The chain of life: Kidney exchange pools doctors, donors, recipientsBy Matt Canham
Salt Lake Tribune
Updated:08/11/2009 10:24:03 AM MDT
Washington-- Shaking off the anesthetic, Jordan Brough sat up in his hospital bed. He gathered himself, cleared his throat and tested his voice. Then he picked up the phone and dialed.
"Hey Mom, guess what I did today?"
What he did was donate a kidney to a complete stranger, kicking off a massive 14-person exchange involving a novel new medical procedure.
What he did was answer the prayers of a 61-year-old great-grandmother who had been tethered to a dialysis machine.
What he did was thoroughly upset his mom -- but just temporarily.
"She freaked out," said Brough, a 29-year-old Salt Lake City native who is now a graduate student at George Washington University. "But she calmed down. Now she's proud of me."
Why not? » Brough said he wasn't even aware that people only needed one kidney until he tuned in to his favorite radio program, "This American Life," about two years ago.
In one segment, Chaya Lipschutz, a Jewish woman from Brooklyn, explained how she came to be what is called an "altruistic donor" and how she felt guilty keeping it from her mother until after the surgery. Turns out that once her mom had some time to let it sink in, she became quite supportive. Sound familiar?
The story moved Brough, who kept thinking "Why not?"
As a man who loves science, he dug into the particulars, learning how the surgery is performed, what the recovery time is and how it could impact his health. He found out that people who donate a kidney have no decrease in their life expectancy, no real increase in disease and are usually back to full health in a couple weeks.
"If I can help somebody and it wouldn't really affect my life physically, why not?" he thought.
He decided to do it, but then life got in the way. He adopted a baby boy. He moved to Virginia with his young family to change careers from graphic design to forensics.
The idea resurfaced, though, when he saw a local TV news piece about a kidney transplant at Georgetown University Hospital. He made the call in January and was a little surprised at how eagerly doctors responded. He was rushed through a battery of tests to determine if he was physically and emotionally capable of giving someone an organ.
Six months passed before he got the phone call. Doctors found a match and more importantly, they needed his help to do something that has never been done before.
Creating the chain » The pioneering group included sisters, brothers, husbands, cousins and friends, all willing to give a kidney to help an ailing loved one. But none was a perfect match for the person they were trying to help.
So medical teams played matchmaker, saying the husband's kidney wouldn't work for his wife, but it would help this woman over here. And that woman's brother is a good match for this other woman.
And so on, creating a chain of eight people. Two other, smaller chains also were created in the 14-person exchange.
But the docs couldn't make it work without two altruistic donors, sometimes called Good Samaritan donors, who were willing to give a kidney to someone they did not know. They are not unheard of but they are still pretty rare.
Brough was the first to have his kidney extracted on July 16. The rest took place over the next week, involving medical teams at two hospitals.
The kidney exchange was groundbreaking and not just because of the number of people involved. All seven of the recipients had developed antibodies that made traditional organ transplantation nearly impossible.
But a team of doctors, including Keith Melancon, the director of kidney transplants at Georgetown University Hospital, created a way to filter those antibodies out of the blood.
They call the procedure plasmapheresis and it should make it easier to perform kidney transplants, particularly for blacks who tend to have higher counts of antibodies.
Right now, there are about 6,000 people on dialysis in the Washington area and only about 250 kidney transplants are performed every year.
"Using plasmapheresis, we hope to double that number," Melancon said.
Not worth living » Elizabeth Garner had always been an active woman, deriving joy from chasing around her kids, grandkids and now her three great-grandchildren. But two years ago, her kidneys failed and she has survived only with the help of a dialysis machine that cleaned the toxins from her blood.
She was in constant pain and lethargic. She thought that dying wasn't such a bad option.
"I had got to the point that I did not want to live if I had to be on dialysis," said Garner, who resides in Clinton, Md. "I know that dialysis keeps you alive, but a kidney lets you live."
Her husband, Larry McPhatter, was more than willing to give her one of his kidneys, but he wasn't a good match. So McPhatter agreed to donate to a stranger and in exchange, Brough's kidney would go to his wife.
It was Brough's first major surgery and while he felt fairly comfortable with the science, he couldn't help being nervous.
"The whole time I felt a little selfish," he said. He had a young family and if something went wrong, who would take care of them?
His wife Misty was very excited when he told her of his plan, but she, too, became a little anxious in the days before the procedure.
An immediate connection » Brough woke up to find a couple small holes in his abdomen and a five-inch incision along his hipline.The surgery went well and while he didn't know it, in another surgical bay in Georgetown University Hospital, his healthy kidney was being transplanted into Garner.
Brough spent two days in the hospital and a week later he was back in class. He went from feeling selfish to feeling oddly detached. He said it felt like he had his appendix removed and his life quickly returned to normal.
But just last week, the seven donors met the seven recipients, many for the first time. Garner looked up from her wheelchair to see a tall young white man coming her way. She started crying and simply couldn't stop.
"He almost lifted me out of the wheelchair to give me a hug," she said. "He gave me the most wonderful embrace."
Brough said he isn't normally a "touchy-feely guy" but he couldn't help himself. "I immediately felt a connection to her."
They held hands and tried to talk, but Garner had a hard time coming up with what to say because "thank you" seemed so small in that moment. Even now, weeks later, she still finds it difficult to express the magnitude of her appreciation.
"In his heart, he knew he wanted to help somebody and I thank God I was that person," she said. "He is such a gentleman, such a loving man."
Brough, for his part, has a hard time explaining his feelings, too, saying the whole experience has been "very humbling." Other than a small scar, he is back to his normal routine, while Garner's life is dramatically altered.
Their story and that of the larger kidney exchange was profiled on the "Today Show," NBC Nightly News and CNN among others. And while Brough said he is uncomfortable with all the attention, he does hope that he may inspire someone, just like Chaya Lipschutz inspired him.
And he plans on staying in touch with Garner and her husband, Larry.
"We'll be good friends for life," he said.
Once she gets a little stronger, Garner hopes she can do something for Brough.
"First thing I can do is baby-sit for him for a weekend and they can go have some fun," she said. "That's what I told Jordan. His little kid will fit right in."
mcanham@sltrib.com
http://www.sltrib.com/news/ci_13032478
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