{"id":27,"date":"2014-06-23T20:09:46","date_gmt":"2014-06-23T20:09:46","guid":{"rendered":"http:\/\/parmzilla.com\/liver\/wp\/?page_id=27"},"modified":"2014-06-24T06:04:48","modified_gmt":"2014-06-24T06:04:48","slug":"the-living-donor-experience","status":"publish","type":"page","link":"https:\/\/parmzilla.com\/liver\/wp\/?page_id=27","title":{"rendered":"The Living Donor Experience"},"content":{"rendered":"<p><strong>So here is where the story of my donation begins.\u00a0<\/strong><\/p>\n<p><a href=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/simspsons_moth_tattoo.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-30\" src=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/simspsons_moth_tattoo.jpeg\" alt=\"simspsons_moth_tattoo\" width=\"259\" height=\"195\" \/><\/a><\/p>\n<p>Now before I get into the story of why, you have to understand the magnitude of this decision. \u00a0<a href=\"http:\/\/www.americantransplantfoundation.org\/about-transplant\/living-donation\/about-living-donation\/living-liver-donation\/\" target=\"_blank\">Living Donor Liver Surgery<\/a>\u00a0has the single highest risk operation that a donor of any kind can undergo.\u00a0 The risk of death to the donor is 1 in 500.\u00a0 In the case of a Kidney donor, the risk is 1 in 10,000.\u00a0 So it is 20 times more risky than donating a kidney.\u00a0 According to what UCSF has told me directly, <em>the recipient\u2019s<\/em> chance of survival is higher than the <em>donor\u2019s<\/em>\u2026\u00a0 But that statistic is so high because this procedure has <a href=\"http:\/\/www.srtr.org\/csr\/current\/Centers\/201406\/pdf\/CASFTX1LI201406PNEW.pdf\" target=\"_blank\">only been done a few thousand times<\/a> over the last 15 years. <a href=\"http:\/\/en.wikipedia.org\/wiki\/Liver_transplantation#Living_donor_transplantation\" target=\"_blank\">The procedure was pioneered in the late 80s<\/a>, with the first successful procedure for an adult to child in 1989. \u00a0While the first adult to adult was performed in the mid-90s.<\/p>\n<p>As soon as I knew I could possibly be a live donor, I stopped drinking immediately to make sure my liver would have a chance to regenerate and undo years of abuse.\u00a0 I joined a gym, with the idea that if I started now I would be in better shape for the surgery, and hopefully the liver I would end up giving my mother would be in much better condition.\u00a0 This could be my chance to give my mother back, what she gave to me: the gift of life.\u00a0 <a href=\"http:\/\/youtu.be\/pHihM5__4JU\" target=\"_blank\">This video<\/a> is a great motivator for living donors, please note that it might cause it to rain on your face.<\/p>\n<p><strong>So let\u2019s start out with the basics:\u00a0 What does the Liver Do?<\/strong><\/p>\n<p>Take a look at the picture below. \u00a0Also note how close the lIver is to both your heart and your lungs (not pictured, but just above the liver).<\/p>\n<p><a href=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-28\" src=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy-300x256.jpg\" alt=\"liver_anatomy\" width=\"300\" height=\"256\" srcset=\"https:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy-300x256.jpg 300w, https:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy.jpg 375w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>The liver has two primary jobs. One is to detoxify the blood by converting substances like alcohol, caffeine, bacteria, and medications to a usable form, then removing toxins and excess chemicals from the body. \u00a0The liver&#8217;s second job is to turn food nutrients into compounds the body can use, storing excesses for future use. \u00a0Your liver also regulates certain hormones in your body, giving your brain signals that you are hungry, or if your GI system needs attention such when you get nauseas.<\/p>\n<p>Fun fact about the liver:\u00a0 <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2701258\/\" target=\"_blank\">After donating about 40% of my liver, it will grow back to its original size<\/a>.\u00a0 Your liver and your skin are the only two organs in\/on your body that will fully regenerate.\u00a0 How soon will it regrow?\u00a0 The surgeons have told me that two weeks after the surgery, my liver will be about 85% of its original size.<\/p>\n<p><a href=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy_2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-29\" src=\"http:\/\/parmzilla.com\/liver\/wp\/wp-content\/uploads\/2014\/06\/liver_anatomy_2.jpg\" alt=\"liver_anatomy_2\" width=\"183\" height=\"180\" \/><\/a><\/p>\n<p>I started researching what I could do to make my liver healthier.\u00a0 90% of what I read lead me to believe that diet is the most important factor in detoxing\/rebuilding your liver was nutrition and diet.\u00a0 Exercise is also an important factor, but almost everything I read was about <a href=\"http:\/\/www.webmd.com\/balance\/natural-liver-detox-diets-liver-cleansing\" target=\"_blank\">diet<\/a>, <a href=\"http:\/\/www.globalhealingcenter.com\/natural-health\/liver-cleanse-foods\/\" target=\"_blank\">diet<\/a>, <a href=\"http:\/\/www.liverfoundation.org\/downloads\/alf_download_200.pdf\" target=\"_blank\">diet<\/a>.