5 Bizarre Consequences of Being Given Somebody Else's Organ
When I was 20 years old, I was diagnosed with polycystic kidney disease (PKD), a rare genetic disorder that, over the next decade, took my healthy, petite 4-ounce kidneys and turned them into diseased 10-pound monstrosities, like the Thinner curse in reverse.
And the goal of the curse was to stop you from peeing.
So, at the age of 30, I underwent surgery to replace my kidneys with one that my mom had donated. And if that sounds like a pretty straightforward operation, well ...
Finding a Donor Is Pure Luck
You might have heard that the U.S. has a major organ shortage; there simply aren't enough healthy organs for all the people who need new lungs, livers, hearts, brains, courage, etc. But as bad as it is to need a heart, things are far worse if you need a new kidney. Of the 122,000 people currently on the organ donor list in the U.S., 100,000 are awaiting a kidney -- that's 82 percent. This is because the disorders that damage other organs to the point of needing a transplant are relatively rare, whereas diseases that obliterate your kidneys are depressingly common. About 67 million Americans have high blood pressure, and nearly 20 million have diabetes -- together, these two conditions cause 70 percent of all chronic kidney disease cases, which is arguably the worst tag team in history outside of the time the Joker teamed up with the Taliban.
Luckily, since you only need one kidney to live, you have the option of using a live donor for your new pee filter. Unluckily, many of the diseases that damage your kidneys are genetic, which tends to eliminate family members, who are the most likely to be genetically compatible. Friends can donate as well, but they're usually not the preferred choice (more on that in a minute). Amazingly, there are some people who choose to donate one of their kidneys to a complete stranger for no other reason than just because (some states even offer a tax deduction for donating an organ).
"We're really doing you a favor. After all, we don't tax your organs ... wait. PEGGY! CALL CONGRESS!"
Kidneys are in such short supply that some hospitals have set up kidney chains, which are entirely different from the Vincent Price jump rope their name suggests. For example, Alice wants to donate to Bob, but is only compatible with Charlie. If Dave wants to donate to Charlie, but is only compatible with Bob, the four of them can form their own little organ key party and swap kidneys. Chains with as many as 60 people have been kidney-centipeded together, just so we can all keep peeing like God intended.
"Are you there, God? It's me, Margaret. Uh, slightly bigger plumbing issue this time ..."
I was fortunate enough to have a compatible donor in my mom (although five friends also offered me one of their kidneys). My mom didn't have kidney disease and matched me on a genetic level usually reserved for twins, so she was the one we decided to go with. Problem solved, right? Nope! Here's the thing ...
Even if You Find a Donor, There's No Guarantee
Whether it's because having people waking up in a bathtub full of bagged ice is bad for Vegas tourism or because there's huge potential for abuse in organ donation in general, there are a lot of hoops to jump through if you want to donate or receive a kidney. Even for my mother to donate one of her kidneys to me, her daughter, which you would think would be just behind "magically sprout a third one" on the list of "totally legitimate ways to get a new kidney," we still had to go through a pretty extensive screening process.
"You have 30 seconds. Go."
You see, the problem with getting a kidney from a living person is that said person might change their mind later. Not that they're going to immediately come sneaking through your window with a knife and an ice cream scooper, but they may very well make your life a living hell. I've heard horror stories about donors demanding their kidney back, and in some cases, the recipient had to get a restraining order.
So if you find a compatible live donor, you and the donor have to go through a psychological evaluation. Some of the questions I got were pretty straightforward and obvious, like making sure I wasn't having thoughts of suicide and making me swear a pinky oath that I would take super good care of my new kidney (after all, they don't want to waste a perfectly good kidney on some asshole). Other questions were more about my relationship with my mom -- did we get along, would we maintain a good relationship after the surgery, how would my mom feel if I didn't follow through with all the lifestyle changes required for my new kidney (she said she would be pissed, but probably wouldn't try to cut the kidney out of me), etc.
"Almost certainly not. Like 70-30."
And now you can probably see why they prefer to do this with family members over friends. Friendships can come and go, but you're generally stuck with your family, whether you like it or not. Of the five friends who offered to donate their kidney to me, I'm still in contact with two of them -- people drift apart. It might be different if I were holding on to one of their kidneys like a cat they couldn't take with them to college or something, but statistically speaking, it isn't. And the potential for bad feelings down the line is huge.
What if they transplant the kidney and it immediately fails, effectively wasting one of their perfectly good organs? Or what if, 10 years down the road, they need a kidney? Up to 10 percent of living kidney donors regret giving up their kidney for a variety of reasons, and if you're the recipient, what can you ever do to make up for it? That's like an IOU they can hold over your head forever.
