The Operation
The operation itself takes between three and four hours and requires a general anaesthetic. Traditionally the operation was performed as an ‘open nephrectomy’ that required making an incision (15-20cm long) on the side of the abdomen in order to remove the kidney. Today it is usually performed using keyhole or laparoscopic surgical techniques, which involves a number of small incisions (1-3cm) through which instruments are inserted to remove the kidney. A larger incision is then made above the pubic line (akin to a caesarean) to take the kidney out.

Once the kidney is removed it is taken to the recipient. After the operation is completed, the donor is taken to a recovery room to wake up from the anaesthetic. A catheter is fitted during surgery because the patient will be unable to walk after the operation for up to 24hrs. Once the patient has come around from the anaesthetic he/she will be returned to the ward and be monitored by staff in hospital for the next few days.

The recovery time for keyhole surgery is around four to six weeks, nearly all of which will take place at home. The donor will be given painkillers to self-administer during this time and be asked to come in for a follow-up appointment four to six weeks after the operation. Stitches are removed by a local GP two to three weeks after the operation.

My Story
Both my half-sister and I went into hospital on the Wednesday morning to have a final assessment and get settled onto the ward. We met the surgeon and the nursing team and chatted with the other patients who had already experienced the operation. It was nice to see others up and about after such an intrusive operation, which gave us hope that all would be well.

After 10pm we were no longer allowed food or drink; instead we were each hooked up to a saline drip to ensure that we weren’t dehydrated ahead of the following morning’s operation. At 7am we were awoken by the nursing team who took our blood pressure, gave us each a pair of tight medical stockings (designed to prevent thrombosis) and our operation gown and underwear. The surgical team then collected me and wheeled me to the operating theatre. My half-sister was to attend her operation later that morning.

In the pre-operation room, the transplant nurse talked to me to calm my nerves and accompanied me into the room where the anaesthetic was administered. After counting backwards from 10 and only reaching 7, the next thing I knew I was in recovery feeling quite battered, bloated and a little sick! I needed to stay in recovery for an extra few hours because my blood pressure was so low, but the post-operation team were very kind and considerate. I was finally wheeled back to the ward at around 3pm, where my partner, family and friends were waiting for me.

The first night of recuperation was a bit of a blur as I was on a lot of painkillers, but I do remember that the leg massagers that had been placed around my calves to prevent thrombosis were amazing! The following morning I was visited by the surgical team and the catheter was removed. I was then encouraged to get out of bed and use the toilet so that they could check that everything was working as it should be. Throughout that day many visitors came to see both me and my half-sister – we were in separate parts of the ward – but that night we both experienced the latent shoulder pain caused by the CO2 gas (pumped in during the surgery to move the internal organs apart) becoming trapped against the diaphragm. It was not pleasant, to say the least!

By the third day, I walked down to the other part of the ward to visit my half-sister and it was great to see her looking so well already. Her skin no longer had a yellowing to it, instead her cheeks were flushed and she looked like herself again. It was such a wonderful experience and reminded me why we had undergone months of preparation and such intensive operations.

Later that day I was discharged and taken home by my partner, who then looked after me along with my son and my mum. It took another week before I was really able to get out of bed and go downstairs and a further week or two before I could do anything without getting out of breath. My stitches were taken out at the local GP surgery in the second week. I returned to work on a very part-time basis around week four and returned fully after six weeks.

It took six months to really get back to normal and about nine before I started to feel 100% again. Over a year and a half later I feel as physically healthy and as fit as I ever did and psychologically more empowered than ever. It was an experience I will never forget and an achievement that I will always be proud of. My half-sister is healthy and happy and it is wonderful to see.

Advice
My advice would be to:

• research as much as you can so that you are prepared;
• feel all the emotions that the experience throws at you;
• take each step as it comes and take care of yourself throughout (both physically and emotionally);
• talk things through with everyone that the decision will impact.

One thing is for sure: it will change your life and that of the recipient – hopefully for the better if all goes well.