<\/p>\n<blockquote><p>\u201cThe doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease\u201d \u2015 Thomas Jefferson<\/p><\/blockquote>\n<p>I have been taking <a href=\"http:\/\/www.webmd.com\/vitamins-supplements\/ingredientmono-1018-N-ACETYL%20CYSTEINE.aspx?activeIngredientId=1018&amp;activeIngredientName=N-ACETYL%20CYSTEINE\" target=\"_blank\">NAC<\/a>, <a href=\"http:\/\/www.mayoclinic.org\/drugs-supplements\/milk-thistle\/evidence\/hrb-20059806\" target=\"_blank\">Milk Thistle<\/a>, and <a href=\"http:\/\/www.livestrong.com\/article\/481099-what-are-the-health-benefits-of-ginger-for-the-liver\/\" target=\"_blank\">Ginger<\/a> for a few years to <a href=\"http:\/\/www.wikihow.com\/Treat-a-Hangover\" target=\"_blank\">help recover from nights of drinking<\/a>. \u00a0But most studies do not show any direct affect from those natural remedies, I still gave them a chance, and found that they did in fact help me recover faster. \u00a0I also thoroughly enjoy the flavors of bitters in cocktails, even outside of cocktails, so I was excited when I found out that <a href=\"http:\/\/www.amazon.com\/Nature-Works-Swedish-Bitters-liquid\/product-reviews\/B0001TRIWS\" target=\"_blank\">Swedish Bitters<\/a>\u00a0are a great way to help detox your liver.<\/p>\n<p><strong>But what if I was genetically pre-disposed to NASH?<\/strong><\/p>\n<p>I began the Living Donor process on a Saturday evening on March 8, 2014.\u00a0 I submitted an online questionnaire that asked me a series of thorough questions about my medical history, and my lifestyle.\u00a0 I was brutally honest with myself in the process. \u00a0I had not been very kind to my body over the years, and in retrospect, I hope that my liver\/body will be good enough.<\/p>\n<p>Did I have any history of genetic disease such as heart disease, cancer, liver disease? \u00a0Well, yes, my mother, and which is why we are here in the first place. \u00a0Had I ever smoked a cigarette?\u00a0\u00a0 Yes, but it had been a long time.\u00a0 How many alcoholic beverages do I consume per week?\u00a0 Luckily I had been sober for nearly 5 months at this point, so that was an easy answer.\u00a0 The questions kept coming and coming, and I began to doubt that my liver would even be close to being a candidate.\u00a0 I completed the form and immediately received an e-mail saying thank you and that I would be contacted shortly regarding my donation.<\/p>\n<p>A month passed, and I heard nothing, so I reached out to the person listed at the bottom of the thank you e-mail, who responded within a few days.\u00a0 They were still reviewing my information, but they asked if I could come in mid April to discuss the option of being a live donor.\u00a0 I showed up to meet the transplant coordinator who sat me down in a room and discussed the options and the process in great detail, reiterating that I could remove myself from candidacy at any time, even up until the hour the surgery would begin.<\/p>\n<p><strong>And then there were the tests<\/strong><\/p>\n<p>After the first meeting, I was given a barrage\u00a0of tests. \u00a0A whole day at UCSF where I had the pleasure of touring the Parnassus campus in its entirety.\u00a0 At the lab, I was\u00a0to turn in a <a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/003579.htm\" target=\"_blank\">Urinalysis<\/a>, a colo-rectal cancer screen, which I lovingly refer to as a \u201c<a href=\"http:\/\/www.cdc.gov\/cancer\/colorectal\/basic_info\/screening\/tests.htm\" target=\"_blank\">Poop-Smear.<\/a>\u201d\u00a0 I gave what seemed to be nearly a gallon of blood in something like 12-15 of the test-tubes, each one with a different colored stopper. \u00a0If I had any genetic predisposition to Liver disease, UCSF would have\u00a0found it.\u00a0 I had an <a href=\"http:\/\/www.cancer.org\/cancer\/lungcancer-smallcell\/detailedguide\/small-cell-lung-cancer-diagnosis\" target=\"_blank\">x-ray of my chest to look for lung cancer<\/a>.\u00a0 I received a <a href=\"http:\/\/www.nlm.nih.gov\/medlineplus\/ency\/article\/003853.htm\" target=\"_blank\">Pulmonary Function Test<\/a>, which had me blow out as hard as possible for 6 seconds, which is nearly\u00a0impossible to do.<\/p>\n<p>I participated in\u00a0<a href=\"http:\/\/en.wikipedia.org\/wiki\/Transthoracic_echocardiogram\" target=\"_blank\">Transthorasic Echocardiography<\/a>, during which they take ultrasound pictures and record sounds of your heart function from various angles.\u00a0I had a\u00a0standard <a href=\"http:\/\/www.webmd.com\/heart-disease\/electrocardiogram\" target=\"_blank\">EKG<\/a>, and then a <a href=\"https:\/\/www.youtube.com\/watch?v=mf2Jnb0N5sY\" target=\"_blank\">Stress Electrocardiogram<\/a>. \u00a0This test was particularly interesting for a few reasons. \u00a0First,\u00a0they had to shave my chest in odd places turning me into a man-o-lantern. \u00a0Second, the test itself is designed to take your heart rate to as high as possible of it&#8217;s maximum, but without running. \u00a0Basically power-walking on a treadmill while having your blood pressure taken. \u00a0I was able to get to about 185 BPM which was around 90% of my maximum for my age\/weight range. \u00a0Right as you reach your peak BPM, you have to jump back onto a table to undergo one last ultrasound on your heart at it&#8217;s peak performance&#8230; all within a 1 minute window, so no room for error. \u00a0Overall, that was very good. \u00a0My heart was in great condition.