to keep your original equipment as long as possible. If you think about it, the longer then you will keep your transplant. I had a donor for my first transplant and waited until my creatinine was in the 6s, GFR was very low, about 10 and could absolutely not take it anymore, I had lost a lot of weight as well, but roared back after the transplant.

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