Friday, May 8, 2009

Transplant decision revisited

An old friend recently got in touch with me. He is now a doctor in the US. He got to know about my renal condition and we discussed my long term plans.

He asked me about a second transplant. I told him about my decision to not go for another transplant for now. He thought I should give it a shot especially since I am young. He felt the quality of life would be much better after a transplant.

I have been thinking about this for the last couple of days.

The main problem in my case is that my primary disease, Hemolytic Uremic Syndrome (HUS) is such that chances of recurrence are high in the transplanted kidney. The first time round, they sort-of concluded that the cause of the transplant failure was HUS recurrence. But I don't think they were sure enough. I had the slides seen by Neeraja, a relative and friend who is a nephro-pathologist. She thought it could be either HUS recurrence or cycolsporin toxicity.

The truth is at the time of my first transplant, I did not push hard enough for conclusive evidence of the cause of the transplant not working out. There were some other complications and these were not logged well enough. I wish I had started blogging (even though the term wasn't even coined back then!). I would have had a clear record of the sequence of events.

This is so important. Today, I am not really sure. The exact details of the first transplant would have been invaluable to decide on a second transplant.

The primary factor dissuading me from going in for a second transplant is that the doctors here are not aggressive enough in dealing with complications. When I talk to different doctors about a transplant, I get the feeling that they are trying to avoid a transplant for me. Probably because they are not sure about what to do.

The record for transplants has also not been very encouraging here. KIMS, the hospital where I had registered saw a flurry of transplants for a couple of years. Things have slowed down following the death of four successive transplant recipients. They have barely had a couple of transplants in the past six months.

I don't think the medical infrastructure here is capable of handling my transplant. It is not practical for me to undergo a transplant elsewhere. So, I guess, my decision of not going in for a transplant stands 'for now'.

1 comment:

PDS said...

kamal, if you feel transplant could be done again then why not consult docs in apollo and maybe register there as it is the premier hospital here. Get another opinion apart from Girish and then take a call.