♪ >> There are close to 1000 Kentuckians waiting for lifesaving organs.

One organ donor can save up to 8 lives.

Today will meet an organ transplant surgeon from the University of Kentucky.

>> And the young woman who you might remember from who a year ago she regained a higher quality of life because of a downer.

We'll talk about all of that now on connections.

♪ ♪ Good day to you and thank you for joining us for connections.

I'm Renee Shaw.

Did you know that anyone at any age can be considered for organ donation?

There are no age limits.

Parents or guardians have to consent to a donation for a deceased donor under the age of 18.

Of course.

>> Today we're talking about the options for those facing end-stage organ disease with the University of Kentucky transplant surgeon Doctor Mehra Gupta and kidney transplant recipient.

Ashley hold, you'll recall was with us over a year ago when she was on the waiting list and now she has a new lease on life.

Good to see you both.

>> And especially good as ICU.

Pretty church.

But it's good to see you.

And you're just you've been beaming ever sense >> Remind the what you what your condition was and how you are renewed hope.

>> I was diagnosed with chronic kidney disease at 35 and was on the transplant for about 3 years and received that wonderful call.

August the 23rd of 2023.

And that started my sick.

It.

>> Life.

Yeah.

Yeah.

And how do you feel?

I mean, obviously there's a difference.

R**** and I did.

Yeah.

Compare.

Oh, my gosh.

Yes.

Thank you.

>> I thought that I was maintaining and doing good with, you know, with the with the with the disease.

Even when I dialysis.

But then led to Lea this next morning from the transplant surgery.

I was up and walking.

I was refreshed in.

I literally was ready to go.

Yeah, I remember you telling me that they had told you can go to work for however, many months in your like, oh, I'm ready to go back after 3 or 4 weeks.

Yes, haha.

I was just >> ready.

Just to do.

you know, just live Matt have to be home at a certain time.

Not have to be connected.

>> To the dialysis machines.

You did that overnight.

Yeah.

Just to be able to live in.

Not really wary.

And so yeah.

If if it's just been, it's just been phenomenal.

Yeah.

Been amazing.

And I am so thankful I'm just I'm just thankful.

Yes, just thankful.

>> Well, Doctor, Mehra good.

He's good to have you on for the first time.

And you've had an interesting day today yourself.

I mean, believe the beam on her face from being a few months out for a transplant.

But today you just did a transplant and a father and a sign, I guess that never gets old for you.

Like the emotion that you hear from patients and see from patients.

Never.

I love it.

I mean, I I went into this knowing how much of an impact I can make on someone's life layer hash Lee's.

I go home every night.

Just so ignited.

So excited about what I do.

Transplants.

One of those fields where patients just have so much hope afterwards, they're just so excited pursue the life that they that they deserve and that they've always wanted to have.

And I get to get to see them and see how they transform.

And and what they do.

Yeah, it yeah.

And today, what in respecting the confidentiality of the patients that you did have family?

I'm a father and son and so talk to us about.

>> Does that happen a lot where there's a good match.

How frequently is?

Is that the possible and and and how they're both doing?

Well, it's interesting.

You say that.

patients who have end stage renal disease, we really encourage them.

>> To seek out potential donors and the people they know are their families are their friends.

People in their community, people at church and so more often than not.

We'll a living donor approach.

The transplant center on behalf of a recipient that they know sometimes we don't.

We have altruistic donors who are donors who just want to donate their kidney to anybody.

But in this this and wanted to donate his kidney to his father.

you know, when his father was cleared and the sun went through evaluation and was cleared, the father was approaching dialysis.

He he was very close to having to start it.

And we were able to get then scheduled and do the transplant so he could avoid.

Being on a dialysis machine.

And and losing.

You know, he's day to I'm activities of Once the transplant of schedule, we take the donor to the operating room, one of our partners to sad and then they take the kidney and then prep it and transport it to.

The recipients room where I got to be the recipient surgeon honor fall we so did in and the kidney worked right away.

you know, they're both doing well.

Yeah, of us can ever recover in the hospital for 2 to 3 days.

>> 2 to 3 days and that's it.

And then go home yet and resume my normal life.

And course there's follow-up care.

Of course, what is typically that look like for transplant recipient.

We follow them very He can't wait to start here at inside this story on you know, immediately after chance that we see them in clinic, at least once a week we get labs on them twice a to measure the blood levels of immunosuppression drugs or anti rejection drugs right >> and adjust the medications because it's very important for us to be able to ensure that they don't reject And then over time we follow them less up to every 2 weeks than every month.

Then every 3 months and so on and so forth until we follow them at least once a year.

If they're stable on their mad and so actually, you know, this routine eye.

