when we were As teenagers, my brother and I had kidney transplants six days apart. It wasn’t supposed to be. He was two years older than him and was due to receive my father’s kidney in April of 1998. Twenty-four hours before his surgery, the transplant team performed a final blood test and found a tissue incompatibility that all previous tests had overlooked. My brother was pushed on the “list”. So he had the generous foresight that the deceased’s kidney would become a donor after death, so he didn’t know how long to wait. I was next in line for my father’s kidney. We matched and the date was set for his August 28th. Then my parents got a call in the early morning hours of his August 22nd. There was a traffic accident. A kidney was available. As with many things in life, my brother acted first and I followed suit.
His surgery went smoothly. After 6 days it was my turn. I remember visiting the doctor right before the transplant. After feeling the needle pricks and stinging flushes of the local anesthetic, I felt the dull tugging of the dialysis catheter pulled out from under my collarbone, nausea and a strange sensation. Later, I remember the quiet mist of midazolam as I rolled into the operating room.
I remember waking up from a very deep depths after surgery in bright light, shaking violently and then falling asleep again. I remember laying naked under blankets in the ICU and going into a mild delirium on morphine while watching a movie about psychiatry. .
But now, 24 years later, I am relatively healthy and can recognize how much I have forgotten. Three times a week, machines drained and reused my blood in an oversized recliner deep in the taupe core of the hospital building. Forget the simplicity of a low-potassium, low-phosphorus, low-salt diet. You forget how strange it is to take a few pills in the morning and a few pills at night to keep a foreign organ in your lower abdomen alive. Unfortunately, I lost sight of the greatest gift that was ever given to me, this grant of unlimited extended time, and 90,000 other Americans await this same gift, often on dialysis for years. About 4% die each year while waiting, and another 4% become ill and unable to undergo major surgery. But here I am, forgetting this grace.
Five years ago, my brother’s kidneys failed and all the buried memories came back to me. His blood tests returned irregular levels, which worried the nephrologist. He was in and out of the hospital with repeated viral infections. His biopsy revealed necrotic tissue perforating half of his kidney, webbed all over like the tunnels of an ant colony. Finally, in May 2018, he emailed his family and friends, attended concerts, hiked the Pacific Northwest, fell in love, got married, and started a family in his 20 years. I extracted the borrowings of . All of these details were delivered with a kind of lighthearted lightheartedness, but as all readers know, they rushed towards an inevitable and awkward conclusion: at his 37th year, I was looking for a kidney. Could you consider it…?
first succeeded A kidney transplant was performed in Boston in 1954 between psychotic Richard Herrick and his identical twin, Ronald. Eight years later, with his new kidney still functioning, Richard died of a heart attack. In Ukraine, in 1933, the kidney of his 60-year-old man with type B blood, who died 6 hours later, was transplanted into his 26-year-old woman with type O blood, who had lost kidney function after poisoning. rice field. she is herself. The recipient survived an additional two days. This is a miracle given the technology, conditions and popular knowledge of the time. In 1950, a Chicago transplant recipient had additional renal function for several months. In the early 1950s, Paris became a hotbed of experimentation. Then came Helix.
While their story was technically spectacular, the central biological puzzle of transplantation remained unsolved: how to tame the immune system. recognizes foreign tissue and sends a series of B and T cells to kill it. As identical twins with sufficiently identical tissue types, Herrick sidestepped this problem. An early effort was to give a lethal marginal dose of X-rays to the whole body before surgery. The intent was to crush the immune system and force new kidneys to rebuild in place. Most patients died of organ rejection, graft-versus-host disease, or both. The field of transplant surgery has become closed and hopeless. Citing the basic precept of avoiding unnecessary harm, the more conservative practitioners of the time denigrated the practice. Around this time, one detractor wondered: And when will you realize that dying is also a mercy? “
