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A. Zabilavičiūtė, born in Marijampolė, has a congenital disease: polycystic kidney disease. Your life is like a piano keyboard made up of black and white keys.
You do not want to remember some passages of time because it is a painful experience when you have to give up dreams and learn to accept what is impossible to change. But there are also great days in the memory of a woman when things turned out well.
“I’m optimistic so there weren’t that many black days,” he said.
Lately, the bright period is taking off. Even while preparing for the hospital and wondering whether to return, because the donor kidney might not fit, A. Zabilavičiūtė was able to arrest herself. To keep in mind, she made a list in advance of the items she might need the most in the hospital room.
The health problems that began in her youth did not seem like a great burden, although the question of why this was happening did not reassure her for long.
He found out about his illness after graduating from high school. Asta frequently fainted, had a low hemoglobin level in his blood, and consulted with more than one doctor until the actual cause of the illness was determined in the Kaunas clinics.
Polycystic kidney disease does not occur in a day, it develops due to genetic mutations. The disease can be familiar and passed down from generation to generation. It is a disease in which normal kidney tissue is replaced by multiple cysts, fluid-filled derivatives that vary greatly in size.
However, both of the photographer’s parents are healthy, her relatives lived a long time, and no one remembered that no one had kidney problems.
After receiving her certificate, she had to lie down in the hospital instead of handling paperwork to study at university.
But a woman doesn’t blame her genes because when she was seriously ill at a young age, she learned to see failure differently.
When he went to the Kaunas clinics, he learned that dialysis was needed as replacement therapy and that he had to prepare for a kidney transplant. The graduate was better suited to her father’s kidney, but she had to postpone the transplant for eight months if she was jaundiced.
In March 1995, the kidney from A. Zabilavičiūtė’s father was transplanted. Although the woman had to be treated in hospital for various ailments, the kidney transplant worked well for eight years.
During that time, he graduated from Marijampolė Vocational Technical School, entered Kaunas College, where he obtained a diploma in advertising management. After moving to Kaunas, he worked in various advertising agencies.
When the donated kidney ruptured, the woman quit her job and started dialysis again.
Participated in temporary additional work. Subsequently, various health problems began, for which the transplanted kidney was removed and a transplant was performed for the second time in 2011.
This time there was little hope that the foreign body would catch, so it was removed a month later. But the procedures and operations seriously weakened the body. As a refreshment for the soul, he discovered photography and immersed himself in creativity.
The photographer has been waiting for a third kidney transplant for a decade. Psychologically, that wait is very exhausting: the day of dialysis was much more difficult.
To better plan his schedule, Asta decided to work independently. After obtaining an individual activity certificate, he realized that he had to do it much earlier.
On August 6, A.Zabilavičiūtė’s kidney was transplanted for the third time in the clinic of Vilnius S University Hospital. The woman was glad that the postoperative tests were good. This is a sign that the foreign kidney is functioning normally, even though your body was immunologically irritated before the transplant, and the operation had to be postponed more than once because the donor kidney did not fit.
Eglė Ašakienė, Head of the Department of Nephrology at the Santara Clinics of Vilnius University Hospital, said that it is not uncommon for the same patient to receive a kidney transplant from a donor for the third time. In his practice, there was a patient who had received this treatment up to five times.
And whoever is born with a shirt of happiness, the transplanted kidney works until the end of life.
38 years: the patient who has lived in the country with a kidney transplant for the longest time can apply for the Lithuanian registry book.
However, there are cases where a patient has to lie on the operating table more than once due to a kidney transplant.
E.Ašakienė, a physician who has worked at the Santara clinics since 1992, admitted that the attitude towards kidney transplantation has changed significantly in the last three decades.
When the kidneys stop working, only a few options remain: kidney transplantation or replacement therapy, which consists of hemodialysis, or peritoneal dialysis procedures, where the blood is cleaned in the abdominal cavity. However, replacement therapy is only one way to save lives and a bridge to transplantation that ensures quality of life.
At the Santara clinics, kidney transplant surgery was stopped only at the start of the pandemic for fear of coronavirus infection. However, only in cases where a living donor kidney has been implanted.
There is currently no such restriction and the number of kidney transplant operations is much higher than last year.
E.Ašakienė said that transplantation is one of the most advanced fields of medicine. Not only are new techniques used for donor kidney transplantation, but also a new generation of drugs that suppress immunity, so the results of the Santara clinics are the same as in the most famous clinics in Europe.