Well, yeah.

Tell us about your personal experience when it comes to the post-transplant care.

like Doctor Gupta said in the beginning, I was like lived in the transplant center, but which was a great place because they take very good care of you.

>> I'm going once a week with labs and visits and things of that nature.

And as we got that, and that is an adjusted and things of that nature was a little less, frankly.

for a little bit there, I was just Mania once every other and then I went to once a month for a little bit.

But then we had no issues or anything.

But of course, I'm especially one they want to be extra careful check.

Saw I I do back to once every other week and visit the doctor once a month.

but I'm I'm good to go.

And so the this is an optimally functioning kidney as I can wear.

My last visit was The teen was super.

>> Excited how things are going.

So yeah.

>> And in a transplanted kidney and in the case of Ashley could last, how many years typically?

>> Well, the average waiting that the average lifespan of a deceased donor, kidneys and cause, which is what you have to actually had a is anywhere between 12 15 years that the average lifespan of a living donor kidneys about 18 to But that's average.

The average only met a young woman who used to run the Kidney Health Alliance of Kentucky, whose father, all other guests all had received a kidney and he and had been 33 years.

yeah, so I wonder if that's the exception and not really the rule like if he's just an o***, her and that right can be.

But I tell you, we've had so many patients who've his kidneys of lasted 30, 40, isn't that I'm a year we had one patient with a kidney that lasted 54 years.

And while you note it said the U.S. yeah, haha direct result of the of the how the patient takes care of the kidney and the Oregon quality.

>> So, OK, let's talk about that.

How do you take care of your kid name and what's your daily routine like to have optimal kidney health?

>> One is the medicine.

>> When make sure that I am on that routine, if I have any questions, I'm able to reach out to the pharmacy teamed with transplant immediately.

All of that good stuff.

A lot of it has been the education that you get in the beginning of how things work in wax and pour in nutrition has been very important in as well.

For a little bit when you're going through before the transplant things your appetite in your nutrition is really challenged in so, you know, you want to eat or you want to have everything that you still have to make sure that you have the proper nutrition that's going to be great and make sure the kidney stays an optimal health.

I still I exercise more frequently.

watch my fluid intake.

Steel water is, you know, go to me.

Haha.

Yeah.

But yeah, I really just make sure that I follow a lot of the direction of my care team.

And I'm also research and things and educate myself on hack into things better as well.

>> So we know that Ashley, you had the experience of doing and I can remember the specific the scientific name for the type of a dialysis.

You did parents, Neil Parrott R-washington member that overnight dialysis like 7 or 8 hours 3 times and I was okay, 10 hours with my job.

I was yours for 3 times a week or so.

And you mention your in this particular case that you talked about that trying to avoid When is the end-stage organ disease like diagnose and I guess that varies from person to person.

>> Yes.

chronic kidney disease.

It comes in stages as the kidney function declines over time.

Once the glomerular filtration rate is what we call it far gfr.

Once that to 20 or below the patient will qualify for a kidney transplant but not necessarily need to start dialysis spread a way that's very important, right?

As a lot of people just think that once you start on dialysis, that's when you're in kidney failure.

Well, that's not true.

You can be in kidney failure and suffering without even being on dialysis.

And so our goal is to try to get education awareness.

Let them know you know, you don't need to wait until you start dialysis to pursue transplant, And we call this preemptive transplantation, which means we transplant patients before they need to start dialysis so we can just avoid it.

Avoided the secondary issues that patients experience on dialysis, the suffering the time lost from doing the things that they love and it's it's helpful.

It helps them gain more waiting time on the waiting last without having to wait while on dialysis and getting the word out is very important.

Do demographic factors play into your diminish time on a waiting list.

So if you're at young African-American woman.

>> As Ashley Holden is, is the wait longer or shorter?

Typically, then it would be for a middle-aged white man.

>> No, not anymore.

>> So previously, when we calculated gfr various races, race was actually a factor.

Again, the calculation.

But as of 2 years ago, that changed so race is no longer part of the calculation.

All races are created and treated equally.

I think it's helped significantly evening the access to organ transplantation.

Yeah.

>> University of Kentucky, of course, is an educational institution.

But it is also an academic medical center.

So we before we started recording, we talked about the number of transplants that word on last year.

And these are total Oregon's 255 127 kidney.

I mean that that's just UK Craig Wright.

So we talk about being an academic medical center.

What kind of additional benefits that provide patients not saying and competition with but way perhaps maybe the experience is different than it would be elsewhere.

Is that true or not?

>> I think being an academic institution is extremely beneficial for patients.

We we do research.

We are heavily involved in teaching young people going into, you know, nephrology which is to KET the doctors, the transplant surgery.

