Brother, Can You Spare a Kidney?

Brother, Can You Spare a Kidney?
In Need of a Transplant, Etna Native Turns to Her Trusted Sibling

Published 7/26/09
By David Corriveau
Valley News Staff Writer

Etna -- Early in the National Kidney Foundation's book, Waiting for a Transplant, past patients emphasize the following advice to people who want to offer their healthy organs to loved ones:

“The decision to donate must be voluntary and free from emotional duress or family pressure.”

In the case of the Washburn family of Etna, the decision to donate a kidney to 31-year-old Annie Washburn boiled down to a game of chance between all-too-willing volunteers.

“One day in January, I called Murray at work (Cannondale Bicycles in Connecticut) and said, ‘We've got to make a decision,' ” 38-year-old Peter Christian Washburn recalled last week. “We talked about it, and I said, ‘Do you have a coin?' ”

Murray Washburn pulled out a quarter, and flipped it.

“I believe Peter chose tails,” 39-year-old Murray Washburn, a 1988 graduate of Hanover High School, said.

Tails it was.

And on June 29, at Dartmouth-Hitchcock Medical Center, with Murray, 34-year-old sister Winnie, and their parents waiting anxiously, Dr. David Axelrod transplanted one of Peter's kidneys to Annie.

Annie, a 1996 graduate of Hanover High, where she excelled in sports, is spending the rest of the summer recovering in the home in which she grew up. Peter -- namesake of the Peter Christian's Tavern that his father, Murray, once ran in Hanover -- returned home to San Francisco on July 22.

“For a while, when I first found out I needed a new one, I thought I'd get in line for a cadaver donor,” Annie said three weeks later. “I didn't want to put my siblings through it.”

“I think I talked you out of that,” Peter said.

Indeed, Peter was the first person Annie called after learning that kidney failure -- apparently triggered by a bout with a skin condition called Henoch-Schonlein purpura in her teens -- was causing her intense headaches and vomiting last summer. Basically, proteins were clogging her kidneys, sending her blood pressure sky-high and poisoning her.

“I said, ‘Well, you can have one of mine,' ” said Peter, who develops software and does math for the Charles Schwab investment firm. “Then, all of our siblings said the same thing.”

While their parents fretted …

“Since December,” Karen Washburn recalled, “Murray and I were waking up in the morning, crying, and at other times raising our hands to heaven and saying, what can be done?”

They're doing quite a bit more than when Karen Washburn worked at the Cleveland Clinic in Ohio in the 1960s, watching some of the pioneering work with kidney transplants.

“It was scary then,” the mother said. “I had a whole different concept of what it was like. To see how far the science has come is amazing.”

While the science has advanced light-years, the matching of donors to patients remains an emotionally fraught exercise in bureaucracy and timing. On its Web site -- www.ustransplant.org -- the Scientific Registry of Transplant Recipients reports that 10,551 patients received donations of kidneys in calendar year 2008 from people who had just died, and almost 6,000 received them from living donors.

Meanwhile, the year 2008 opened with 75,834 patients waiting for donations, and ended with 80,972 on the waiting list.

“Typically, it'll take four years to get one (by going on the donor registry),” Annie said. “Four years of dialysis is not my idea of a good time. I can't even imagine. I can't believe people wait that long.”

Even with three willing, genetically related and healthy living donors, it took months for the Washburns to make everything fall into place.

“Typically, I guess it costs so much just to test one donor,” Annie said. “But they eventually went with it … after some coercion.”

Then came the long-distance exchange of test results from far-flung locations: Annie analyzes environmental data for a power plant in Wyoming, while Peter works in California.

“They do everything on faxes,” Peter recalled. “It took, like, three months for something that, in my opinion, could have been done in a week.”

At first, the Washburns considered kidney centers in the Rocky Mountain area -- within the coverage area of Annie's employer's medical-insurance carrier. Eventually, however, both Annie and Peter won approval to undergo the procedure at DHMC, where they could recuperate at home without the insurance companies needing to pay for family housing and other expenses.

Also, co-workers donated personal and vacation time, allowing both siblings maximum time to prepare for the operation and time to recuperate.

Finally, they came east in mid-June, Annie with her dog, her fiance and her various medications, Peter with his dog … and that kidney.

“I was talking to it on the way,” Peter said. “I told it, ‘You're going to go to a new place. It's going to be scary, but you’ll like my sister.’ ”

It liked Annie well enough to make her go to the bathroom every 45 minutes those first few nights after the operation.

“I'm down to about two hours now,” Annie said. “Pete gave me the Super Kidney.”

“It was producing four or five liters (of urine) a day,” Peter said.

“I was up to eight at one point,” the younger sister replied.

Annie estimates that she is now taking seven or eight types of medication a day -- including immuno-suppressants and blood-pressure pills -- at the rate of 11 pills in the morning, three at noon, nine around supper and three at bedtime.

Peter is taking mostly Tylenol for the residual pain as “the nerves start to reconnect down there.”

And the loser of the coin flip is wondering what might have been.

“On the one hand, obviously, there was a sense of relief,” the younger Murray Washburn said in an e-mail. “I had just taken a new position at my company and started bike racing again, so the time away would've been difficult, not to mention the physical pain and recuperation.

“But the more intense and long-lasting feeling was a strange sense of loss. I'm the eldest of the siblings and had always just assumed that I would be the donor. I had come to terms with the risks and challenges, but really liked the idea of going through the process with Annie. Plus, getting to spend a few months together while we recuperated sounded great. When Pete won the toss, I felt a distinct sadness that that wasn't going to happen.”

“The worst part is, my family is really funny,” Annie said. “It hurts so much to laugh. One day, my sister got me going, and finally, she just had to avoid me for the rest of the day. You forget how funny people are until you can't laugh.”

That said, it beats the alternative.

“Now,” Karen Washburn said, “we're weeping in gratitude.”

http://www.vnews.com/07262009/5873008.htm