Two transplants are better than one

Yes, I was aware of pancreas transplants. But, no, I never thought they were successful for much more than a year. So I wasn't even considering a pancreas transplant.

That is, until I talked with Dr. Amit Basu, a UPMC Presbyterian surgeon.

He said UPMC has had grand success with pancreas transplants and referred to a patient with a functioning pancreas 15 years after the transplant. The pancreas is what produces insulin. A successful transplant potentially could cure the diabetes after 43 years. My ears perked up like antennae.

Dr. Basu, with a steady and determined gaze, convinced me to get on the list for a combined kidney-pancreas transplant. That means being on two lists simultaneously -- one for a kidney and another for a kidney-pancreas.. The wait for a kidney generally is two to three years. But for a kidney and pancreas, the wait can extend to four years. (I noticed this morning that Dr. Basu's patients give him four of a possible four stars. I understand why.)  

Dr. Basu said I'll be healthier if I undergo the transplant(s) before undergoing dialysis. It bolstered my determination to maintain my kidney function with diet, exercise and close control of my diabetes. Read more about pancreas transplants here.

That's to say, my evaluation went well.  

I fully expect soon to be placed on the transplant lists. Yesterday, the Thomas E. Starzl Transplantation Center spent about five hours with nine candidates for kidney transplants. All nine were males. I had sessions with a physician's assistant, then a nephrologist, then Dr. Basu, then a social worker (who wanted to help me with anxiety or fear, among other things.) Hey, I'm calm and collected -- until the tranplant call comes. Then a lady reviewed my health benefits to make sure I can afford it. It looks like my PPO Blue will cover it with the help of Medicare. 

But the highlight was talking at length with my UPMC contact person, Amy Singh (smiling in the picture below), was assuring, knowledgeable and helpful in walking me through the necessary steps. She answered various questions and even supplied me her e-mail in case I need information for my "Dave's Kidney" blog.

My sugar did dip a few times throughout the morning but I had glucose tablets and Amy got me some cookies to tie me over. She also told me that, if necessary, I should eat lunch then return to finish out the evaluation. The cookies and tablets kept me intact. UPMC called me later at home with word my blood test had revealed a sugar level of 42. That's dangerously low. But I was fully functional and ate glucose tablets immediately after the blood test as I headed straight to lunch at the hospital cafeteria.

Anyone needing a transplant should be prepared to qualify for one.

They don’t put a valuable kidney into a body that cannot survive the ordeal or remain healthy once immunity is suppressed.

Because a transplant requires immunosuppressant drugs to prevent organ rejection, doctors at the Transplantation Institute require solid proof that the candidate has no infections, cancer or other disease conditions that would threaten one’s health and well-being once the immunity is suppressed.

I’ve already undergone 15 medical tests in anticipation of the evaluation — colonoscopy, various ultrasounds, stress tests, electrocardiograms, blood tests, stool occult (worst of all), and a chest x-ray. I’ve had my dentist, Marshall Little in Claysville, verify I have no gum infections. My urologist, Dr. Ronald Benoit of UPMC, had to notify them that I have no prostate cancer and an adequate PSA (2.6), while my endocrinologist Dr. Vijay Bahl at Shadyside Hospital, provided an overall evaluation of my general health. Dr. Bahl has been my doctor for 14 years. Everything was coordinated through my nephrologists at Teredesai McCann and Associates. I have a whole herd of doctors caring for me, and I think they are the best.

They take time to explain things, listen to my soliloquies and theories that they sometimes tactfully counter with medical science or simply shrug it off and look the other way. They provide me advice by which I usually abide.  

Teeth are good. My eyes, according to Dr. Ronald Salvitti in Washington, are in great shape ever since I underwent laser surgery in 1988 for retinopathy — hemorrhaging capillaries in the retina caused by high blood sugar. Dr. Salvitti once told me my eyes are in excellent condition, despite having to save my left one after I walked eye-first last year into a tree branch.

The transplant doctors also require two tests to confirm blood type. I think mine is O-negative, although tests will confirm that.

Women must complete 18 tests.

I also had to complete a five-page medical history and other paperwork prior to the evaluation. During the evaluation I had to provide a urine sample, take a tuberculosis test (shown to the right) and then watch as they drew 16 tubes of blood from my arm. The nurse assured me there was enough left over for the ride home.

This stuff takes time, needles, pokes, prods, and tons of expensive equipment and medical expertise.

I stand confident of passing my evaluation and being placed in good standing on the transplant list. Doctors do want me to undergo a doppler test of my carotid artery and also an utrasound of a leg artery. I forget its name. They want to check my arteries after 43 years of diabetes.

Once those tests are completed, a committee will decide whether I qualify for transplants. The Starzl Institute will send me a letter within two weeks after the committee decision.

I patiently await the results. .