Transplant goes smoothly Monday

Transplant goes smoothly Monday
Colette Abbott, wife of University of South Dakota President Jim Abbott, had good news to report the evening of Monday, June 4, from her husband's hospital room at the Mayo Clinic in Rochester, MN.

Both Jim and Bruce King, USD's assistant vice president of academic affairs and chief diversity officer, were back in their hospital rooms after a rigorous day of surgery.

At approximately 9:30 a.m. Monday, Jim was wheeled into an operating room. Surgeons removed one of his kidneys in a two-and-a-half hour procedure and successfully transplanted the organ into Bruce's body.

If all goes well, the donated kidney will mark the end of serious health problems Bruce has experienced for years.

He has suffered from end-stage renal failure since May 2005.

"I just ran upstairs to visit Bruce in his room," Colette said Monday evening. "His surgery naturally took longer than Jim's, and he's still pretty groggy. But he looks good, and I think the kidney is working."

By Monday evening, both men were tired, but awake at times. When Colette visited Bruce, she even had an opportunity to speak with him briefly.

Jim's kidney was removed laparoscopically, and doctors expect him to make a quick recovery.

"He's hoping to get out of the hospital on Wednesday," Colette said Monday, "and we will stay here on Thursday, and if everything looks good, on Friday we very well may be coming home."

Bruce and Jim's unique adventure had its start shortly after Bruce was diagnosed with kidney failure. He sent an e-mail to friends and colleagues explaining the problem after he was diagnosed.

According to news reports, Jim responded immediately, said Bruce's wife, Marcine King.

"We've had a lot of people say they'd consider it, a lot of people who say that they'll do it, but it's whether or not you're a match that counts," she told the Volante, USD's student newspaper.

Bruce said many people had approached him saying they wanted to be donors, but he didn't have any expectations.

"President Abbott came to me and explained that he had always wanted to do this for someone," King said in a story published in the Yankton Press & Dakotan. "But like so many others, it didn't really register with me."

Jim said he got tested at the Mayo Clinic after discussing the situation with his wife, Colette, whose father and a brother suffered from kidney cancer.

A blood test confirmed Bruce and Jim were both O positive, and Jim underwent an extensive matching process.

"I was hopeful from the beginning," Colette said. "You know, we'd all probably do it given the chance, but it takes someone special to go ahead with it. That's the kind of person Jim is."

"I was just glad to help," Jim said in a news story published shortly before the surgery was scheduled.

Bruce called Abbott's gift a "wonderful example of man's humanity to each other."

We never know how we will be tied together," he said. "I'm so grateful that I was the fortunate one to come along at the right time."

Bruce said before Jim was tested, he thought he would just have to wait. O blood types usually have to wait five years on the organ transplant list, said Lynette Fix, Jim's nurse coordinator at the Mayo Clinic.

About 69,000 people are waiting for kidneys, and only 16,000 get transplants nationwide each year, she said.

Fix said Mayo Clinic performs 230 to 250 kidney transplants a year, and rejection rates hover between 5 and 10 percent.

Transplant patients stay in the hospital for three to four weeks.

According to information available on the Mayo Clinic's Web page, the goal of successful kidney transplantation is to help recipients feel better, become more active, and enjoy a better quality of life. The main benefits of a successful kidney transplant are:

  • Freedom from dialysis.
  • Increased feeling of well-being.
  • Fewer restrictions on diet and activities.
  • Increased energy level.

    The following issues must also be considered when assessing the option of kidney transplantation:

  • There is a risk that the transplanted kidney will never work or may be rejected by the recipient's body at any time. With rejection, the recipient would require dialysis and have to wait for another kidney transplant.
  • Antirejection medications must be taken for as long as the transplanted kidney functions. These medications have many possible side effects.
  • Transplant requires major surgery. Surgical complications are possible.
  • Transplant may worsen medical conditions such as hypertension or bone disease.
  • In some patients, the original kidney disease can return after transplant. Transplant candidates must discuss the chance of recurrence with a nephrologist.
  • If a living donor is not available, the waiting period for a cadaver kidney can be lengthy.

    During kidney transplant surgery, an incision is made in the transplant recipient's abdomen, usually on the lower right side near the hip bone. The donor kidney is placed near the bladder on the right side of the recipient's pelvis.

    Surgeons usually attach the donor ureter to the recipient's bladder, allowing urine from the new kidney to flow normally. Surgeons restore blood supply to the donor kidney by connecting it to blood vessels supplying the recipient's legs.

    The patient's own kidneys are usually not removed. In some cases, such as when the kidneys have been a lingering cause of high blood pressure, one or both kidneys are removed during the transplant or at a later operation.

    Transplant typically takes about three hours. The recipient usually gets out of bed and takes a short walk the day after surgery. Liquids can be sipped the day of surgery, and a normal diet is usually resumed within two to three days.

    During recovery, most patients gradually experience less discomfort in the incision, a greater ability to move around, and return to normal activities. The donor kidney should begin to function immediately, and patients typically remain in the hospital for three to five days.

    After Bruce is eventually dismissed from the hospital, he will need to stay near Mayo Clinic for approximately three to four weeks so Mayo staff can monitor the function of the new kidney and the his recovery.

    During that time, Bruce will make regular visits to see the medical and surgical staff and the transplant coordinators.

    Mayo staff will also update local health care providers about the Bruce's progress and Mayo's recommendations for his care after he returns home to Vermillion.

    Mayo's staff will provide consultation or support as necessary.

    Follow-up appointments at Mayo Clinic are sometimes necessary during the first year after surgery, and some patients are asked to return annually. Mayo staff are always available if problems arise.

    Within three to six weeks after surgery, most kidney transplant recipients like Bruce can resume their usual daily activities, including returning to work. Mayo's transplant nurse coordinators remain in close contact with the transplant recipient and the physician who provides regular care at home. Bruce will be required to carefully follow a treatment plan developed in cooperation with his physician and the Mayo transplant team.

    All transplant recipients need lifelong treatment with immunosuppressant medicines to prevent rejection of the transplanted kidney. These medications must be taken daily.

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