1. Steps leading to transplantation, being on a waiting list, and  what to expect with the surgery and afterwards

2. Living donation

3. Financial Overview

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1. The steps leading to transplantation are:

 The Referral

- your doctor sends a referral letter to MUSC to start the process. This has already been done.

The Education Class

We just completed that today.

The Evaluation

This is based on your medical history. Not every patient will need every test. You meet with the transplant doctor to discuss the surgery and you also meet with a social worker. Ours is scheduled for June 28th at an MUSC clinic held in Greenville.

The Review Committee

Once you have had your evaluation, your paperwork gets sent to the Review Committee. They look it over and let you know if there is any more information they need, any additional tests you need to take, and determine if you are even a good candidate for transplant.

The Transplant List

You are then placed on a waiting list. We are hoping that we won't have to be put on a list. We want to try to go with living donation.

The Transplant surgery

The operation is about 2-4 hours.  The stay at the hospital is only 3 days and within the first 24 hours, I will be eating and walking.  After the 3 days, since we live so far away, I will get moved to a transplant hotel (Homestead Studio Suites) for another 3-7 days.  At that point, I will need a caregiver (most likely Sally) with me. We can rotate caregivers, but I will need someone with me all the time.  I will continue to see a nurse once or twice a day while I'm there.

Life after surgery

After I return home, I will have frequent visits back to MUSC. Once a week for awhile, and then once every other week, and so on for about the first 6 months.  They will monitor my lab work, kidney function, and make sure the medications I'm taking are at the right dosage and doing their jobs.  I will be on medication (immunosupression drugs) for the rest of my life.  These are essential because they keep my body from rejecting the new kidney.  They are so important that I cannot miss a dose!  After 6 months (unless I am having problems), I can most likely just see my doctor in Greenville and have him perform the tests to monitor my progress.

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2. Living Donation

There are many benefits to living donation. The wait for a kidney is shorter, it becomes a planned surgery, and a living donor kidney lasts longer than a cadaver's.  Living donation is the way we're hoping to go, but it will depend on if we can find a match.  After I have been evaluated, then we can start the process of finding a possible donor. 

To become a donor, you obviously need to be willing to be tested. You also have to complete a health history form (this can be done over the phone - see 800 number below).  If you pass the initial tests (blood type, blood pressure and two 24 hour urine tests), and you seem like a good candidate for donation, then you can proceed with the physical at MUSC.  We were told that the initial tests can be done locally, and possibly MUSC can contract with a local health center for the big evaluation (physical, x-rays, etc.) so possible donors don't have to travel all the way to Charleston.

There are many things to consider before offering to be a donor.  You need to consider travel and taking a leave from work.  If you're female, you need to think about how it might affect your ability to have children since you'll only have one kidney.  Sally asked about this and the guy said that yes, women can still have children after donating.  He said they prefer the woman to have already had successful pregnancies (i.e. no gestational diabetes or other complications).  I guess Sally wants to make sure (if she winds up donating) that she can try for #3 after my surgery!

There are two types of surgery procedures:

1. Laparoscopic - This one gives you 3 tiny incisions and 1 small incision and you'll have a quicker recovery.

2. Mini Open - This is just one incision.

Facts about the surgery:

- No cost to you (we're not sure how insurance handles it all, but you should pay NOTHING. Our insurance pays for the donor's operation)

- Your stay in the hospital is about 1-2 days

- Slightly noticeable scars

- No medication after the surgery unless you need pain medication

- No driving for 2 weeks

- No heavy lifting for 2 weeks

- Return to normal routine in about 3-6 weeks

- Need to return to MUSC for follow up, but we were told that if it was too difficult to return (due to cost, distance, etc) that you could possibly be checked out locally

If you are interested in getting tested to see if you're a match for me, please call 1-800-277-8687. Option 4. Option 1.  Tell them you're interested in being a donor for Michael Dean and they'll let you know what you need to do.

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3. Financial Overview

This is the most complicated part of the whole process. Insurance is so confusing and each company is different, so it was hard for the financial coordinator to give us anything concrete.  We do have a case manager with Cigna that helped us better understand how much we can expect to pay. We will work with him closely if we have questions about coverage.

A Kidney transplant costs roughly $75,000. If you do a living donation transplant, it is $85,000.  The medication that I will have to take for the rest of my life can also be costly. That's why it will be important to always have good insurance.  We were also told about Medicare.   If you go on dialysis or have a kidney transplant, you are eligible for Medicare.  If you have a transplant, you are eligible for Medicare for 3 years.  We are still not sure exactly how it works or if it would be beneficial to us.  We have to sit down and look at all the possible plans (there are 18 in SC alone!)  and determine what our premium would be and if it's worth it.

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