Kidney donors' gifts stretch beyond suburbsBy Anna Madrzyk | Daily Herald Staff
Published: 6/7/2010 12:05 AM
Cara Yesawich didn't want to wait until she died to become an organ donor.
In one amazing act, the 54-year-old marketing consultant changed the lives of eight people.
Yesawich was the "domino" that started an eight-way kidney exchange at Northwestern Memorial Hospital in Chicago - one of the nation's largest kidney swaps in a single hospital. The surgeries took place over three days in late April.
Yesawich's kidney went to Dan Becker, a 52-year-old Naperville veterinarian who has had diabetes since he was 3.
In turn, Becker's sister - who had wanted to give a kidney to her brother but wasn't a match - donated one instead to a man from Yorkville. His ready-to-donate daughter was a match for another recipient. And so on.
"Cara put the whole thing in motion," a grateful Becker said.
Yesawich is one of a small but growing number of altruistic or Good Samaritan donors willing to give up a kidney simply to help a stranger.
In March, Loyola University Medical Center in Maywood launched its Pay-it-Forward Kidney Donation Program, the first of its kind in the Midwest, with four altruistic donors. Since then, 21 more potential donors have stepped forward. They are in the screening process, but could eventually start chains that would result in scores of transplanted kidneys.
While still rare, the concept of the Good Samaritan donor is gaining acceptance from the public and the medical ethicists. Not that long ago, "the general thought was, 'Why is someone coming forward to give a kidney - are they nuts?'" said Dr. John Friedewald, transplant nephrologist at Northwestern. "What we've found is that there are a lot of people who are consistent blood donors or do a lot of volunteering and they want to continue that trend."
More than 85,000 people nationwide are waiting for kidneys. Many of these desperately ill patients have a family member or friend who is willing to donate, but isn't a match.
In a paired exchange, the kidney patient and non-matching would-be donor are paired with a compatible donor-recipient pair and they swap kidneys.
The recent eight-way swap at Northwestern was a domino paired kidney exchange, or a closed-chain transplant. Most paired exchanges don't require an altruistic donor, but this one needed Cara Yesawich for all the matches to work. In this situation, there is one extra donor, and his or her kidney can go either to someone on the transplant waiting list or to start another chain.
In theory, a kidney chain involving hospitals throughout the country could go on forever.
"I believe if we work at the national level using chain theory and collaboration, we can dramatically reduce the waiting list," said Dr. John Milner, kidney transplant surgeon at Loyola. "If enough 'pay it forward' donors come forward, we would have no waiting list."
Loyola is working with the National Kidney Registry to coordinate the donations. Tim Joos, 53, of St. Charles, was one of the first donors in the Pay-it-Forward program; his kidney was packed on ice and flown to a patient in Pennsylvania.
The United Network for Organ Sharing (UNOS) will pilot a national program this fall to get more medical centers involved in paired exchanges. The pilot program will involve a limited number of centers, and then expand to create a national pool of incompatible donor-recipient pairs, said Northwestern's Friedewald, chairman of the UNOS committee on paired exchanges.
Some Good Samaritan donors want to give their kidneys to specific individuals whose stories have touched their hearts.
Yesawich says she would have gladly done so if that's how it had worked out. But she also liked the idea of being the "domino" setting in motion a chain of transplants.
"If you're going to give, why not go for the gusto and get the most out of the kidney you can?" she said.
Yesawich, a Chicago resident, started thinking about kidney donation four years ago. While in California on business, she went to gala fundraiser for kidney disease. Two tables away, a couple was waiting for a kidney donor for their 4-year-old son. Their pager went off during dinner.
"It was so overwhelming," Yesawich said. "That was when I knew I wanted to do it."
But the timing wasn't right. Then, last year, she was laid off. It was devastating, but she figured she could take time out from job hunting to donate a kidney.
"I knew this was something I wanted to accomplish, and I didn't have time before," Yesawich said.
In January, she filled out her paperwork for Northwestern's living donor kidney transplant program. The next step was extensive screening to make sure the donor has two healthy kidneys and rule out underlying medical or psychological issues. Living donors meet with a social worker and a psychiatrist to make sure they aren't donating for the wrong reasons.
Yesawich's surgery was minimally invasive. Using a laparoscope, surgeons worked through two small incisions in her side to loosen the kidney. Then they pulled it out through a 5-inch incision in the bikini line.
She didn't feel great pain afterward, but it was "uncomfortable, certainly," she said. "Two weeks after, I felt pretty good."
There is some risk to any surgery, including the risks of general anesthesia. But recent studies support the long-term safety of living kidney donation. And in the unlikely event a donor ever needs a kidney, he will be bumped to the top of the waiting list.
Yesawich wanted to meet her recipient, and vice versa.
"I told Dan, 'if you find yourself craving dark chocolate, that's me,'" she joked.
Becker's kidney function numbers were normal before he even left the hospital two days after surgery. After months on dialysis, he feels great.
He plans to return to work at Boulder Terrace Animal Hospital in Naperville on Aug. 1, or sooner.
"Basically, (the transplant) gave me my life back," he said.
And Cara Yesawich believes she has found the answer to why people have two kidneys, when we can function perfectly well with one.
"I like to think it's for sharing," she says.
Becoming a kidney donor
More than 85,000 people nationwide are on the waiting list for kidney transplants. Here are some resources to learn more about kidney donation:
• Northwestern Memorial Hospital living donor kidney transplant program, (312) 695-0828
• Loyola University Medical Center Pay-it-Forward Kidney Donation Program, call the kidney transplant coordinator at (708) 216-3454 on weekdays
• The National Kidney Foundation of Illinois, (312) 321-1500, nkfi.org
• MatchingDonors.com, (781) 821-2204
• Living Kidney Donor Network, (312) 473-3772 or lkdn.org
• Cara Yesawich's blog: simplycara.blogspot.com
• National Kidney Registry, kidneyregistry.org
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