February 5, 2011

Getting back to the point when Tommy had told me he was a 5 out of 6 match, I walked to my car as I was on my way back to my office after having been in a meeting.  I sat in the my car for what seemed like forever, just thinking to myself that this is actually going to happen…I still couldn’t believe it.

I then called Christine, and told her the good news, though, at first, it didn’t come across as such.  The more I thought about it, the more I felt like I was getting choked up.

I began by telling Christine that Tommy had just called, and then, unintentionally, I stopped as if to take a breath.  “Annnndddd?”, Christine nervously said on the other end.

“He’s a match!”, I said.  “Really?!  Oh, my God!  I am so happy for you!”, Christine finished.

I then called mom, and had nearly an identical conversation.  I just remember mom continuously saying: “Oh, my God…Oh, my God” between her tears…”I had a good feeling about this, I just can’t believe it…Oh, my God”, Mom continued.

So began the process that a potential donor under goes when they are being evaluated as an organ donor.

I wish it was as simple as a blood test, and then it’s off to scheduling the surgery if there’s a match.  But it is not as simple as that.

During this process, Tommy, has met with doctors and undergone a series of tests that are not necessarily invasive (except for maybe the colonoscopy), they are really just more time consuming.  His work-up is being done at Beth Israel Deaconess Medical Center in Boston, where the transplant will take place.  According to their website, anyone considering donation goes through the following:

·         Meeting with the transplant nurse coordinator and an evaluation with the transplant social worker or clinical psychologist

·         Complete medical history and physical examination

·         Chest X-ray to evaluate the lungs

·         Electrocardiogram (EKG or ECG) to evaluate the heart

·         Blood and urine tests

·         24-hour urine collection to assess kidney function

·         A possible glucose tolerance test if you are overweight or have a family history of diabetes

·         Spiral Computed Tomography (CT) scan to determine any abnormalities in the kidneys or the blood vessels that lead to them

·         Final cross match to check for antibodies within one week of transplant

·         Transplant surgeon consult

In addition to the above, the transplant evaluation may also include additional tests including, but not limited to, a colonoscopy, Pap smear, mammogram and/or PSA.  Anyone who has ever had a colonoscopy (myself included), you know the prep is worst part of the whole experience.

Once all of this has been completed, and the transplant team feels they have enough to make an evaluation from, the entire case will go to a transplant committee.  From my understanding, this committee is where the final approval, the “green light”, if you will, comes from of whether or not a donor will be able to move forward with donating a living organ (i.e. kidney, liver, etc.).  This committee could also delay a possible surgery if, for instance, they saw an abnormality on the CT scan and wanted it repeated in three months, or if they saw something on one of the other tests and wanted further evaluation before making a final determination.

By all indications, Tommy is at the end of his evaluation, needing to complete one (hopefully) final test.

Then…..our case goes to committee…….