THANKS to his wife Elaine and a course of treatment they had been previously been unaware of, civil servant Bryan Masterson is a man with a new lease of life.
The 53-year-old had been on the waiting list for a cadaveric kidney transplant for 18 months, before learning of a procedure known as an ‘incompatible kidney transplant’, which opened the possibility of receiving a kidney from a donor despite them having a different blood group.
Staff at the renal unit at Noble’s Hospital first put the idea to Bryan, and then organised seven months of tests to find out whether Elaine would be able to donate a kidney to her husband.
‘I have a kidney disease called IgA nephropathy,’ said Bryan. ‘That is where a person’s immune system attacks their kidneys.’
For a year he had been on peritoneal home dialysis, an alternative to the hospital-based hemodialysis – both are systems of artificially cleaning a patient’s blood.
The new option entailed medication that would suppress Bryan’s immune system enough to accept an otherwise incompatible organ.
Bryan said: ‘Elaine volunteered to donate her kidney but I wasn’t keen to ask family, I wanted to wait [for a compatible donor]. But she pointed out I had been waiting a year-and-a-half already and nothing had happened. She said: “Why allow yourself to deteriorate?”. My wife is a very brave woman.’
Overseen by Abdul Hammad, a visiting consultant from the Royal Liverpool University Hospital, tests showed the wife-to-husband organ transplant would be possible.
Bryan was admitted to the Liverpool hospital two weeks ahead of the operation to begin intensive immune-suppressant treatments before Elaine was admitted and the seven-hour transplant was carried out. The operation was successful – Elaine was discharged six days later and Bryan returned home after five weeks’ recovery. The couple live in Albert Street in Douglas.
‘Now I live a pretty ordinary life. I don’t have to do dialysis any more, thanks to Mr Hammad and his marvellous team,’ said Bryan, ‘People say I look better now, though no one said I didn’t look well at the time!’
Elaine is fully recovered and back working in her role as a clinical nurse specialist in the mental health service. Bryan is back working part-time at the Department of Social Care. Medication to suppress his immune system will continue however, though he says low immunity is a small compromise against freedom from his kidney disease. ‘I just have to be careful with food that may cause infection,’ he explained. ‘Silly things like buying wrapped meat instead of from the deli counter’.
It is now six months since the operation, the earliest Bryan thought it appropriate to say it had been a success, and he hopes his story will inspire other renal patients who may not have realised an incompatible organ transplant was an option for them.
‘Our story may help or bring hope to the many people in the island who are currently receiving dialysis,’ said Bryan. ‘Apart from anything else, it is an item of good news in these economically challenging times.’
Even if this kind of transplant isn’t possible, Bryan is also an advocate of peritoneal home dialysis.
He said: ‘People are sometimes apprehensive about dialysis at home, because you have to take more on your own shoulders. But there’s lots of support from the renal unit and I never had any problems. It gives more control over your life than hospital dialysis.’
That said, the successful transplant has changed his life for the better. Bryan concluded: ‘The best way to describe the difference the transplant has made is that it’s like going back to living the way we were before becoming ill.’
Christina Davis, a clinical nurse specialist at Noble’s renal unit, said the procedure that provided Bryan with a new kidney was still rare, having only been performed in UK hospitals within the past three years and being limited by availability of kidneys.
There is also a funding issue – these transplants are not ‘life or death’ operations as dialysis is always an option.
Bryan was in the fortunate position of having a willing donor and antigen levels in his blood low enough that suppressant on his immune system meant treatment would work.
Christina added that there are 15 to 20 patients in the island who are potential kidney transplant recipients. The issue – as was the case with Bryan – is that if a patient has a common blood group, the waiting list is very long and moves slowly.