Transplant stories

68 year old Freda Scarehill from Yately in Hampshire and 39 year old Paul Mc Philips from Swindon are being kept alive by dialysis. Their kidneys failed after they were damaged by their own immune systems, and without machines to remove toxins from their bodies, they would both be dead within 48 hours.

‘I used to garden, I used to walk, and of course you’re tied down all the time, because all the time you’ve got to be back to do the dialysis, wherever you go you’ve got to think ‘got to get back, got to get back’.’

‘Lost all my energy, just totally tired all the time, you wake up Saturday / Sunday morning, we’d go down the coast, can’t even do that any more.’

But there’s now a chance for them to return to normal life. Freda’s daughter Angela and Paul’s wife Debbie are giving them the greatest gift possible. They’re each donating one of their kidneys after tests showed their blood and antigens matched.

‘I just felt that I couldn’t sit there doing nothing knowing that the chance was I could do something. She’s helped me when I’ve been in trouble in my life, so I figured it was the minimum I could do really.’

‘It will benefit both of us, and if you see somebody suffering, putting the needles in day in day out, you would do something to help them.’

The operation days are tense. While Angela and Debbie get ready to go to theatre, all Freda and Paul can do is wait on the ward at the Churchill Hospital in Oxford.

‘Keeping my fingers crossed that everything goes OK and I come out of here a different person.’

Meanwhile the world-class transplant teams begin the intricate task of removing Angela and Debbie’s kidneys. Three years ago this would have involved removing a rib, leaving a large painful scar.

‘They’re firmly embedded in the very back of the abdominal cavity so it’s attached to a lot of other structures, so there’s a good deal of surgery to free a kidney up and we have to do that whilst maintaining its blood supply, without a vein so that the kidney remains alive and is therefore suitable to function once it has been transplanted.’

Thanks to advances in technology like this telescopic camera, the kidney can now be removed using keyhole surgery. It means the recovery time for the donor has been halved from around ten weeks to around five.

It’s done by making five incisions in their abdomens; one for the keyhole camera, one for air suction and two for the surgeon’s left and right hand instruments. Once the kidney is freed, another small cut is made lower down to remove it.

‘It’s a new operation which is pretty much the high end of keyhole surgery, because as you understand the stakes are high, you’re doing an operation on someone who is fit and healthy and in real terms does not need that operation.

‘I’m worried about my wife. She’s going through a lot of pain at the moment. She had no reason to do it, so I am very, very nervous at the moment.’

It takes three hours of precision work from the team; it’s all done by looking at a screen and requires pinpoint accuracy. Just one slip could be disastrous.

‘The big challenge compared to the conventional surgery is that there is absolutely no room for error; you can’t make a mistake. Because if one of those large blood vessels starts to bleed the whole area will fill with blood and you won’t be able to see.’

Both Angela and Debbie’s kidneys are removed successfully, they are cleaned, the arteries and veins are flushed through, and they are preserved on ice and Freda and Paul make their way to theatre to receive them.

Part 2

Freda Scarehill’s daughter Angela has slowly watched her mum’s health deteriorate. Freda’s kidneys have failed and she’s on dialysis four times a day. It keeps her alive but her condition has had a devastating impact on her life, so Angela has made the difficult decision to give her mum a kidney.

Paul McPhilip’s wife Debbie has reached the same decision, after watching her husband suffer for the last four years. When a tissue match came back positive, she knew she could do something about it.

Angela and Debbie have already been through keyhole operations to remove their kidneys at the Churchill Hospital in Oxford. Their kidneys have been preserved on ice and now Freda and Paul arrive into theatre to receive them. Success is now in the hands of the consultant surgeon and the team.

Once the kidneys are removed from the ice the race is on to get them connected as quickly as possible. The operation requires four hours of intense concentration and dexterity.

‘When you try and plumb these vessels you have to be very focused on technique and make sure there is no damage done to the recipient vessels; because obviously the donor vessels are better quality, and therefore you’ve got to make sure that your technique is perfect.’

The donated kidney is inserted into the pelvic area so that it can be accessed easily in the future if necessary. It’s connected to a vein and artery in the bladder. The failed kidneys remain in place, because removing them is risky and unnecessary.

The transplants are complete: Freda’s new kidney works immediately and Paul’s begins to work after five minutes.

‘I don’t think there’s any operation out there that can give you more gratification than a transplant: and the outcomes from transplants are really good nowadays and you know you’re doing something really good for the patient, I think possibly that is the best operation you could do.’

It is thanks largely to this pioneering surgeon. Professor Sir Peter Morris fought to set up this transplant unit in Oxford and performed the first operation in 1975. It’s now the largest kidney and pancreas transplant centre in Europe.

‘It wasn’t easy and at the time, the results of kidney transplantation were extremely bad in this country and the government felt they were pouring good money after bad. I persuaded them that results could be better so they agreed to fund a transplant centre in Oxford.

30 years on Freda and Paul are a testimony to Sir Peter Morris’s efforts. Their lives have literally been transformed. Paul is no longer tied to his dialysis machine at home in Swindon and he can look forward to the future.

‘My whole life has just changed completely after the transplant. I’m not restricted to the house now.’

And what do you think about what Debbie’s done?

‘Well, she’s great!’

Freda is back in her garden in Yately and is now looking forward to moving to Cyprus with her husband thanks to Angela.

‘She’s given me my life back.’

‘Well you’re worth it Mum. What do you think of the staff at the John Radcliffe?’

‘I can’t tell you. They’re just phenomenal, the whole lot, every single person in there was absolutely amazing.’

Paul and Freda will have to take immunosuppressant drugs every day for the rest of their lives. 30 years ago there would have been a 40 percent chance their new kidneys would reject. The development of these drugs means that chance is down to just three percent. They can look forward to a healthy future.

The transplant is truly one of the miracles of modern medicine.

Part 3

‘I do a lot of travelling, every time I come back I think ‘thank God for the National Health Service’; if I was one of your pundits out there, as an ordinary patient, they don’t realise how lucky they are.’

‘There’s a real attempt to deal with problems and to put patients first. I am very positive about the future of the NHS, and I’m a complete believer in the fundamental principle that this is the sort of health system a civilised country should be providing.’

‘I have had the most amazing experiences with the NHS, I cannot find fault anywhere.’

‘It’s been absolutely brilliant, I can’t fault it.’

‘I don’t think I could have had better, even if I’d gone private, I couldn’t have had any better treatment.’

‘I’m a completely committed NHS supporter. I’ve worked abroad for short spells and you see the difficulty people have accessing healthcare because they cannot afford it at that moment when they need it.’

‘Overall, yes, thumbs up; clearly there are problems, clearly there are things that we need to work to improve. There’s always this issue of whether there’s enough funding.’

 

‘I think the constant tampering from the top, often from people who don’t really know what they’re doing; I think that’s been frustrating. I think despite that it’s run at ground roots level by managers who care, by nurses who care, by doctors who care and I think, you know, long may it live.