Wednesday, January 09, 2008

UCSF Again

We went to UCSF on Monday to see the surgeons again. Everything was fine, and it was pretty much the formality that we expected it to be.

We saw Dr. Hirose again, and he did tell us one interesting thing. The US is divided up into regions, and each region gets organs within its region and disburses them to residents of its region. But, if a kidney patient is a perfect match of all six factors, that patient gets the kidney no matter what region the organ or the recipient is in. Which is good for the recipient. But, the transplant center that gets the organ has to donate another organ back into the national system. Somehow over the past year or so, UCSF has developed an organ debt, so they have had to give up some organs that were procured in their region.

Because of this, UCSF only did 19 kidney/pancreas transplants last year, when they usually do about 30. That probably kept Gail from getting called.

Dr. Hirose thinks this is not fair and disadvantages his patients. He is trying to get this system changed.

I don't think Gail was particularly upset by this. Both of us were just relieved to learn more about the process. And it does provide a better answer to why she hasn't been called yet. So that is good.

When we left UCSF, we both felt like it may be another year before she gets her transplant. We mentioned that people had suggested that we move to other regions where the waiting list for new organs are shorter. He thought about it, and said that he thinks we should stay here. Another transplant center might not take her because of her age, so he thinks it is better for us to stay with UCSF, which we are happy to do. He said if we were waiting for a liver transplant, though, he would recommend that we move to another region. That was pretty shocking. I guess because without a replacement liver, you die. Whereas with kidney failure, you just go on dialysis.

We have never seriously considered moving; but it was interesting to get more information about it.

We met her new nephrologist today, and we liked him a lot. It sounds like he will be following her mainly by seeing her at the dialysis center, which will be good for her. But it means I won't be there as much and may not know as much about what is going on. But I guess that is OK.

He asked her why she wasn't doing peritoneal dialysis. She hasn't considered it because a transplant has been immanent for the last 13 months. If she doesn't get a transplant in time, I guess that will be an option for her. But we are still hoping for the transplant.

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