Kidney Failure – Part 2

On arrival at the hospital I made my way to the renal transplant ward. Once there, more blood tests were taken and then began a wait to see if I was the best match. In the meantime I was given an ECG and prepared for surgery, just in case I was a match.

A few hours later the results came back and I was a perfect match for the kidney and now all systems were go. At 10:30pm I was taken down to the operating theatre, for the transplant.


St. James Hospital, Leeds
St. James Hospital, Leeds

3 hours later the operation was complete, and I was in recovery and then back in my room (not that I remember much of this!). The next I was in and out of consciousness, though I do remember that I passed nearly 16 litres of urine in 24 hours! (Luckily I had a catheter in my bladder).

Much of this had to be replaced through an I.V drip.

As well as all this, there were new medications to take in order to prevent the transplant from rejecting. There was some pain, but everything was going well.

After a day, I was encouraged to get up and around. The drains were then removed and a couple of days later the catheter came out (and that was certainly a relief!).

A week later, things took a bit of a turn for the worse, and it appeared I was having a rejection episode. Luckily this could be easily treated with a course of methyl-prednisolone, and after three doses everything settled down and my transplant was back to working well.  Over the coming week things continued to improve, and I was transferred from Leeds to Hull.

Three days later I was allowed home, with the transplant continuing to function well.

The next few weeks saw me regularly returning to hospital for blood tests and medication adjustments to monitor the function of the transplant. These appointments started at 3 per week and were soon one a week and then, over time, became less frequent. After a couple of months I was being seen in the transplant outpatients once per month and things continued to work well.

Things continued to improve, and the appointments became once every three months. After 3 years it was decided it was time to tie off the fistula. In mid-1997 I had an operation to tie off the fistula by placing a clip on the connection between the artery and vein, this was performed under general anaesthetic and the next day I was home.

Over the next 10 years the transplant continued to function well and I almost forgot all about it being there, but in early 2007 things were about to change suddenly.

One evening a began to feel and actually be sick, and spent most of the night vomiting. Thinking I had a stomach bug I made an appointment to see the GP. Luckily I was able to see him that day, he decided to give me an anti-vomiting tablet but, more importantly, he decided that I needed a blood test ‘just in case’. A couple of days later I got a phone call saying I needed to see the GP, after speaking to the nurse I got an appointment for the next day, I really didn’t think anything serious was wrong.

That Friday, three days after I first went to see a doctor, I saw my GP and the blood test should that my transplant had effectively failed – my potassium level was 7.2 mmol/L and Creatinine was 1472 micromol/L. I was immediately told I needed to make my way to the Acute Assessment unit. (I was later told that I really should have been sent by ambulance, under a blue light, since the potassium level was high enough to have caused my heart to go into cardiac arrest suddenly).

On arrival I had another blood test, which confirmed that the transplant wasn’t working. I was then immediately admitted to the renal ward, there a line was placed into my jugular vein and I underwent emergency dialysis.

The next three weeks were spent in hospital undergoing tests, including a biopsy, in an attempt to find out why the transplant had failed and to see if it was possible to rescue the transplanted kidney. Unfortunately the transplant was beyond rescue, and could not be re-started. As for the cause, the doctors believe that an infection had caused the transplant to fail.

Hull Dialysis unit 2007
Hull Dialysis unit 2007

I was now back on dialysis and for the time being this was being done through a tunnelled line (line into a vein which is ‘tunnelled’ under the skin). I would need a new fistula to be remade in order to allow me to continue with haemodialysis longer term. In May, I was booked in to have a new fistula constructed, in the same place as the previous one.

The operation was successful and the new fistula was ready to be used about 6 weeks later. However, it would prove difficult to needle, and for the first few weeks, it would repeatedly ‘blow’ causing pain and significant bruising. This did however make the fistula stronger and eventually dialysis became much easier using the fistula. 