"Oh, you don't have money to pay for lunch? That's strange, you had plenty of money
to pay for surgery when you TOOK MY KIDNEY."
Dialysis Is Miserable
If you're one of the many people who aren't able to find a donor right away, you have to go on dialysis, which is a fancy word for a robot that cleans your blood.
"That's right, human. Trust me. Trust me with your precious blood."
You see, when your kidney function falls below a certain point, they aren't able to clean your blood effectively anymore, which means in order to continue living, you have to go to a hospital or dialysis center three times a week and sit connected to a dialysis machine for three or four hours. The machine pumps your blood out through a tube in your arm called an AV fistula, gives it a good spit shine, and then sends the clean blood back to your body. Sounds simple, right?
Well, the machine replaces only a small fraction of healthy kidney function, just enough to keep you from turning into a giant pee water balloon -- you still feel like shit most of the time, as one would expect from perpetually living on the edge of death. And as advanced as the machines are, they're still nowhere as good as a real kidney. Up to 50 percent of dialysis patients suffer from muscle wasting as a side effect. When you eat a lot of protein, your body can't store the extra protein as fat the way it can with carbohydrates, so it's up to your kidneys to filter out the superfluous protein. A dialysis machine has to do the same thing, only it filters out all the protein in your blood, not just excess stuff. Without any protein in your blood (coupled with the fact that dialysis patients have to maintain low-protein diets), your muscles are unable to repair themselves and begin to slowly waste away.
"Yessss, human, make yourself weaker for us."
And that's just one of the problems. You lose a little bit of blood to the machine, so you feel tired and lethargic from anemia. You have to maintain a very strict diet with low fluid intake, making you dehydrated all the time. A lot of people experience constant nausea and vomiting, among other symptoms. It's a bit like being hung-over all the time, only without the fun of being drunk, and this is what you have to do until you either get a new kidney or die. And because dialysis requires you to spend so much time getting your treatment (the facilities tend to work 9-to-5 hours, just like everyone else), most patients end up having to quit their jobs, which forces them onto Medicare or Medicaid (6 percent of Medicare's entire budget is spent just on dialysis).
A dialysis nurse told a story about how a patient receiving treatment fell asleep beneath a blanket (which is very common, because the treatment makes you feel sleepy and cold), when her vital signs suddenly started tanking. When they pulled the blanket off of her, they saw that the bed was literally covered in blood -- the woman had moved her arm in her sleep and accidentally dislodged the needle from her fistula, so the machine had been steadily pumping her blood straight out of her body. The dialysis machine circulates all of your blood every 15 minutes, so it can bleed you dry very quickly. And this isn't an isolated case -- venous needle dislodgment is a relatively common problem (common enough to have a fancier name than "tube slipping out of your arm-itis"). While they caught it in time to save this woman, not everyone has been so fortunate.
"Nurse, she's bleeding out! Quick, move her before she permanently stains the sheets!"
Because my mom was a close match and seemed unlikely to try to repossess my kidney at any point in the future, I didn't have to go on dialysis. Which is lucky, because no one wants to be indefinitely hooked up to a mechanical vampire.
The Drugs Are a Pain in the Ass
Even though my mom is so close to me genetically that I suspect I may be my own grandmother, I still have to take anti-rejection drugs for her donated kidney. Your immune system is kind of like an insane bouncer at an exclusive nightclub -- nobody waiting outside is allowed in, and anyone who makes it inside is killed. While this is a favorable response for invading germs, it will utterly destroy your new organ. Because you can't calm your immune system down by patiently explaining that the two of you need this new kidney to live, you have to take immunosuppressant drugs to stifle its intruder-slaying rage.
"Poppies ... poppies ... poppies will put them to sleep ..."
While this helps preserve your kidney (even though the drugs themselves actually damage your kidneys), it also opens you up to every other microbe that wants to kill you. You are much more susceptible to illnesses, so much so that about one-third of kidney transplant patient deaths are due to infections. Minor cuts and injuries have to be taken very seriously because of how easily they can become infected. Even if you don't catch something serious, you soon realize how much day-to-day maintenance your immune system normally does, because you will catch minor irritating illnesses constantly. Urinary tract infections, yeast infections, flus, colds -- basically everything that isn't serious enough to kill you, but bad enough to make you miserable.
The drugs themselves are a constant source of anxiety, too. Immunosuppressant drugs have tons of dangerous interactions and side effects, and not just with other prescription drugs -- over-the-counter stuff like aspirin or ibuprofen, which you normally take without a second thought, has to be monitored closely to avoid a potentially lethal interaction with your medication. Even your food can cause problems -- you can't drink green tea or eat grapefruit because of the interactions it can cause, which just adds to the ever-expanding list of reasons why grapefruit sucks.