However, public attitudes toward the possibilities of transplant medicine are changing much more slowly. It is still thought that when a kidney hits, it is better to wait until the last moment when they stop working and only then prepare for a transplant. Such a delay does not promise anything good.
When a patient’s life is in grave danger, it is much more difficult for doctors to transplant a kidney because the patient’s body is weak.
Such treatment must be planned in advance. Worldwide, kidney transplant surgery is considered the first-line treatment for chronic kidney disease.
The first operation, half a century ago
For people with kidney failure, the only way to recover is a transplant. In Lithuania, more than 3,000 of these operations have already been carried out. In the Baltic countries, kidney transplantation is performed in four centers: in Tartu, Riga, Kaunas and Vilnius. The Santara Clinics of Vilnius University are leaders in this field.
The first kidney transplant operation from a deceased donor in Lithuania was performed in 1970. The pioneer in this field, Professor Balys Dainys, has been awarded the Commander’s Cross of the Order of the Grand Duke of Lithuania Gediminas.
Professor Marius Miglinas, head of the Nephrology Center of the Vilnius University Hospital Santara Clinics, said that modern transplantation is becoming increasingly complicated: kidneys are transplanted from living and dead donors, of compatible and incompatible blood groups.
– How has the flow of patients requiring a kidney transplant changed?
– There is an increasing number of patients who have received a single kidney transplant, that is, repeat transplants. There are also a growing number of immunologically sensitized patients who find it increasingly difficult to select the right donor.
Another trend is that patients are not subject to age restrictions.
In the past, young patients were on the waiting list for a kidney transplant, now one in five is over 60 years old.
Kidney transplant surgeries are also performed on patients with comorbid conditions, such as one in five with diabetes.
Until 2010, kidney transplantation operations in Lithuania could only be performed with donors of a compatible blood group. The new method has removed that obstacle. This can be done by taking a kidney only from a living donor, as preparing the recipient for surgery takes about a month.
And a deceased donor kidney transplant can be transplanted within 24 hours.
– Why are potential donors missing?
– The characteristics of deceased donors are also changing. Many of them are elderly donors who have died from various diseases such as ruptured aneurysms, hemorrhagic stroke. Such a kidney is more difficult to keep viable.
In the past, donors were much younger, mostly young people who died in car accidents.
There are fewer such accidents on the roads now, which is good, but transplant specialists have to work with organs from much older donors. This encourages the emergence of various innovations.
If the donor dies from certain pathologies, urologists, after extracting the kidney, attach it to the perfusion device, which helps preserve the vitality of the organ. After a transplant, the kidney starts working faster and longer.
– How is the transplanted organ preserved?
– This year, more than 40 donor kidneys have been transplanted at the Santara clinics alone. Our goal is to do everything possible to keep the transplanted kidney working for as long as possible. If the implanted kidney does not work, the patient is dialyzed. The new transplant is also possible, but our goal is to preserve the first transplanted organ for as long as possible.
Nephrologists working in the field of transplantology are an important part of the team, which is made up of specialists in various fields, such as immunologists, surgeons, anesthesiologists, rescuers. It is the nephrologists who must choose medications for the patient that suppress the immune system.
In modern treatment regimens, it is important to avoid the body’s rejection reaction, as well as the complications that can be caused by excessive immunosuppression.
Complications can lead to infections, oncological processes, accelerate cardiovascular disease. Consequently, we must ensure that the transplanted kidney works for as long as possible and does not develop concomitant disease.
– What kind of countries could Lithuania follow?
– In chronic diseases where kidney failure develops, transplantation is considered the first-line treatment.
Consequently, the number of patients is increasing, but there is a shortage of donors. We need to provide the public with as much information as possible so that not just family members, relatives can donate a kidney.
However, Lithuanian law allows only spouses and family members to donate a kidney;
With the introduction of a new method of treatment for patients with severe kidney disease, there is much more hope for recovery.
At that time, more than half of all kidney transplants in the Netherlands came from a living donor. In this country, a neighbor, co-worker, friend or classmate of a seriously ill patient can donate a kidney.
The Benelux countries, Switzerland and Austria are also following this path, I think it is time for Lithuania to improve its legislation and expand the list of people who could become kidney donors. These can be classmates, co-workers, neighbors, members of the church community, friends of the family.