Any any type of specialty they actually touch transplant patients to in some way.

And being an academic place, we have learners and teachers and people who are doing research.

We see on the forefront of technology research and new emerging.

An exciting treatments for patients so we're always looking for the better treatment.

We're always looking for the better approach.

We just a kidney donation programs.

And now we're doing the kidney donors using the robot and that's been very exciting for us.

What does that mean exactly.

>> Haha.

>> And the a machine that you can say and use to operate on patients.

Do you hospital time?

Our recovery time reduce the risk of complications.

Have better been traditional laparoscopy.

And I think it's been wonderful for some of our donor now, our patients a little skittish about that are do our debate fully embrace that?

>> In our experience, I think they fully embrace said I think they're excited about it.

It's new technology is something >> emerging in and adopting being adopted everywhere.

But humans are still in complete Yeah, so we're not you're not just, you know, letting a robot know it's being driven by the U.S. all the conversation about AI.

>> I really want to make sure that we give folks a clear understanding of that.

So you feel great.

You are a few months out my 9 months out and so we've done a lot of programming together.

As a member of the Frankfort, Lexington, Kentucky, chapter of the links incorporated.

We provided community screenings and you've been >> really instrumental in helping us reach those communities.

Let's talk about how do we avoid?

Where you've best yet, right?

And and having those screenings are very important.

And what does that look like?

So with kidney Health Alliance of Kentucky.

I'm a part of that and being part of their executive board.

>> I do do a lot of the community outreach and making having people be aware of their kidney health.

And we do that by a quick urinalysis screening similar to what you will receive your primary care doctor in a facility.

And basically we screen for pro team.

We screen for glucose.

We screen for Luka lights, a blood trail.

Traces and what I tell people I'm a consumer of medicine.

And so I'm not yeah care.

Part of your care team, right?

And so I want you to take these results that she just got free and done in 3, 4, minutes and have this conversation with your provider with your your team so that they can explain a little bit more.

RD.

Go a little deeper.

I always tell people that you just you want to be aware and you may not know the questions to ask why, but you have the information that you recently received that you can share with your care team who can guide you and educate 2 on a little bit more I also tell folks that you have to advocate for Some people I find when I'm in the community doing those screenings, they like it had that it did this.

My doctor well and I quickly shared with My quick story about, well, we thought we KET, but kidney disease is one of those diseases that happens quickly.

And some of the symptoms conditions mask as other things.

And you would have no clue that it would be chronic kidney disease or what state you're in until you see a provider.

So making sure that you're aware of your own health and that you advocate for yourself when it comes to your new kidney, your kidney health is very important.

Yeah, because you share with us.

Last year in a previous are about your journey and you are surprised to learn what I would danced.

Yeah.

You're a chronic kidney disease has developed has quickly and how quick one stage to here.

I am it into failure.

>> And having to make the decision, if we're going to proceed with still waiting for the kidney transplant.

We're on dallas's for 3 years.

I was on dialysis for a year.

I actually was one of those that back to get the talked about that.

I was already an end-stage renal failure I held off on held off on dialysis and still I couldn't anymore made the decision with my care team that we may want to go ahead and consider in.

They educated me and she shared with me the actions I wish I would've made that decision a lot sooner than that to have suffered so loud.

And now let's talk about this multi interdisciplinary care team.

What does that look like and what provide there's a make up this team.

We have so many providers that are all very important in our team.

We have not just the transplant surgeons and then our fallen just Our social workers are pharmacists are registered dietitians.

>> We have a financial counselor who needs the Asians about concerns regarding transplant finances and how they can afford their medications.

And afterwards we have a living donor coordinator who can meet with patients, our transplant.

Social workers are wonderful.

We patients part group yet that they run where patients can actually come and share their stories and patients have been transplanted.

Yeah, can also come and provide hope for patients who are sitting in a way to peer support, to add to our and behind the scenes, we have a ton of people.

We have our transplant coordinators are administrators and people who KET our program running.

Well, that's pretty extensive.

And you've benefited from all of that.

And it lasts one of those team members.

Yes, and I still do and not do that actually had a collar.

>> My social worker today has been seen a former take that another appointment.

So might this just if it's your family and your family for every right.

And so that's the other thing is like how long?

And as the post-transplant care continue.

And you said once we get a year in the family for good, right?

Yeah.

Yeah.

Family for like yeah.

And to maintain those appointments.

So even if you feel welcome, some people may say, oh, it's been a year or 2 out.

I'm doing just fine.

I don't need all that extra service.

Leave that for other folks.

You would say, Ashley, what?

Absolutely not.

Yes, she all of that and they need to to because they like to see the fruits of their labor day.

