Another Crossmatch??

[Dirty Rocker]

Okay, so I was approved by the transplant comittee to become a donor last week. I spoke with the coordinator, and she had to check with the surgeons, but we decided unofficially on April 23rd for surgery. Well, my recipient saw his doc yesterday, and they want to do a more sensitive crossmatch on the 16th because he has developed a new antibody. I spoke with the coordinator again, and she said that we are going to go ahead and schedule for the 23rd so that we don't lose the OR, but it's possible we will have a positive crossmatch when we have this next test (this is not the preop cxm, that will be the day before).

Has anyone else had a similar experience or bump in the road like this? I'm kinda freaking out.

What if we've come this far for nothing? It could take months or years to find a compatible paired donation.

So, as it stands, even though the surgery has been scheduled, travel arrangements have been made, leave from work has been approved and we've gotten this far, I won't know for sure that I'll be able to donate to him until 4 days before the surgery.

How on earth am I going to make it through the next two weeks without becoming a total basket case?

[Fr Pat]

     The waiting can be very difficult, for sure. But in EVERY living kidney transplant a bad cross-match can turn up, even the day before surgery if the recipient develops the wrong antibody. So that possibility always should be kept in mind. They do have to be careful, to make as sure a possible that the transplant will last. No sense in going through with the transplant if rejection seems probable due to bad anti-bodies.
     But in some cases if the crossmatch is bad they can perform plasmpheresis over several weeks on the recipient to remove the antibody from the blood. I don't know how often this is possible. As you mantioned, a paired exchange would also be possible although it might take a while. Some places also offer the possibility of a "list exchange" in which the incompatible donor gives the kidney to whomever the hospital choses from the waiting list, and in turn the intended recipient goes to the top of the waiting list for a kidney from a deceased donor. This can cut the waiting time a lot in some cases, although a kidney from a living donor is preferable.
     So, not much to do but wait and see.
        best wishes,
               Fr. Pat

[Dirty Rocker]

Thank you Fr. Pat. After getting a good night's sleep, I feel much better about it today. It will never be a 100% guarantee until we are in the OR, and I realize that. I'd much rather be ruled out than see him go through acute rejection. The waiting IS difficult, but both of us have done everything we can do. Now all that's left to do is wait and keep a positive attitude.

[SWB]

I had a similar last minute test.  It can be un-nerving...  You know there is nothing you can do but hard to relax.  Just try to be patient and hold on my friend.

[Karol]

Our daughter had a positive crossmatch result 3 days before the surgery. They decided, since it was a mild B cell sensitivity, to do plasmapheresis and IVIG the day prior to the surgery. They followed up with more IVIG over several weeks. She had chronic rejection after 3 years and over the next 3 years her kidney function declined to where she now needs dialysis as she waits for a new transplant. And the rejection created 100% antibodies so finding a donor is going to be tough. They know more now about crossmatches than they did 6 years ago, so hopefully they could avoid this for your recipient. You have to be ready for any outcome, but in most cases it turns out fine. Just "hope for the best and prepare for the worst." Good luck!

[Dirty Rocker]

Karol,

Thanks for putting things in perspective - I definitely want the best outcome for my recipient.

My heart goes out to you and your daughter!

[Karol]

  Keeping good thoughts here!