Vampirzahn

Kapitel 3

"If only the kidney transplanted this time could survive well in Ms. Mariko's body, what a pity..."

Dr. Yoshizumi sighed. Upon hearing this, Mariko lowered her head and bit her lip tightly.

Thinking of this, Mariko couldn't help but blame herself: It's all my fault. It's because I didn't listen properly that the surgery failed. Although everyone pretends to be relaxed on the surface, they must all hate me and don't want to care about me anymore. She felt that this Oda guy clearly didn't know anything, yet he was still asking all sorts of questions, which was really annoying.

"Have you been sick recently? Have you caught a cold?" Oda began to inquire about Mariko's health in detail.

Mariko answered stiffly, "I haven't been sick, and I haven't had a cold." As she spoke, she clutched her chest with her left hand, desperately trying to calm her wildly pounding heart. Was she really going to have to undergo a second transplant? And this time, the kidney being transplanted wouldn't be her father's, but a kidney taken from a stranger's corpse! Suddenly, the word "corpse" weighed heavily on her mind. Images of the pufferfish she had dissected in biology class and the cat's body she had once seen run over by a car on the roadside flashed through Mariko's mind.

She suddenly felt a chill in the air around her.

don't want!

Please stop performing transplant surgeries!

But the other person completely disregarded Mariko's feelings and continued to ask, "Do you know when your father will be back?"

"Well... I usually come back very late."

"Please tell your father to call me back as soon as he returns. I will discuss the specifics of the transplant with him then, and he will have the final decision on whether to accept the transplant surgery. If we cannot contact him in time, we will have to pass this opportunity on to the next candidate. So please ask him to contact us as soon as possible, thank you."

An Qizhongde got home after 11 p.m.

His department is responsible for the sales of next year's new word processor, and they are now in the final stages of the campaign. Therefore, during this period, he can't relax or even unwind on weekdays or holidays. This habit of always prioritizing work was something he developed in his youth.

Anzai Shigetoku opened the door and went inside, finding the hallway light off. He was a little surprised. He turned the light on and looked at the shoe rack. Mariko was already back. But why hadn't she left the hallway light on today? She always did. Anzai Shigetoku was puzzled.

He loosened his tie and went into the kitchen. He took some ham and a can of beer from the refrigerator, then opened the door to the living room, stuffing ham into his mouth. Next, he sat on the floor, picked up the TV remote, and turned it on. The evening news was reporting on a plane crash in South America. As Anqi watched the television, he thought to himself that he hadn't seen Mariko much lately. They were both so busy in the mornings that they didn't even have time to talk properly, and they even ate breakfast separately; when he came home at night, although he knew she wasn't asleep, he hadn't gone to her room to check on her. However, this situation had become a habit, and it would probably continue until Mariko went to university. Thinking this, Anqi picked up his beer and took a few sips.

Twenty minutes later, the evening news broadcast ended. Anqi thought he should probably check the documents he had brought back, so he turned off the TV and stretched. Just then, he heard Mariko call out from behind, "Dad."

Anqi was startled and turned around to see Mariko standing there in her pajamas, with some redness and swelling around her eyes.

"What's wrong?... What's wrong?"

"..."

Mariko wanted to say something, but she didn't.

Seeing her daughter's hesitant manner, An Qi couldn't help but feel a little angry and said, "You've already eaten dinner, what are you going to do now? It's better not to have a midnight snack."

"...Just now, there was a phone call..."

Anqi noticed his daughter's troubled expression, as if she had something she needed to say but was hesitant to say. He put the beer can on the table, stood up, and...

"A phone call?... It's from the hospital, isn't it? Is it the doctor who did your dialysis?"

"No...it was someone who said they were in charge of transplant coordination who called."

Transplant! Anqi gasped.

"What did that person say? Do you remember? When did they call?"

"Around 8:30..."

"Why didn't you say so sooner!"

Anqi clicked his tongue and strode to the phone, quickly dialing the number he'd finally managed to get from Mariko. "Finally, it's Mariko's turn," Anqi thought. He couldn't think of anything else. The only thing that puzzled him was why Mariko was being so hesitant and reluctant to talk about this.

The call was answered immediately. The other party first told Anzai that a suitable kidney had been found for Mariko, and then asked, "Will your daughter accept this transplant surgery?"

Section 8

“Of course I accept! I’m leaving everything to you,” Anqi replied happily.

The woman in charge of the transplant coordination briefly explained some precautions and asked Mariko to come to the hospital for a check-up as soon as possible. She said that if the test results were good, then once the donor's heart stopped beating, the transplant surgery could be performed on Mariko.

Anqi thanked him in a trembling voice, then hung up the phone.

