A perspective from a Transplant Coordinator
Transplantation and organ donation are issues close to my heart. I am in my19th year of employment at Lynchburg Nephrology Inc. We are a comprehensive medical facility providing pre-dialysis medical care, kidney dialysis, and post transplant care. We follow patients with kidney disease through the progression to end stage, requiring dialysis or transplant for survival. Our facility offers in-center hemodialysis, home peritoneal dialysis ( CAPD,CCPD), home hemo dialysis, and the newest mode of treatment: nightly home hemodialysis. We serve about 250 dialysis patients and provide ongoing medical care for about 80 kidney transplant patients.
Back in the first few years of my employment, transplants were a rare occurrence. Success rates were at 40% for one year, meaning that at the end of one year 60% of all cadaveric kidney transplants had failed. With success rates like that it is understandable why most patients chose to stay on dialysis rather than take a chance on transplant.
When the anti-rejection drug, Cyclosporin came on the market it literally transformed the field of transplantation. Success rates more than doubled for kidney transplant' and patients began to consider transplant more seriously. The number of patients on the waiting list grew as did the number of transplants being performed.
Like any job, my responsibilities have changed as the facility has grown and the needs have changed. I started in 1979 doing dialysis and for the past few years my responsibilities have been as Transplant Coordinator/Dialysis Nurse and evolved into Transplant Coordinator/Office Nurse/Pre ESRD Education. For any one who wants a kidney transplant, I work with the transplant facility to help arrange and coordinate the medical evaluation required to get on the waiting list. If a person has a living donor, I help coordinate both donor and recipients medical evaluation. As an office nurse I also participate in the medical care of patients who have already had transplants. With my dialysis background I help begin pre-dialysis education early in the disease process and assist with treatment choice counseling. We are also able with bi-monthly seminars on Treatment Choices and Chronic Renal Failure to teach patients about the options for treating kidney failure, and the importance of blood pressure and blood sugar control in slowing the progression of renal disease. The well informed patient is the one who takes better care of themselves, follows their diet closely, takes their medications as ordered and who ultimately stays off dialysis longer
Clearly I have found the field of dialysis and transplantation to be very rewarding work. I feel that I am giving patients the information they need to improve their health status and assisting them with treatment choice decisions that can improve their lifestyle and their quality of life. Over and over again I see how transplantation has changed lives, literally transforming "invalids on dialysis anddisability" to healthy individuals who are able to live an independent lifestyle, travel, finish raising their children, enjoy their grandchildren, and yes, even return to the workforce as working taxpayers once again.
Of course, transplant is not for everyone and not everyone is a success story. But the chance the transplant will succeed is by far greater than the chance it wi11 fail. Yes, there are medication side effects and occasional complications but these can be managed with regular medical care. And with research and the development of new and better anti-rejection drugs, who knows what success still lies ahead.
For those of us who work in the field of transplantation the choice of whether or not to be an organ donor is clear. Being an organ donor is a way to live on in others, an opportunity to save and improve lives, and a way to still influence this world long after you've left it. If you have not made that decision, I strongly urge you to get the facts on donation from your local Organ Procurement Agency. Discuss them with your loved ones. Make your decision and tell your family to be sure your wishes are clearly understood.
For all of you courageous individuals whose love of life left you no choice but transplantation, you have my respect, my admiration, and my best wishes for a long and healthy life. Make your second chance at life be more and better than you ever imagined it could be. You aren't finished yet!
Valinda Wilson LPN,CHT
Lynchburg Nephrology Inc.