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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on December 19, 2009, 10:16:00 AM
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Published: 12.19.2009
'A very generous act of love'
By Stephanie Innes
ARIZONA DAILY STAR
"The kidney is working fine.
It means everything. It's a very generous act of love for someone to do."
~Lena McCline
Lena McCline was spending nine hours a week in dialysis, an exhausting process for the 70-year-old Tucson grandmother of six.
And she was waiting for a kidney donor. And waiting. When a match with a deceased donor came up in the spring she was briefly buoyed by hope. But that hope turned to disappointment. The donor had been a drug user and though she was told the kidney was nonetheless healthy, McCline refused.
"Psychologically, I think that would have messed me up," said McCline, who believes her kidney damage was brought on by chemotherapy after a bout of colon cancer 13 years ago.
So it was back to square one, looking for a donor on a waiting list that can be as long as seven years. That is, unless a "living donor" were to come forward — a blood match who could pass the screening process and who would be willing to give up a kidney for her.
And one did.
"I just called her up as soon as I heard and said, 'Granny, I want to do it'," said her grandson, 23-year-old Chris McCline.
"I tried to talk him out of it," his grandmother said.
But she couldn't.
On Friday the two sat, pajama-clad, side-by-side on Lena's hospital bed at University Medical Center. Both were recovering from surgery that took place Tuesday. And Lena had a new kidney — a nice, young kidney, she said proudly.
The surgery was unusual for two reasons. The removal of the kidney was performed with a spider-like da Vinci surgical robot in a procedure that Chris' doctors said was the first of its kind in Arizona. It took just 90 minutes.
And because Lena is a Jehovah's Witness, doctors had to be extra careful about blood loss, since she was adamant about not accepting a blood transfusion, which her religion forbids.
The da Vinci robot, a $1.5 million device that UMC acquired last year, allowed Chris McCline's surgeon, Dr. Carlos Galvani, to perform laparascopic surgery by operating a spider-like robot from a console. The four-armed robot performed the surgery, as Galvani operated the commands.
"It makes my movements more precise," explained Galvani, who came to Tucson to become the director of the Minimally Invasive, Bariatrics and Robotic Surgery program at UMC earlier this month from the University of Illinois in Chicago, where he'd been preforming robotic-assisted surgery since 2004.
"The system will filter any tremor that I could have," he said.
Galvani is scheduled to perform another kidney removal using the robot next week — on a young woman who is donating a kidney to her boyfriend.
The robot also shortens the surgery time and helps minimize blood loss, he said.
Blood loss was a major concern for Dr. Rainer Gruessner, the chairman of the UA's department of surgery, who performed the 2 1/2-hour open surgery transplant on Lena.
"It was a little bit riskier. We had to do a surgery with as little blood loss as possible. We gave her a drug — epo — to boost the red cell blood production," Gruessner said. "Before epo was available in the 1980s, 1970s, a surgery on Jehovah's Witnesses was very risky. They would bleed out ... and die."
Gruessner said the number of "living donors" for kidneys has been growing at UMC, a trend he'd like to continue. Overall, they have better outcomes, he said. He said that while the risks of being a donor aren't zero percent, they are nonetheless low.
"The risks of having that kind of procedure, of dying, is about one in 8,000. Now Chris, he's younger, he's in good health so his risk was probably one in 15,000. The risk of a major complication is less than three percent," Gruessner said. "So by and large it's a very safe procedure."
Chris, who manages a local McDonald's, isn't expected to have any lasting effects from the surgery. He already had some role models in that area. Both his aunts donated kidneys to Chris' father, Jerome McCline, when he was suffering from kidney failure. Brenda Roberts donated one in 1988 and when Jerome suffered complications, Rhonda McCline donated her kidney in 1990. Jerome died in 2004.
"We're the one-kidney club," Rhonda said.
Chris will have to watch his blood pressure, since high blood pressure runs in his family and can affect kidney function. In the event that he ever needs a transplant himself, Chris' donor status puts him on top of the waiting list for a transplant, Gruessner said.
Chris' grandmother is looking forward to having more energy and the freedom to travel without being restricted by her dialysis.
She's expected to go home from the hospital on Sunday. Grandma and grandson are talking about going on a cruise.
"The kidney is working fine. It means everything," Lena said. "It's a very generous act of love for someone to do."
Contact reporter Stephanie Innes at 573-4134 or sinnes@azstarnet.com. Follow her on Twitter at twitter.com/stephanieinnes
http://www.azstarnet.com/allheadlines/322011