Good Morning Readers,
As I said in my last post, I was going to have my consultation at UCSF for my kidney transplant. The consultation consisted of watching a slideshow, talking with a nephrologist, social worker, financial advisor, and my nurse coordinator who I have been in contact with. I obtained a great deal of information, of which I mostly already knew and some that I did not.
My brother matches on 3 out of the 6 human leukocyte antigens (HLAs, which are markers on cells in your body that help your body distinguish between what is you and what is not you). You inherit 3 antigens from your father and 3 from your mother for a total of 6 antigens. Siblings who have the same parents may inherit the same or a different combination of antigens (www.itns.org). In this case, my sister had 0 out of the 6 antigens and so did my fiancé.
For example, my brother received the blue antigens from my father, and I received those same blue antigens as well. But he received the 3 purple antigens from my mother and I received the blue antigens from my mother, which has him matching in 3 out of the 6 antigens.
My sister, could have received the red antigens from my father and the blue antigens from my mother, while I received the blue from my father and the purple from my mother (or vice versa). Having us match in 0 out of the 6 antigens.
Since my brother matched 3 out of the 6 antigens, they felt it would be best to have him do more testing as he may be a better match for me. I also did another blood draw at my consultation appointment a couple days ago of which they will find out if my titer count is low or high.
What the heck is a titer?
Here’s a brief explanation– “Antibodies are the part of your immune system that recognize foreign cells in the body (like a cold, flu, or other infection) and then stop them from hurting you. However, antibodies may also consider a new transplant foreign and try to prevent it from “hurting” you by rejecting it. Therefore, it is important to check whether your antibodies are compatible with the potential donor’s antigens. Your specific antibodies are determined by a blood test which measures the degree of response, or the strength of preformed antibody, by testing your blood against a panel of reactive antibody (PRA) titers. The percent PRA is a measure of a potential recipient’s sensitivity against all possible antigens. If you have a high PRA level, this means you have already formed antibodies to many different antigens and are therefore more likely to reject a donor organ than a recipient who has zero perfect PRA or no antibodies.” (www.itns.org)
So maybe not as brief, but as of this week they will figure out if I have a low or high titer count. If my titer count is too high, that means my body is more likely to reject my brother’s kidney and he will not be able to donate. Even though my sister, and fiancé were also in the process of testing to be potential donors, they too, will not be able to donate because they are all blood type A. If my titer count is low, it will be safe to say that I can go through with the transplant with my brother’s kidney, but will have to go in prior to the transplant surgery for treatments called plasmapheresis.
Plasmapheresis is basically the process of filtering the blood of harmful antibodies. From what I’ve been told, it is similar to Dialysis. Plasmapheresis will help remove the harmful antibodies so that my body has a better chance of not rejecting my brother’s kidney. I would also be given a medication to prevent antibody production. I was told that depending on the titer count, would determine the number of treatments I would have to go through before the transplant.
Whew! A lot of information I know. So my family and I are keeping our fingers crossed that my titer count will come back low and we will be able to go forward with the transplant. If my titer count is high and if we are not able to do the transplant, the next option would be paired donation (my brother would donate to someone in need of a kidney that is compatible with him, in exchange for a kidney that can be donated to me that is compatible with me), or hoping to find someone that has blood type O. However, the waiting list for the paired donation can still be as long as 18 months, which would most likely mean I would probably have to go on dialysis.
Positive thoughts here on out! I should be finding out my titer count results the beginning of next week!
go wrong, as they sometimes will
When the road you’re trudging seems all uphill
When the funds are low and the debts are high
And you want to smile, but you have to sigh
When care is pressing you down a bit
Rest if you must, but don’t you quit.” – Author Unknown