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What every kidney recipient should know
1. What Every Kidney Recipient Should Know
Sunday, September 11, 2011
Lee Chen Hoe
Deceased Donor Transplant Recipient
Kuala Lumpur Hospital
July 27, 1996
1
3. Coping with CAPD
-Took me 4 months to finally accept the fated illness
- A supportive family and my loving twin girls
-I was reassigned to desk job in charge of Material
Control from Technical Service
-Had to stop once or twice in the North South
Highway to take a cat nap before continuing my
journey of 60 km to work
-To put up with unfriendly and hostile remarks
-A strong determination to pull through 3
5. My Preparation for Transplant Operation
-Signing up for the Waiting List
-A Positive mind set
-Walking exercise
-Practice of Wai-tan-kung tai chi exercise to stay healthy
-Closely followed my dedicated CAPD nurse’s advice
-Had my teeth checked by the dentist to prevent infection
-Resourceful on pre and post transplant care
-Emotionally, mentally, physically and psychologically
prepared for the transplant operation
5
6. Post Transplant Operation
The success rate of transplant operation in
Malaysia is 90+ %, compatible to any part of the
world
-You will be back to normal
-No need to stick to Haemodialysis /CAPD schedule
-Sexual life
Can start 3 or 4 weeks post transplant operation
when the site of the wound is alright
6
7. Post Transplant Operation
-You will be placed in the Intensive Care Unit
-Transfer to a Single Occupant Quarantine Room for about
two weeks
-Follow closely to the heavy dosage of anti rejection
immunosuppressive drugs
e.g. Cyclosporine, Tacrolimus, Mycophenolate,
Prednisolone, Azathioprine (Imuran) Twice daily
-Hypertensive drugs e.g. amlodipine, Atenolol,
-Cholesterol drugs e.g. lovastatin
-Store medicine in cool and dry place away from children
- Be wary of the expiry date of the drugs
7
8. Post Transplantation Operation
Medical Follow up with Kuala Lumpur Hospital
-Ultrasound or Computerized Topography (CT)
Scan
-Nuclear Magnetic Resonance (NMR), if necessary
Doctor will prescribe 2 to 3 months of medical leave
for you to recuperate after the transplant operation
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9. Post Transplantation Operation
Medical Follow up with Kuala Lumpur Hospital
Blood Test
-Urea (1.7-8.3 mmol/l)
-Sodium (125-145 mmol/l)
-Potassium (3.5-5.0 mmol/l)
-Creatinine Level (65-122 mmol/l)
-Uric Acid ( Male 202-416 µmol/l)
Female 142-239 µmol/l)
-Urine Test ( Free of albumin)
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(Source: Nephrology Department of Kuala Lumpur Hospital)
10. Post Transplantation Operation
-Meet the Dietician
-Stay in touch with the Transplant Coordinator
-Observant of any bodily changes for the first six (6) months
caused by the immunosuppressive drugs
e.g. Cyclosporine will cause
-Moon Face
-Hairy body/ Ladies will start to grow moustache
-Pimples
-Will put on for a few kilos of bodily weight
-Temperamental/Emotional caused by Prednisolone
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-Drink at least 3-5 litres of water during the initial
11. Post Transplant Operation
Signs of graft rejection
-Fever
-Pain or swelling in the graft area
-Less urine output
-Report immediately to our “Holiday Resort”
-Creatinine level will increase from the normal
level to ≥ 200 mmol/l
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12. Post Transplant Operation
Three types of graft rejection
-Hyperacute rejection occurs within first 24
hours of transplantation
-Acute Rejections occurs first few weeks or
months after transplantation
-Chronic Rejection
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13. Post Transplant Operation
Administer of Medication for rejection
-Intravenous Methylprednisolone
-Change anti rejection drugs
e.g. FK506
-ATGAM/Thymoglobilin-Very costly drugs
10 – 14 injections
13
14. Post Transplant Operation
Precautionary Measures to take
-Wear a face mask during the initial first 3 to 4 weeks
when going out
- Do not go to crowded places
-Keep away from pets
--Keep away from people who have a cough or fever
--Keep away from family members who have
chickenpox or measles
-No taking of herbs or direct sales stuff
-Don’t be your own doctor, i.e. subtracting the drugs
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15. How I look before and after Kidney Transplant Operation
Pre Kidney Transplant-1994 Post Kidney Transplant – 1999
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Hb 7+gm/dl Hb 13+gm/dl
21. My Post Transplantation Self Care
1. Regular medical follow up in Kuala Lumpur
Hospital
2. Look at life differently and positively
3. Consume more fibrous diets-lots of fresh fruits,
vegetables, and less meat
4. Exercise-brisk walking, badminton, wai-tan-
kung tai exercise
5. Drink about 3.0 liters of water daily
6. Non smoking or drinking
7. Leading an absolutely normal quality of life 21
22. MBA Graduation- August 2, 1999
Continue education to
enhance your market
values by returning to
university
With my mother at the
Universiti Putra
Malaysia
22
23. Or…
-Start your own business so that you are
financially independent
e.g. Insurance agent, unit trust, will writing
-Start your own family
-Ladies need to discuss with the doctors should
they decide to conceive a child
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24. I am Grateful:
-Thankful to the donor family
-The doctors and medical staffs of
Kuala Lumpur Hospital
-My parents, my wife, my twins and
siblings
-Involve in Organ donation awareness
campaign 24
25. Many organ recipients take things for
granted and never say a word of thanks
to the DONOR family !
