Posted on Tue, Apr. 21, 2009
Twin brother is perfect match for kidney transplantBY JOSE PAGLIERY
When Geoff Gackle was diagnosed with a deadly kidney disease, he didn't have far to look for a donor:
His identical twin brother, Greg.
The donor-recipient match wasn't close. It was perfect.
''I don't remember it being something I had to wrestle with. He's my twin brother,'' said Greg Gackle. ``We have this connection in that we're one and the same. We're very different, but we were created together.''
Sitting in his nephrologist's office in August, Geoff Gackle expected bad news. The former life insurance sales representative had just been denied life insurance by the very company he had once worked for: Northwestern Mutual. The level of creatinine in his blood was far too high, about 400 percent above normal.
Dr. Gaspar Barreto-Torrella put it plainly, looking his patient square in the eye.
''You have kidney failure,'' the doctor told him.
``Like, they're gone?''
Barreto-Torrella explained that Geoff Gackle had chronic kidney disease, so his kidneys were functioning together at an unsustainable 22 percent. He'd need another kidney.
OFFERED INSTANTLY
Geoff immediately called his brother, laying out the facts. A minute into the conversation, Greg offered his brother his kidney.
Growing up, the brothers looked so alike they fooled teachers and switched classes. On the basketball court, opponents could only tell them apart by their jersey numbers.
But doctors saw something else: Genetics determined that, as identical twins, a kidney from one was a perfect, 100 percent acceptable match for the other.
Geoff Gackle, 30, was spared the long and arduous wait for a kidney donor.
Surgeons at Jackson Memorial Hospital were ecstatic to hear that Geoff Gackle had a perfect match. The chances that his body would reject the donated organ would be reduced to nearly zero, so he would avoid having to take immunosuppressants that often cause diabetes problems, high blood pressure and an increased risk of infectious disease and cancer.
''The holy grail of transplantation is tolerance,'' said Dr. George W. Burke, chief of the division of kidney and pancreas transplantation at University of Miami/Jackson Memorial Hospital.
Burke said the operation provided Jackson's surgeons the opportunity to experience the third twin-to-twin transplant in two decades.
More importantly, Burke added, it let him put a revitalized Geoff -- a worship leader at University Baptist Church -- back into the community.
For months, the brothers had numerous appointments with specialists and surgeons, who gave the April 9 operation a green light. Greg Gackle, a communications director at the same church, was offered the chance to back down on several occasions.
His response was often the same: No dude, he's my brother.
But the news got worse for Geoff. Just weeks before the operation, a biopsy of one of his damaged kidneys revealed he had focal segmental glomerulosclerosis, or FSGS, a deadly disease whose cause still eludes doctors. The disease meant some segments of the small filters inside his kidneys had been scarred and could no longer filter his blood properly.
Greg Gackle's left kidney changed all that.
In order to keep worried friends at bay, Greg Gackle updated his Twitter account up until the operation and soon afterward, even uploading pictures before the two-hour surgery, which went smoothly.
MONITORING
Now doctors are monitoring how each brother is doing with just one functioning kidney.
Geoff, who said he feels ''at 55 percent'' but is getting stronger, walked slowly across his living room at his Pinecrest home Monday as he clutched his abdomen, which is now scarred by 10 inches of sutures.
Greg, who slowly sat himself down on the couch to keep his back straight, has the dark traces of a small incision circling around his bellybutton.
''He's got my organ now,'' Greg Gackle said. ``I don't know how much closer we can get.''
http://www.miamiherald.com/news/miami-dade/story/1009392.html
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