Siblings go through kidney transplant

Siblings go through kidney transplant

Updated: Saturday, 27 Jun 2009, 9:02 PM EDT
Published : Saturday, 27 Jun 2009, 7:32 PM EDT

* Alyssa Ivanson

FORT WAYNE, Ind. (WANE) - Brent Doctor was an active person. He grew up helping his father on the farm and was a professional kickboxer. Sitting for several hours each day is not his idea of a good time, but that's what he has to do for his dialysis treatments.

"It's now a part of my life. I do four dialysis treatments a day and each takes 30 to 40 minutes," Doctor said.

When he was 12 years old, Doctor was diagnosed with Type 1 diabetes. Diabetes is a leading cause of kidney failure, or end-stage renal disease.

"Diabetics on dialysis have a three year survival rate of only 35 percent, so they need a transplant and they need it now," Lutheran Hospital Kidney Transplant Program Director and Surgeon Dr. Tarik Kizilisik said.

Doctor, 30, went into the hospital in November 2008 with kidney failure. He started dialysis at home in December. But, he didn't have to wait for a kidney long.

"I have an extra one for a reason and thankfully I get to help him out," Doctor's half sister Jenny McConnell said.

Doctor was adopted as a baby. When he was 18, he put his information up on an adoption Web site. Four years ago, Doctor's birth mom found him.

"We're still getting to know each other, but it seems like we were never apart. He fits in so well with us and has so many similarities to our mother, it's like I've known him my whole life," McConnell said.

Last April, their mother, who also has diabetes, needed a kidney transplant. McConnell, 26, wasn't a match.

"When I couldn't help her, I wanted to help him, no questions. I never hesitated. I knew it was going to come, but I didn't know it would be so early," McConnell said.

Just a few months later Doctor went into kidney failure. This time, McConnell was a match.

"We were very excited and it's creating a stronger bond," Doctor said.

After the transplant, Doctor's looking forward to spending more time being active with his daughter, 8-year-old Cara, and going back to school to be a nurse to work with other diabetics.

McConnell's also a mom. Her son, 4-year-old Bryce, said he's going to help her get well after the surgery.

"He gave me a big hug and kiss and told me good luck and that he was in my heart no matter what," McConnell said.

McConnell hopes the surgery will motivate her to be healthy.

"It's going to make me live a healthier lifestyle so down the road I won't become a diabetic," McConnell said.

The Transplant Surgery

Doctor and McConnell's transplant was scheduled for Wednesday morning at the Lutheran Hospital Kidney Transplant Center. It started two years ago, and outside of Indianapolis, is the only other place for kidney transplants in Indiana, said Dr. Kizilisik.

Doctor's transplant was the center's 52nd.

"I would like to have more. I wish we had 150. We have a great team here. We're ready. We could do two or three transplants a day, just show me the organs," Dr. Kizilisik said.

At Lutheran, there are 69 patients on the waiting list for a kidney and another 88 are getting evaluated.

"Since opening this program, patients aren't traveling and spending a lot of time and money. Now they can come to us," Dr. Kizilisik said.

He added Lutheran is doing the follow-up care for about 500 patients who already had transplants. Kizilisik said Lutheran is also one of the few transplant centers in the country to use robotic surgery for the donor patient.

Technology over the years has changed the donor surgery. The donor used to have a painful incision that cut the muscle under the rib cage.

Now at Lutheran, Dr. Erik Weise uses the da Vinci robot to take the kidney out.

"Removing a kidney from a living patient is a procedure where nothing can go wrong. It's one of the highest stakes surgeries we do," Weise, the Director of Robotic Surgery at Lutheran said.

Weise can also do the surgery laparoscopically. Either way, the incisions are much smaller and heal much faster. There are three incisions in the abdomen about the size of a pinky finger and then another cut either above the belly button or in the groin to remove the kidney.

"The kidney is attached by blood vessels and the urine tube, which takes urine to the bladder. I free up the kidney inside through the three small little holes, and cut the urine channel and make sure the kidney is making good urine," Weise said. "Then I make a small incision, remove the blood flow and remove the kidney immediately, so it's deprived of blood for a very short time."