And the successes in that helps.

I know when I go.

>> To my appointments at the transplant Senate, I I.

Actually love go it.

I see other folks that have just had transplants are they've been out for, you know, had been out post-op for like 10 12 years.

And they're still going.

And so it just gives me hope in it gives me it gives me a relief like okay, this is happening and then I get super excited to know that they still people out there don't maybe so others can be a part.

And so, hey, that's like my monthly Hank.

Yeah.

Haha.

Not everybody can be part of a club.

That's right.

That's right.

You know, that's right.

Yeah.

Yeah.

Yeah.

Why?

It's so very true.

let's do talk about, you know, we did talk about some of the things that you do because you you also don't know what other diseases that you could be dealing with, right?

So you want to make sure the disease management is not just >> about the kidney health, but other things out in your case.

But generally speaking.

And so let's talk about the importance of like vaccinations and other screenings in order to maintain the health of the Oregon that has been.

>> Transplanted what all of the things you would already do.

Always do you still do?

And you probably do it with greater consistency that maybe some of us who have not had that experience.

Yes.

you know, we remind patients to maintain their >> routine health screenings there.

You know, their colonoscopy, their mammograms, Pap smears, except anything someone would normally have to KET up with because we want to make sure that they don't any other problems after transplant were fully invested in their care.

We manage their blood pressure, their their sugars if they have because we want them to live a long life and hopefully out live.

You know, their enjoy what they what they deserve.

And in life and we we remind them that, you know, it's important for them to maintain health maintenance.

And that also includes vaccinations.

We encourage them to get vaccinated on schedule.

You know, but that's something that encourage them to do.

We don't force them to do it right.

But by and large, I think the patients to do do it because they are also fully invested in their in and their health after chance.

>> And is there immune system still somewhat compromise?

And to what extent after a transplant are they still somewhat immunocompromised?

That is even the case.

They are heavily immunocompromised within the first year because of the high doses of anti rejection medications that they're >> over time we do bring their doses down so long as they're maintained and they don't have episodes of rejection.

>> But that's why we see them so often because we don't want them If they do have episodes of rejection, we treat them and then we follow them closely.

We KET them on certain levels of immune compromise states to maintain their organs, but also KET in mind that their risk of developing infections and cancers and everything to Amman, immunosuppression, anti rejection drugs is higher than the average percent without a transplant.

So we follow all of those things, right?

and we're there for them.

>> Yeah.

And if they reject a particular anti rejection medication, I'm sure there are adjustments that could be made a part.

A patient shouldn't be discouraged if one regimen doesn't seem to be successful.

No, no, they're different types of each version.

Haha that we use.

>> And if there's intolerance, then we choose a different one a week, right?

And we follow them.

And and and make sure that they they have a successful trance.

And so in a couple minutes we have remaining, I think it's important.

We just finished an April was donate Life Month.

And we know that you've been very involved and we should also mention that doctor Meredith, to hear is an award-winning.

>> We know she's award-winning surgeon, a very complex, but the community as recognize her accomplishments.

Ashley, tell us about the award was bestowed upon a reason why I'm not really for sure the name of a lie because they that you gave out.

But it was from the National Kidney Foundation.

And our chapter here for Kentuckyian Doctor Gupta.

>> Was awarded.

It was really me.

I was in there at the gala.

I was like that's part of the team.

She read that play at Bay.

>> And so just to that community really recognize the work that a lot of these providers do and how they help KET people like me in have helped families who choose to donate as the whale was just remarkable.

And I'm glad to be a part of that family and that team with Doctor Group in the rest of the providers is I KET I was in great hands.

Even when the nation recognize back to group than the teen.

Yeah.

Well, congratulations on and for those who about being a living donor, can you allay their fears about 40 seconds?

>> Yes, so anyone can be a living donor.

A lot of people think that they would never qualify and >> you'd be surprised who would qualify for a living donation we usually, you know, tell people General health average kidney function for their age.

And, you know, active.

And then if they want to consider it, we encourage them to just fill out a questionnaire and lead us to the figuring out.

I think it up for you so that you can, you know, play a bigger part in saving a family member, friends life.

Yeah.

Well, thank you.

I told you the conversation go by really.

>> 6.30, is not that a lot of all.

Thank you for all your great work and continued health and success.

Do you Miss Ashley?

Thank you.

Thank you for watching connections today.

I'm Renee Shaw.

KET in touch with us and some of the stories we're telling about those who have received organ donations on Kentucky.

Addition each week night at 6.30, Eastern 5.30, central and follow me all the ways you see on your screen there on the social media channels until I see you again.

Take really good care.

So long.

♪ ♪ ♪