Fall 2009

Kidney Living Donor Transplant A Case Study

Karen Shatka, 47, was diagnosed with polycystic kidney disease when she was 25. For many years she had no symptoms, but in her early 40s, blood tests showed decreased kidney function. Her nephrologist said she would need a transplant within a few years.

"It was a total shock," said Shatka. Married with three sons, Shatka was still working 12-hour days as a nurse. As the months went on, however, she began to feel increasingly exhausted.

Shatka, who lives near Fresno, chose UCSF Medical Center for her transplant surgery. Eleven family members and friends offered to donate a kidney. The first three candidates were incompatible, but her stepsister, Ellen Monsalve, was a good match. "I am so blessed to be a living donor for Karen," said Monsalve. "I'd do anything for her."

Shatka, though, had elevated antibody levels, likely due to her pregnancies. To reduce her antibodies, UCSF Medical Center arranged for a home health nurse to intravenously administer rituximab, and coordinated with her community hospital to perform plasmapheresis and administer intravenous immune globulin (IVIG).

The transplant surgery went well, but several days after discharge, she demonstrated signs of B-cell rejection. Shatka was readmitted to the medical center and underwent additional plasmapheresis and IVIG treatments, which successfully halted the rejection process.

"Everybody was fantastic, from the nursing staff to the residents and transplant team," said Shatka. "They were caring and did everything perfectly. Everybody becomes like a family to you."

Two years later, Shatka works full time and enjoys biking, walking and aerobics. She is also training for a half-marathon in November. Shatka returns to the UCSF Transplant Clinic every six months, and the transplant team keeps in close contact with her nephrologist at home.

"I'm so thankful to have my life back again," said Shatka.

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