My Fistula in use
My Fistula in use

Over the next few months it became obvious that I would need to have the failed transplant removed, and I was put on the list to have the operation (a transplant nephrectomy) at St. James’ Hospital back in Leeds.

At the end of March 2008, I was admitted to St James’ Leeds and the operation went ahead and the transplant was removed. 3 days later I was back in Hull, and recovering well.

Over the next few years I would continue to dialyse and things fell into a sort of routine, where I would go to work during the day and then dialyse in the evenings of Tuesday, Thursday and Saturday (which would later change to Monday, Wednesday and Friday).

Over the next few years I would get married and move to Retford, and once there, dialyse at a new unit at Bassetlaw Hospital in Worksop.

In the early hours of 25th April 2013 there was a knock at the door; an ambulance man was there to take me to Northern General Hospital in Sheffield as they had a kidney for me. It seems my mobile phone wasn’t working and the renal transplant unit had been trying to get hold of me.

So, at 4am I set off for transplant number two. As before when I arrived I had blood tests, a chest x-ray and an ECG. When the results came through I was good to undergo the operation. I was wheeled down to the operating theatre, and given the general anaesthetic. I expected to wake up with a new kidney, but that wasn’t to be so.

I was woken by the anaesthetist shouting my name to get me to wake up. The transplant operation had not actually gone ahead. It turned out that while under the anaesthetic my heart had gone in atrial fibulation and almost needed to be shocked back into a normal rhythm but luckily had reverted back before this was needed.

I was kept in hospital for the next three days as doctors tried to figure out what had gone wrong and why. I was then allowed home, but suspended from the transplant list until the cause of what went wrong could be found. For over a year tests and ECGs (electro-cardiographs) were done to find out the cause, until it was decided that it was likely to have been a reaction to the general anaesthetic.

I was now back on the transplant list and waiting for my second transplant.

It would only take 6 months of being back on the list before I got another call for a transplant, at 9:30pm on the 16th September 2014 and, as before, I was soon on my to the Northern general Hospital in Sheffield.

When I arrived, I had blood tests and then chest x-rays, an e.c.g and an ultra-sound to check that the artery was ok to be connected to. Things were pretty much the same as previous calls in for transplant, this time however the doctors were more wary and decided that I should take a beta-blocker, which hopefully, would prevent a re-run of the previous attempt at a transplant.

This time it would take another 2 days before the kidney was ready to be transplanted, went the time came the doctors decided that it would be safe for the operation to go ahead. At 8:30 on Thursday 18th September I went down to the operating theatre to have my second kidney transplant, not really knowing if I would actually wake up.

I did wake up, and the transplant had gone ahead and I now had a transplant. However, the kidney had not fully ‘woken up’ and was only producing a small amount of urine and I would still need to dialyse until its function came up enough for dialysis to stop. Over the next week the function continued to slowly improve, and after a week I was allowed home (though function was still around 10%) with a whole new set of tablets designed to suppress my immune system and prevent rejection. As previously I was closely monitored, with appointments every other day witch were slowly reduced over time.

In early November I developed a CMV (cyto-megalovirus) infection which almost caused the transplant to fail, but luckily after a short term reduction in my medication, cleared up. At the same time, as a result of the steroids I was taking, I ruptured my left Achilles tendon which required an operation to repair. 2 weeks later, while still wearing a cast on my left foot, I slipped and ruptured my right Achilles tendon (which had also been weakened), this left me with a cast on my right foot and a support boot on my left and almost incapable of walking.


Ruptured Achilles tendons
Ruptured Achilles tendons

Despite this kidney function continued to generally improve, and my care was transferred back to Doncaster Royal Infirmary. Currently my transplant is working at around 40%, which isn’t too bad and things a ticking along nicely.

As with all transplant I have no I idea how long the kidney will last it, but as things stand it’s doing well. There are side effects from the medication but it is better than being connected to a dialysis machine four hours, three times a week.