Ex-babysitter is a perfect match for kidney patient

Ex-babysitter is a perfect match for kidney patient
Donor's gift spares woman years on transplant list

By Rachel Saslow

Carol Cromer and Kendra Dill, a dental hygienist and an assistant, have worked together at a dental practice in Prince George's County for 19 years. When Dill started there, she also babysat for Cromer's daughter, Etienne. Dill was the only non-family member Cromer and her husband trusted to take care of their only child.

"Early on we realized there was something special about Kendra," Cromer says.

Here's how special: On Monday, Dill, now 36 years old, donated one of her kidneys to Etienne Cromer, 23, who lives in Mitchellville. The women are recovering at Johns Hopkins Hospital after their four-hour surgeries.

"I know it sounds strange," says Dill, who lives in Severn. "Why would you just up and do this?"

Etienne Cromer received a diagnosis of minimal change kidney disease in 2002. In the years that followed, the updates about her health were usually negative: The steroids that she took to treat the disorder destroyed her hips, requiring both to be replaced.

Etienne Cromer's kidney disease caused proteinuria, excretion of unusually large amounts of protein, which led to such severe swelling of her face, hands and feet that she sometimes gained 20 pounds in a week.

Meanwhile, Dill faced a trial of her own when her older brother went into kidney failure. Dill was a perfect match to donate a kidney to him, but he also developed lung cancer, which ruled out a transplant. He died in March 2005.

Dill, grieving the death of her brother, wondered, "Why did I find out that I was a perfect match if there was nothing I could do for him?" She decided that the reason was Etienne. She asked Carol Cromer which blood type her daughter was and found out that they were both O-positive. "If she ever gets on a waiting list for a kidney," Dill told Carol Cromer, "let me know." A compatible blood type is essential for a kidney donation, but there are other important factors such as tissue type and general health.

In July 2008, Etienne Cromer went into kidney failure, surprising her doctors because minimal change disease doesn't typically lead to renal failure. They changed her diagnosis to focal segmental glomerulosclerosis, a disease that attacks the kidneys' filtering system.

Carol Cromer and her husband were first to offer a kidney to their daughter, but both were ruled out because they had high blood pressure. Etienne told her mother she didn't feel comfortable asking anyone outside the family to go through such a major surgery for her.

"When Etienne said that she didn't want me to pursue asking anyone to help take her out of her misery, my hands were tied because she's an adult," Carol Cromer remembers. "Although she's my child, she's my adult child. I had to honor her wishes."

Dill says she "kept throwing it out there" to Carol Cromer that she was willing to get tested to see if she was a donor match.

Four months later, Etienne Cromer went on dialysis. She sat hooked up to a filtering machine at a clinic in Largo every Monday, Wednesday and Friday for three hours. Usually, she slept. Sometimes she did homework for the elementary education classes she's taking or watched cooking shows on the Food Network. After dialysis, she remembers feeling "wasted, like I've run a marathon."

She got on the waiting list for a kidney from a deceased donor. Estimated wait time: five to eight years. She started to rethink her position on having a living donor.

"I thought, if this is what Kendra wants to do, I need to let someone help me," Etienne Cromer says.

Also, she had a new motivation to get healthy fast: her baby daughter. When she first got pregnant, the doctors had warned her that she had a 98 percent chance of either miscarrying or delivering a baby with severe birth defects as a result of all the medications she was taking. Etienne Cromer considered the statistic, looked at her mother and said, "There's still 2 percent, Mom." ("The thing about percentages," Etienne Cromer says, "is that I'm used to ending up on the smaller side.") She delivered a healthy baby girl on March 20, 2008.

At the Dental Group, Carol Cromer gave Dill the phone number to call to arrange kidney donor testing. Dill let it hang on her refrigerator door for a few days. Her husband told her to think one step at a time: See if you're a match, learn about the risks, make a decision. Dill was already thinking about the surgery.

"I needed my husband to understand that I would go this far," she says. "That if I was a match there was no turning back."

She made the call. Blood and urine tests, a CT scan, an EKG and a chest X-ray all proved Dill to be an excellent match for Etienne Cromer.

Most people supported Dill's decision to donate a kidney, but some of them asked, "Are you crazy? That's a long recovery and you're a mother of two." Dill is expected to stay in the hospital Tuesday and Wednesday. The risks of donating a kidney are the same as with any major surgery, such as bleeding and infection. She will be able to lead a normal, active life with one kidney, and it does not affect her ability to have more children.

Etienne Cromer will recover at the hospital for seven to 10 days. She'll take anti-rejection medication and her doctors will monitor her closely for two months. Focal segmental glomerulosclerosis is an autoimmune disease; some people who have kidney transplants go on to live normal lives, but in other cases the disease comes back to attack the new kidney.

"I'm excited for Etienne because my vision is it gets her off the dialysis machine and gives her the energy to play with her little girl," Dill says.

http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902995.html