"Mariko, you'll be having a transplant soon! I never expected we'd find a suitable kidney for you so quickly. Now you can finally eat properly!"

Anqi smiled as she looked at her daughter. But Mari's face was ashen, her whole body trembling, and she shook her head slightly, saying, "No, no."

Seeing this, Anqi swallowed the cheer that was already on the tip of his tongue, reached out to stroke her, and asked, "What's wrong, Mariko? The transplant surgery can be performed, aren't you happy?"

"……don't want."

"Mariko called out in a hoarse voice. Anzai was even more confused."

"What happened? You won't have to do dialysis anymore. Weren't you happy during the transplant surgery last time? Why are you so upset this time..."

Mariko pushed her father's hand away.

"No! I don't want to have another transplant!"

Anqi staggered toward Mariko, trying to get closer to her, but Mariko tried to back away, her eyes filled with tears, and she began to sob, looking somewhat panicked.

Anqi thought that perhaps the reason she was like this was because the matter had come too suddenly. But he didn't know how to comfort her or calm her down.

"...Mariko."

Mariko retreated to the wall, leaned against it, her knees trembling, and shouted, "I don't want to become a cobbled-together monster!"

"Parasite Eve"

Chapter Seven

When Oda, who was in charge of coordinating the transplant, contacted Dr. Yoshizumi Takashi, it was already 11:30 p.m.

At the time, Yoshizumi was studying patient materials at his desk. When he heard that a kidney donor had been found at the university hospital, he unconsciously straightened his posture and listened carefully as the other person continued.

"It was a 25-year-old woman who died of brain hemorrhage this afternoon. We have met with the deceased's family and signed an agreement."

As Yoshizumi listened, she deftly jotted down key points in her notebook. Oda Azusa had only started coordinating transplants last year, but her efficiency and compassion for the deceased's families had earned her high praise. Thanks to Oda's skillful handling of the transplant surgeries Yoshizumi oversaw, they were generally successful. The municipal central hospital where Yoshizumi worked was the region's kidney transplant center. Once a brain-dead patient was found in the emergency hospital, and their family expressed a willingness to donate a kidney, the attending physician at the emergency hospital would notify the municipal central hospital. Then, the transplant coordinator would travel to the emergency hospital to meet with the family, explain the kidney transplant, and obtain their consent before finally signing the kidney donation agreement. Even if the brain-dead patient had registered with a kidney registry before death, these procedures still had to be followed, because if the family objected, the transplant could not proceed.

"In addition, the patient who will receive the kidney transplant has also made her decision. I will send her information to you via email right away," Oda said on the other end of the phone.

Yoshizumi nodded and turned on the computer on the table.

The preparation process is halfway complete when contact is made with the lead surgeon, Dr. Yoshizumi. For organ transplant recipients, the Municipal Central Hospital primarily follows these procedures:

First, the relevant personnel responsible for transplant coordination obtain the consent of the deceased's family. Then, the hospital sends a blood sample from the donor to the clinical laboratory to test for HLA type and blood type. Further checks are then conducted to determine if the deceased had any infectious diseases such as HIV/AIDS. If the test results are normal, the hospital sends them to the relevant department responsible for transplant coordination, where staff match the donor with a suitable patient according to requirements. At the designated kidney transplant hospital in the area—the Municipal Central Hospital—all registered transplant applicants' information is stored in a computer, including the patient's name, date of birth, dialysis equipment used, tissue adaptability, transfusion history, transplant history, and dialysis history, etc. In this region, approximately six hundred patients have registered for deceased donor kidney transplants. When searching the patient list, patients whose blood matches the donor's are first selected, and then arranged in order of HLA compatibility. Since a donor can donate two kidneys, in most cases, two patients can be selected for transplantation. One of these two patients is often coordinated and the transplant surgery is performed by the hospital where Yoshizumi works; this has become standard practice. Therefore, the municipal central hospital selects two patients with the highest HLA compatibility from its database, conducts physical examinations, and then chooses the patient most suitable for transplantation at that stage to undergo the transplant surgery. If no suitable patient is found locally, the responsible department will continue the search at the National Kidney Transplant Center—Sakura Hospital in Chiba Prefecture—and then transport the kidney to other regions. However, if transportation is inconvenient or the journey is too long, the kidney may not survive in the recipient's body. In other words, if the transportation time is too long, the kidney will become stale, and its tissue function will weaken. This is the main reason why transplant matching is done locally whenever possible.

Yoshizumi held the receiver between his shoulder and his fingers, typing on the computer keyboard. Soon, the computer screen displayed data from the transplant coordination department—a list of candidate patients after screening, arranged in descending order of HLA type compatibility. Yoshizumi dragged the mouse, quickly browsing the entire list.