The Transplant Coordinator got to
purchase a Thank You card as if it was
from the recipient and send to the donor
family as appreciative of their noble and
altruistic act of organ donation, the Gift
of Life! 25
27. “You must give something to your fellow
men even if it’s a little thing, something
for which you get no pay but the privilege
of doing it”
Albert Schweitzer
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28. Chen Hoe Lee:
I'm so glad to see how healthy you two
are looking! Thanks for keeping me up to
date on your progress and on all the work
you do for transplant issues. My family is
so happy that my husband's kidneys have
served you so well!
Best wishes, Madge Bender
(May 28, 2009)
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29. Dear Chen:
I'm so pleased that we were able to make
your life and your "twin's" life longer
and happier. Your efforts to make
transplants more common and acceptable
in your country and your region are
commendable. Keep up the good work
and good luck with it!
Best, Madge Bender
(May 29, 2009)
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30. The Visionary Leader and Nephrologist
Dato Dr. Zaki Morad
Mohd Zaher
Senior Consultant
Nephrologist
Head of Nephrology
Department
Kuala Lumpur Hospital
1985 to 2006
NKF Kidney Walk-March 15, 2008
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31. Nephrologist
Dr. CC Tan
Consultant
Nephrologist
Head of Nephrology
Department
Hospital Tengku Ampuan
Rahimah
Klang
NKF Kidney Walk-March 15,2008
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33. Had it not due my twins in giving me the
motivational inspiration to courageously drive
on plus a shower of medical care and touch
from Dato Dr. Zaki Morad, his team of
doctors and medical staff from the Nephrology
and Urology Department of Kuala Lumpur
Hospital to remain healthy to this day, it
would have been difficult to persevere for 19
years in seeing them through their education,
was the proudest moment and achievement of
my mission in life
33
39. 1. Carry more than enough medication that you need
during long distance travel or holidays
2. Carry your medicine prescription booklet with you
or a doctor’s letter stating your dosage in the event
there is immigration or custom checks
3. Carry two (2) sets of medicine - one set kept in the
check in luggage and another in hand luggage, or
ask travel partner to carry one (1) set
4. A list of Healthcare providers and contact nos.
5. Ask the doctors for a short supply of antibiotics,
e.g. diarrhea, nausea, giddiness
(Reference: Roche Pharmaceuticals)
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40. 6. Drink your own boiled water and lots of it
7. Keep your watch at home time if you are traveling
to countries of different time zones
8. Carry your insurance card with you
9. Have your blood test check one (1) week or so before
your travel
10. Upon return, take a rest for a few days before
going for a blood test because you would be
dehydrated during travel.
11.Use sun block for out doors activities
- Our risks of contracting cancer is 5 x higher than
that of a normal person 40
41. Green Ribbon Support Association
1. To promote and provide support, care
and counselling to patients who
have undergone transplant of organs
to return to lead normal life again in
the society.
2. To create awareness of major health
diseases leading to end stage organ
failure.
3. To improve donor rates in the country.
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42. Be There for the newly diagnosed patients-
Prof. Masuri Othman of UKM-Feb. 27, 2003
Ms Marzianna wanted to donate a kidney
to her 8 years old daughter-
December 5, 2009
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48. I always have these PICTURES in me whenever I
am out for Organ Donation Awareness Campaign
P-A burning passion and love for the job
I-Taking the initiative to strike a conversation on
Organ Donation
C-Communicate in the simplest possible language
on the topic
T-Take time off from my appointments or work
U-Understand from the viewpoint of the other person
R-Research on the topic and responsible for my work
E-Enjoy the work and ever grateful being given a
chance in this noble act. Expect nothing in return
S-A sincere and supportive family and derive the
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greatest satisfaction for the work done as it saves lives
49. World Transplant Games-
Gold medalist in Badminton
1997-Sydney, Australia
1999-Budapest, Hungary
2001- Kobe, Japan
2003-Nancy, France
2005-City of London, Canada
Silver medal
2007-Bangkok
2009-Gold Coast, Australia
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50. What are the Financial Assistance?
1. SOCSO
• Must have made at least 24 contributions to SOCSO
• Below 55 years old
• Claimable for Invalidity Pension Scheme
• Claimable up to 50 to 65% of your maximum income
of RM 2,000 per month
• Dialysis is taken care of by SOCSO
2. Social Welfare Department
• Claimable up to RM 300 /month 50
