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Blood Wash
10-18-2007, 02:16 PM
Post: #1
Blood Wash
Eric's body killed his donor kidney. He needed another to save his life-
but first doctors had to give his bload a Wash

this is a story I recently read in the newspaper called "Daily Mail"
I thought it would be a good one to share, as it walks you through the
the treatments Eric must endure.

The Patient

Quote:My proudest time was competing in the Los Angeles Olympics in 1984.
I jumped my personal best in the heats and came eighth in the final.
But by the following spring, I sensed that, physically, things weren't
right. After training, I was no longer experiencing a surge of feel-good
endorphins, I felt shattered.

When the competition season started in May of 1985, I was jumping a
meter less than usual. By the summer, I was struggling to jog a lap
of track as a warm-up and my coach insisted I get medical advice.

When the doctor examined my urine sample, he raised his eyebrows.
"You're passing a lot of protein", he said. I know now it can be
a sign of kidney disease but, at the time, his words meant little.

I was admitted to hospital immediately. Tests revealed my kidneys
were functioning at only 5 per cent of their ability. I had unexplained
renal failure- possibly caused by high blood pressure. Doctors told me
I would need dialysis to take over the role of the kidney in removing waste
products and excess fluid from my body. And I would be put on a
transplant waiting list.

There are two forms of dialysis I chose the form I can carry out myself.
Changing the fluid one day, the enormity of it hit me. "This is my life,"
I realized.

Ironically, being an athlete made dialysis harder. Big muscles produce
more waste, so I was having to insert three liters of dialysis fluid at
a time. I felt so bloated that running was out of the question. Just
six months later, in April 1986, the phone rang. A suitable donor kidney
had become available. The next morning I underwent surgery.

After checking with my consultant, I began to train five months later.
In 1987, I took part in the world transplant games and set records
for the long jump and 100m sprint. I really felt on top of the world.
Gradually my performance started deteriorating. The following year
I failed to qualify for the main Olympics. Though I felt fine, tests
revealed my body was rejecting the new kidney and I had to go back
on home dialysis. But then I got a fungal infection in the catheter
and had to have hospital treatment instead, three times a week.

I was hoping for another transplant, but the doctors told me the
rejection of the of the first had produced [b]high antibodies
so high that levels that my body would react against the tissue of
another donor.

Then, two years ago my wife read abut a new treatment called
Antibody incompatible transplantation (AIT) "Washing Away"
antibodies. I was told 25 per cent of people are turned down
for this treatment because, physically, it is so stressful. But Dr.
Higgins agreed I would be suitable because, apart from the kidney
problem, I was fit.The risks are twice as high compared to normal
transplants, but Dr. Higgins success rate is 90 per cent.

Unbeknown to me, my sisters and wife had offered to be donors.
Doctors agreed a kidney from my older sister was my best chance.
Ten days before the operation, I started the blood washing treatment.
The week after the transplant, I had strong anti-rejection drugs.
Two weeks later I was allowed home. And, three months on, I feel
great!

The Surgeon

Dr. Rob Higgins says, about 5 to 10 per cent of the population
has minor kidney disease, often related to high blood pressure
without being aware of it. This can lead to serious disease and
progress to kidney failure. This is what I suspect happened to
Eric.

Early intervention can prevent irreversible damage, but, unfortunately,
it's possible to lose nearly all of our kidney function without
feeling unwell. Skin itchiness, tiredness, nausea and vomiting
are all very late symptoms. Research suggests that after 12 to 15
years of dialysis, it starts to take it's toll on the body, however fit
the patient. A build-up of material, called dialysis amyloid, can damage
bones and joins. A transplant doubles life expectancy.

Eric developed antibodies against the tissue type of his first donor
organ. These were likely to reject most other kidneys, so the risk
of rejection was too high for him to have a normal transplant. With
plasmapheresis, the idea is to wash away the antibodies
before the operation and remove the risk of an immediate graft
failure.

"We perfected the technique and carried it out successfully and carried
it out on 30 patients before Eric was referred to us". Before surgery,
he was attached to a machine for the blood washing, because the
removal of antibodies works only on a temporary basis, most patients
have five sessions on alternate days, in the ten days before the
transplant, with the final one on the day before the operation.

During each session, the blood passes through two
filters that trap antibodies, before allowing the blood back
into the patients body. Some protein is lost naturally during this
process and we replace this with bottled protein or albumin straight
into the bloodstream.

Each session take two hours and a lot of patients suffer side effect.
such as fluid retention, and so find it physically stressful. Once
the antibodies have been removed the operation is the same as any
live donor transplant, taking 90 minutes. If antibody levels are going to
cause rejection, they will do so in the first two weeks. Some patients
require further sessions of blood-washing to keep them to a a minimum.

~The most important things in the world
were accomplished by people who have
kept on trying when there seemed to be
no hope left~
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