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Kidney Transplant

Summary

December 2000 Update

Sam is now in his 43rd month since he received his transplanted kidney from Charles. Thanksgiving Day marked the 3 1/2-year point and gave this entire family much to be thankful for as they gathered together. Sam and Charles and their families live near each other and have shared traveling, hunting and chopping and selling firewood this fall. Sam travels around the country periodically for his job and remains employed doing computer drafting. He doesn't have to give much attention to his transplant now with the exception of taking his medications daily and seeing his nephrologist every two months. Sam states that the biggest problem for him and his wife since his transplant have been insurance issues.

While Sam feels well, works full time and lives a very active lifestyle, his kidney function has never been as good as he and his physicians would have liked to see with a living-related transplant. His last visit to his nephrologist was on 10/30/00. Lab was drawn on that date and revealed the following:

Creatinine 2.3
BUN 36
Sodium 139
Potassium 5.7
CO₂ 21
Calcium 9.4
Glucose 125
Albumin 4.7
Hemoglobin 11.9
Hematocrit 33.7

Sam's nephrologist noted in a letter to Sam that the glucose was high secondary to steroids and that it would continue to be monitored. He also noted that the creatinine and BUN were better than in August when they were 3.3 and 51. Sam's creatinine and BUN have generally remained in the 2 to 4 range since his transplant. The nephrologist also cautioned Sam about the elevated potassium, and he noted that the hematocrit was a little worse than in the prior August visit. A possible explanation for that might be that Sam had gained 8 pounds of fluid since the previous visit and the extra fluid might have caused a lower hematocrit. Sam had noted some shortness of breath on exertion. A chest x-ray did not show any abnormalities. Sam's nephrologist cautioned him to be more careful with his diet, particularly with high sodium and high potassium foods.

The nephrologist noted that the transplant kidney was non-tender, blood pressure was good at 116/84, tremors from medications were improved, depression was under good control with continued Prozac and appetite was good. He reviewed all medications with Sam and noted the following current medications:

Baby aspirin 1 daily

For immunosuppression to prevent rejection:

Prograf 5 mg. daily
Imuran 50 mg. 2 daily
Prednisone 20 mg. every other day

For blood pressure control:

Atenolol 25 mg. daily

For acidosis:

Bicitra 3 T, 2 daily

For mood:

Prozac 10 mg. daily

Sam's insurance pays for 80% of the cost of his medications. He pays for the remaining 20% which is a sizable amount, but it is possible with him and his wife both working. Although his transplant and health are not perfect at this point, he is stable and feeling well. He, Charles and the extended family continue to be thankful that Sam has not rejected this kidney which would have required him to initiate dialysis and be placed on a waiting list for another kidney. Charles has always felt he did the right thing in donating his kidney to his brother, noting that it has been worth it to see Sam feel well again, and he knows Sam would have done the same thing for him had the situation been reversed.