"According to the order of the list, the first person to receive this transplant surgery is Mariko Anzai, and the third person is Matsuzo Iwata. The person whose surgery will be performed by our hospital is Ms. Anzai, who is listed first."

Upon hearing this, Yoshizumi frowned, then exclaimed "Ah!" as if he had suddenly remembered something.

Yoshizumi hurriedly scrolled to the top of the list on the screen. Sure enough, the first patient was a 14-year-old named Anzai Mariko, who had a previous transplant performed at the Municipal Central Hospital. Yoshizumi then carefully examined Mariko's HLA type. The information showed that her HLA type was completely identical to the donor's, with no difference whatsoever.

Mariko Anzai.

Yes, it's her.

The girl who underwent a transplant surgery two years ago, with Yoshizumi as her attending physician.

Two years ago, Yoshizumi attempted to transplant a kidney from Mariko's father. The surgery itself went smoothly, and there were no obvious rejection reactions post-surgery. However, a small mistake later caused the kidney to fail to survive in her body, and it had to be removed. Thinking about this, Yoshizumi bit his lip tightly, filled with regret. HLA is short for Human Lymphocyte Antigen, a type of glycoprotein on the surface of human cells. When other cells attempt to invade, immune cells recognize the HLA of the invading cells. If the recognition result does not match the recipient's own HLA, the immune cells will treat the invading cell as a foreign object and attack it. This is the so-called human immune function. Similarly, the surface of the transplanted kidney cells also contains HLA. If the HLA type does not match the recipient's own HLA, the recipient's immune cells will treat the transplanted kidney as a foreign object and attack it, preventing its survival. Therefore, during transplantation, it is essential that the HLA of the transplanted kidney matches the recipient's own HLA. However, HLA classification is not as simple as blood type, which is divided into only four types: A, B, O, and AB. Its structure is extremely complex. Generally speaking, it is divided into six major types: A, B, C, DR, DQ, and DP, and each of these major types has more than ten subtypes. Among them, A, B, and DR are the fastest to analyze, so compatibility with these three types is the primary consideration in transplantation. Due to the vast number of antigen types, finding a donor whose HLA is completely compatible is extremely difficult, thus posing a significant challenge to transplantation. Even among siblings, the probability of having identical all six antigen types is only one in four; and among strangers, the chance of a match is often only one in tens of thousands. Therefore, in actual transplantation surgery, one or two antigen type discrepancies can be tolerated, but the probability of survival cannot be denied.

In Mariko Anzai's first transplant surgery, her father donated a kidney, so the tissue compatibility was very high, and the transplant surgery should have been without problems. Unfortunately, the surgery ultimately failed. This was all because the transplant team, led by Yoshizumi, did not have Mariko's full trust.

Section 9

Yoshizumi took a deep breath, staring intently at Anzai Mariko's name on the list. He then pressed his temples to suppress the flood of memories, telling himself to concentrate on his work. He then asked the person in charge of transplant coordination on the other end of the phone, "Is Anzai Mariko's HLA completely identical to the donor's?"

"Yes, there are no other patients exactly like her locally. You can take a look at the records."

Yes, that's right. There's really no one else besides her. However, there are five patients with only two antigen type discrepancies. One is the man ranked third, and another is a 51-year-old replacement patient for this transplant, with a five-year dialysis history, receiving treatment at a hospital in a neighboring county. The woman ranked second on the list hasn't been contacted yet. Transplantation is often plagued by the problem of selecting recipients. Because various factors can influence transplantation, it's a gamble for recipients. Of course, age and dialysis history are considered when selecting recipients, but the prerequisite is that the patient's HLA matches the donor's. Furthermore, it must be considered that a donor can only donate two kidneys. Statistics show that there are approximately 120,000 kidney dialysis patients nationwide, of whom 20,000 have registered for transplants of dead kidneys. However, among these 20,000, only about 200 have the opportunity to undergo transplantation each year. Therefore, the contribution of transplantation to these patients with chronic renal insufficiency is negligible. Compared to countries in Europe and America, it is a well-known fact that the proportion of transplant recipients among dialysis patients in Japan is much smaller. This is not due to a lack of advanced medical technology in Japan, but rather because brain death is not widely accepted or understood by the public. This sentiment negatively impacts both doctors and transplant recipients, causing them to hesitate about undergoing or receiving a transplant. Patients endure the immense psychological and financial burden of dialysis while hoping for a kidney transplant that may never come. To date, those fortunate enough to receive transplants have recovered and are living normal lives. Those who were not selected, however, must continue to endure the long and arduous journey of dialysis in endless waiting.