All the effort of an orange for the taste of citrus-flavored anus.
The drugs can cause some ... other problems as well. After the surgery, they had me nuked out of my gourd on painkillers in an effort to trick my body into thinking it hadn't just been sliced open and had part of its guts juggled out. Unfortunately, the painkillers had more or less stopped my digestive system, which is the diplomatic way of saying that I stopped pooping. The nurses loaded me up with stool softeners (real prescription stool softeners, mind you, not over-the-counter stool softeners like Hot Pockets), but nothing worked. Until my last night in the hospital, that is.
I had been slowly tapering off my pain meds in preparation for being discharged when my intestines finally woke up. I told the nurse, "I think I can poop now." I scuttled off to the bathroom and then proceeded to explode out of both ends for about 20 minutes. For three months, that was all I could do. I would sleep for half an hour, wake up and go obliterate the bathroom like the world's worst sprinkler toy, and then go back to sleep for another half hour. This cycle went on until I had finally recovered enough that the doctors could take me off the cocktail of drugs I was on and just left me with the lowest dose of anti-rejection drugs.
"And your stigmata is clearing up nicely."
And once things stabilize and you're out of the woods -- assuming you make it there at all -- you have to deal with the fact that ...
You Don't Know How Much Time You've Got Left
The average life span of a transplanted kidney is 10 to 12 years, but there's a huge amount of variation; some kidneys fail a few hours after the surgery, others last the rest of your life. Doctors can make guesses, but the simple fact is nobody really knows how long it will last, and that knowledge hangs over your head like the Sword of Damocles.
"I would go camping this weekend, but my kidney might explode at any second, so I think I'll have to pass."
Many factors can influence how long your relief pitcher will stay in the game, such as your age and overall health, whether the kidney came from a live donor or a cadaver, how long you've been on dialysis, and the number of voodoo curses that have been placed on you recently. But beyond that, you're essentially rolling the dice as far as how long you've got until your new kidney shrivels out of existence like a High School Musical star.
After the surgery, the doctors immediately begin monitoring your kidney function to make sure it's actually working, because even with the anti-rejection drugs, your body can still reject the kidney. You can also suffer from a disease called graft versus host, wherein immune cells from the donor stow away in the kidney like plague rats and then start attacking your body once the organ is dropped inside. Even if you manage to dodge all of those complications, sometimes the damn kidney just refuses to work, and nobody knows why.
"What do we want?"
"When do we want it?"
"After an increase in plasma osmotic pressure!"
It's been a few years since my transplant, and my kidney is still working like a champ. Another guy I met during this whole process had gotten a kidney from his stepsister only four or five years prior and was already showing early signs of kidney failure, so it really boils down to the luck of the draw.
Otherwise, all you can do is watch and wait. Six months ago, I got to feeling bad enough that I went back to the hospital. When I got there, the doctors diagnosed me with sepsis, which is the final stage of an infection before your organs begin to shut down. I had gotten a minor kidney infection that was exacerbated by the anti-rejection drugs and had spiraled out of control. It would have been easy to treat if it had been caught early, so why didn't I go to the doctor as soon as I started feeling like shit? Simple: I had forgotten that feeling awful wasn't a normal way of life.
"Wait, you guys don't feel like absolute shit all the time?"
By the time of my transplant, I had been living with declining kidney function for a decade. I was used to being swollen and puffy from all the fluid my body was retaining, I was accustomed to the general malaise that comes from your blood having dangerous levels of toxins, and excruciating kidney pain from ruptured cysts was just another day of the week to me. I had lived in agony for so long that I'd forgotten that feeling terrible is your body's way of telling you something is very wrong.
But, over time, you gradually start to remember what it means to be healthy. I was out to lunch with some friends, and I suddenly realized that I didn't hurt anymore. My medications were no longer making me sick, I had a healthy kidney doing its job and keeping my body clean (no need for robo-vampires, thank you), and I was able to enjoy the sun on my skin and the company of my friends, free from distracting pain or sickness. I actually felt good, which was a nice change of pace for me. All it took was a chunk of living meat carved out of my mother's body and an impossible amount of luck.
Now if only she would stop holding a knife and rubbing my side while I'm sleeping.
This article was constructed from an interview conducted by Chris Radomile. Chris writes for his website and tweets. He also hosts a podcast that is still legal in most states. You can find Angela's musings at The Amusing Ingenue.
Related Reading: Kidneys aren't the only organ that come with a warning sign, apparently disembodied brains are extremely dangerous. Or that your nurse might be stealing your pain medication? And did you know that near-death experiences are pretty overrated and painful? Have a story to share with Cracked? Email us here.
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