<\/p>\n<p>All \u00a0of this in less than 8 hours. \u00a0The good news, is that I now know the Parnassus campus of UCSF like the back of my own hand.<\/p>\n<p>Round two of testing happened in early May. \u00a0It started with an early morning abdominal ultrasound. \u00a0This is one of the most important\u00a0tests as they look for an enlarged liver, scarring, gallstones, or any other abnormality in my liver, any of which would have instantly disqualified me as a donor. \u00a0The test itself took around an hour, and I did not know the results of the tests until way later. \u00a0I was asked for more blood tests, this time the <a href=\"http:\/\/en.wikipedia.org\/wiki\/Phlebotomy\" target=\"_blank\">phlebotomist<\/a> had to take blood in a slightly unusual method;\u00a0immediately placing the blood on ice to preserve the\u00a0<a href=\"http:\/\/www.webmd.com\/heart-disease\/homocysteine\" target=\"_blank\">homocysteine<\/a> levels within the blood.<\/p>\n<p>I met with an Internist regarding my medical history, who also performed a physical on me looking for any signs which would discredit my viability of my donation. \u00a0I was asked questions about my medical history once again, and was once again brutally honest. \u00a0The good news is that I had passed all of the tests so far, and things continued to look good for the potential donation.<\/p>\n<p>Round three of testing included meeting with a Psychologist to ensure that I was of sound mind and that I was not being persuaded in any way to give up my liver for cash, or any other reason. \u00a0I am happy to report that I passed with flying colors. \u00a0Apparently there are quite a few people that get this far through the process of the living donor evaluation before being denied as a donor for being under duress, or worse, not cognoscente\u00a0enough to make the decision to donate their own organ.<\/p>\n<p>I then sat and waited to\u00a0have a contrast CT scan, which if you have never had one, it makes you feel like you peed your pants, not a very fun sensation. \u00a0This is a very important step in the evaluation process as it provides a map of the vein structure within the liver, allowing the surgeon to see exactly where they can make their incisions for the operation. \u00a0Note that the surgeons will use existing veins and arteries in the donated portion of liver to tie back into the veins\/arteries of the recipient.<\/p>\n<p>I also had an <a href=\"http:\/\/www.radiologyinfo.org\/en\/info.cfm?pg=mrcp\" target=\"_blank\">MCRP<\/a>\u00a0which means they stuck me into an MRI machine, with an IV, then injected a contrast metal called <a href=\"http:\/\/en.wikipedia.org\/wiki\/MRI_contrast_agent\" target=\"_blank\">gadolinium<\/a>\u00a0into my bloodstream so they can map the vein structure in my liver in 3D.\u00a0 The MCRP was extremely difficult because you have to keep your hands above your head while staying completely still and holding your breath for 1-minute intervals non-stop for over an hour.\u00a0 My arms were burning and throbbing after the procedure, but I knew I was almost at the home stretch of testing.<\/p>\n<p><strong>What else could be left to test?<\/strong><\/p>\n<p>Not much else. \u00a0I had one final blood test to confirm my general health. \u00a0I was asked to get a TB test from my local healthcare provider, which I did without incident. \u00a0I was also asked to donate blood&#8230; to myself. \u00a0<a href=\"http:\/\/www.bloodcenters.org\/hospitals-physicians\/autologous-donation\/\" target=\"_blank\">Autologous Blood Donation<\/a>, is the more technical term. \u00a0Best part about donating blood? \u00a0All the cookies and juice that you can drink after donating.<\/p>\n<p><a title=\"Under the Knife\" href=\"http:\/\/parmzilla.com\/liver\/wp\/?page_id=38\">So now we start discussing the procedure.<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>So here is where the story of my donation begins.\u00a0 Now before I get into the story of why, you have to understand the magnitude of this decision. \u00a0Living Donor Liver Surgery\u00a0has the single highest risk operation that a donor of any kind can undergo.\u00a0 The risk of death to the donor is 1 in &hellip; <a href=\"https:\/\/parmzilla.com\/liver\/wp\/?page_id=27\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">The Living Donor Experience<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":2,"comment_status":"open","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-27","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/pages\/27","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27"}],"version-history":[{"count":5,"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/pages\/27\/revisions"}],"predecessor-version":[{"id":41,"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=\/wp\/v2\/pages\/27\/revisions\/41"}],"wp:attachment":[{"href":"https:\/\/parmzilla.com\/liver\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}