“In addition, if the patient ranked first cannot receive a transplant, the female patient ranked fifth will take her place,” Oda said. “That patient is thirty-six years old, has been on dialysis for three and a half years, and has two slightly different HLA types from the donor.”

"I see."

Yoshizumi printed out the relevant data for the two patients. The current situation was that if Mariko refused the transplant due to fear of post-operative complications, the 36-year-old woman would receive the transplant. However, both patients first needed to come to the hospital for a physical examination to determine if they were suitable candidates for the transplant.

Yoshizumi further discussed the specifics and schedule regarding the transplant with Oda, and the general steps are as follows:

First, Yoshizumi went to the university hospital to remove the deceased's kidneys, giving one to Oda, who was then responsible for transporting it to a hospital in a neighboring prefecture. The other kidney was taken by Yoshizumi to the municipal central hospital for transplantation. Oda and Yoshizumi meticulously reviewed every step of the plan. Since speed was crucial for both the kidney removal and transplantation surgery, they had to act immediately after the donor's heart stopped beating, following the meticulously planned procedure. Oda's responsibility was to coordinate the work between the lead surgeon, Yoshizumi, his assistants, nurses, and the transplant recipient.

After confirming every specific step of the plan with Oda, Yoshizumi said, "Okay! I understand."

Then, he stood up from the chair, thinking: This time I will definitely succeed, Mariko Anzai, I will definitely help you live a normal life.

"Parasite Eve"

Chapter Eight

Three days after signing the donation agreement, Shengmei's heart rate began to gradually decrease.

Saint-Mei was still on a ventilator, as this at least kept her breathing more regular. But even so, her bodily functions had reached their limit.

The monitor showed that the pulse, temperature, blood pressure, and other indicators were indeed gradually decreasing.

"The medical team from the Municipal Central Hospital responsible for the transplant surgery will be coming here tonight," the doctor who had previously performed the brain death assessment for Shengmei told Liming.

“Once Miss Saint-Mei’s heart stops beating, her kidney must be removed immediately. Therefore, some preparations are needed beforehand. Tonight, the transplant team will perform a minor surgery on Miss Saint-Mei’s femoral artery to ensure that a catheter can be inserted there immediately after her heart stops beating to administer medication and freeze the kidney in time.”

The surgery on the femoral artery was completed quickly. When Liming returned to the intensive care unit, he saw a mark on Shengmei's thigh for catheter insertion. The vasopressor that had raised her blood pressure had been discontinued. However, Shengmei's blood pressure did not drop immediately and remained around 100. The doctor told Liming that this condition might continue until the next morning.

Hearing this, Liming thought blankly that perhaps Shengmei's body temperature would never rise again. Shengmei's bodily functions were still declining little by little, which meant that the time to donate a kidney was getting closer and closer. Thinking of this, Liming felt even more that he should stay with her a little longer. So, he spent the entire night by Shengmei's bedside.

Around ten o'clock at night, as usual, the lovely young nurse came to help Shengmei with her cleaning. She first cleaned up Shengmei's excrement, used cotton swabs to remove any obstructions from Shengmei's mouth and nose, then wiped Shengmei's slightly sweaty back with a towel, and turned her over to prevent bedsores. There was not a trace of disgust on the nurse's face; she occasionally gave Liming a considerate smile before continuing her work. So far, Liming had never been seriously ill, so he seemed to have no connection with hospitals. Although he had some contact with doctors at academic conferences and meetings with patients' families, he knew nothing about the actual work that doctors and nurses did in hospitals.

“Thank you very much,” Li Ming said sincerely, bowing his head. “I am personally very grateful for your dedication to Saint-Mei.”

Upon hearing this, the nurse stopped what she was doing, smiled slightly, and said, "We are honored that you say that. But we are very sorry that we were unable to cure Miss Shengmei."

"No, no, you have already done your best."

Li Ming hurriedly shook his head and said. At this moment, the nurse suddenly stopped smiling, looked away from Li Ming, and continued her work.

“I’ve been working as a nurse in the ICU for a long time, and sometimes I feel confused,” the nurse murmured to herself. “Although we take good care of the patients, someone still dies almost every day. What role are we playing? I feel very disappointed. Compared to other departments, many nurses serving in the ICU have long since passed away. But…” The nurse paused here. After finishing cleaning up Saint-Mei, she began to dress her. When all the work was done, she quickly turned to Liming, placed her hands in front of her abdomen, and said politely, “Your words have given me a lot of encouragement, and made me realize that I must work even harder in the future.” After saying that, she left the ICU.

"Parasite Eve"

Section 10