The call

It was midnight last night when my cell phone rang.

I had fallen asleep about half an hour back while waiting for my tech, Jairam to come and start dialysis. We've changed the cannulation sites and so he's been doing the cannulation for a few days now. I had called him around 10:30 and he said he would be late because he was caught up in the hospital.

I answered the phone half asleep. It was Jairam. Was he not going to come tonight? I was about 3.5 above my dry weight and I could pull off another day. It would be good if he did not come. I could have a comfortable sleep.

"Bhaiyya (brother, in Hindi as he calls me), we've just got a cadaver and the blood group is O positive. Will you be interested?"

I had recently registered at the Krishna Institute of Medical Sciences (KIMS), Secunderabad for a transplant. I had initially broached the subject with my nephrologist, Dr. Girish Narayan and he said that we should now try another transplant. I had my first in November 1998 and after 11 days of normal function, Hemolytic Uremic Syndrome (HUS), my original disease had recurred causing the transplanted kidney from my mother to fail.

For a few years, I did not even think about another transplant but for the past few months I have been getting a little fed up of dialysis and started wondering if I should try again.

Dr. Girish Narayan asked me to register at KIMS since they have a large number of transplants happening. So, I went and met Dr. V. S. Reddy, the nephrologist at KIMS and discussed everything. I completed the necessary formalities and got onto their list.

Immunosuppression was going to be tricky. Cyclosporin, the most commonly used drug can cause recurrence of HUS. Both Dr. Girish Narayan and Dr. V. S. Reddy were going to do some research on the internet and then decide on the regimen for me. I was going to pitch in with my own findings.

When I registered I enquired about the statistics and calculated that I should not expect a call for atleast about 5-7 years. So, I took the research bit easy. I guess so did the doctors.

I was shaken out of my partial slumber with a mental jerk. A kidney for me! I was flooded with a thousand thoughts at the same time. No more dialysis. No more worrying about fluid. But wait a minute. What about the immunosuppression? That was not decided yet. I could not use cyclosporin. Last time I got a transplant, cyclosporin caused recurrent HUS.

I called Dr. V. S. Reddy and confirmed that he had not had a chance to check on the immunosuppression either. Both of us decided then on the phone that we should not go in for the transplant now.

Shucks! What an opportunity lost!

But I guess in these circumstances this was the right thing to do. Why take a risk when we are unsure?

At the same time, I'm not sure when I will get another chance.


Anonymous said…
Prograf is less renally toxic than Cyclosporine, although there is a new form of Cyclosporine being trialed in the US called "voclosporin".

Here in the US, they are using Prograf and CellCept, and some centers are not using Prednisone at all ("tolerogenic immunosuppression").

Good luck.
Vinay Mantha said…
Damn Kamal, that was an anti-climax indeed. While i was reading through, for a minute i was really excited thinking that you are going to go in for another transplant and reshape your future.

Anyways, keep bugging your docs to do their research soon. Did you ever see the movie "swatimutyam" (telugu, directed by viswanath and starred by kamal hassan, a true masterpeice). In that movie, somayajulu (of sankarabharanam fame) once mentions to kamal hasan that he will try and find a job with him. That is it. Kamal gets on to his nerves from that moment on, morning, evening, night, every where every place this guy goes to. Call that brain-eating or perseverance, your choice.

Vinay Mantha