Dr. Weise used a stapler with tiny staples to cut off the vein and artery connected to the kidney. The kidney is put in a bag and then pulled out of the donor's body.

While Dr. Weise was working on freeing up McConnell's kidney, Dr. Kizilisik was in the operating room next door preparing Doctor to receive the new kidney.

"I open and prepare where we will put the kidney in while the donor surgery is happening," Dr. Kizilisik said.

Dr. Kizilisik came into the donor surgery and was standing buy with a bucket of ice. As soon as the kidney came out of McConnell, Dr. Weise put it

in the bucket.

Dr. Kizilisik started working on the kidney to make sure it was a good organ. He also started flushing it to get all of McConnell's blood out of it and cooled it down in ice. After working on it for a few minutes, he carried it through a short hallway into the operating room where Doctor was ready for the transplant.

Once the kidney was out, Dr. Weise's surgical team started the process of closing McConnell up to finish her surgery. Her surgery lasted about two hours.

Once he was in the second operating room, Dr. Kizilisik continued to work on the kidney, making sure all the blood was flushed out. He also marked the veins and arteries to make it easier to connect them in Doctor's body.

After connecting the blood flow of McConnell's kidney in Doctor's body, Dr. Kizilisik used a doppler machine to make sure blood was beating through it.

Dr. Kizilisik also checked to make sure the kidney was making urine by squeezing the ureter, which connects to the bladder. When urine spayed out, he knew the kidney was working.

"The kidney is put in the groin area, not where the native kidneys are. Because we have to hook the kidney artery and vein to the vessels and hood the ureter to the bladder, for that the most suitable area is the groin," Dr. Kizilisik said.

After the ureter was connected to the bladder, the surgical team checked the urine meter bag to make sure Doctor's new kidney was functioning.

Two days after surgery, both McConnell and Doctor were doing well. McConnell was scheduled to go home from the hospital on Friday and Doctor should be able to go home on Monday.

Now that the surgery is over, Doctor will go to Lutheran for checkups two times a week for the first month.

"We follow them very closely and act proactively if there are any problems," Dr. Kizilisik said.

That close follow-up care is one reason Kizilisik said Lutheran's kidney rejection rate is 6 percent when the usual rejection rate of a kidney transplant is around 15 to 20 percent.

Doctor will also take immunosuppressant medications to help prevent his body from rejecting the kidney for the life of his transplanted kidney.

Kidneys from a living donor can last about 15 to 20 years, while a kidney transplanted from a cadaver, or person who died, lasts about 10 to 12 years.

Organ Donation and Transplant Wait Lists

Dr. Kizilisik said about 100,000 people in the United States are waiting to get a transplanted kidney. Only about 15,000 to 16,000 kidneys come from cadavers a year, and that leaves a large gap of people who still need a kidney.

That gap is widening and wait times are getting longer. The average wait time in Indiana for kidney is three years. Two years ago the wait time was about 18 months, Dr. Kizilisik said.

He said people living longer and better diagnosis of kidney failure are contributing to the longer wait times.

"People die waiting for a kidney. We need more organs," Dr. Kizilisik.

Almost half of the transplants at Lutheran so far have been from living donors. Usually the donor knows the recipient, but two people have volunteered to donate their kidney without having a recipient in mind.

"We're particularly touched with patients who come in unattached. It's wonderful to be a part of when a healthy person gives someone with medical needs the gift of life," Dr. Weise said.

Dr. Kizilisik said people can survive on dialysis for several years, but it's not meant as a long term treatment. It's designed to keep the people waiting for a transplant alive long enough to get a new organ.

"If there's ever the opportunity to do something really great for someone else, even if it's just a test, even if you aren't a match, I wouldn't hesitate to do it," McConnell said.
McConnell isn't worried about having one kidney.

"Actually 60 percent of one kidney is enough. So why did God give us two kidneys? God gave us two kidneys so we can donate one of them," Dr. Kizilisik said.

If someone donates a kidney and has kidney problems later in life, Dr. Weise said that person is moved to the top of the waiting list.

"It's very rare for a patient who donates a kidney to get into trouble. Someone who is a candidate for kidney donation is screened to have two perfect kidneys," Dr. Weise said.

For more information, contact Lutheran Hospital Kidney Transplant Center at (260) 435-6275.

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