Outlook positive after woman donates kidney to twin

Outlook positive after woman donates kidney to twin
After woman's mom, twin sister donate life-saving organ, the three share a unique bond and special understanding

By Elizabeth Johnson • THE TENNESSEAN • July 22, 2010

SPRING HILL — Jenny and Cristy Purky have been virtually inseparable since taking their first breath.

From the womb to their friendship and now their Spring Hill home, the 28-year-old twins have shared most everything — except good health.

In that realm, they couldn't be more different.

Cristy, who had never undergone surgery and never even had stitches, donated one of her kidneys to her sister, who had spent the past four years on peritoneal dialysis after an earlier transplant failed.

"She lives at the doctor, and I never go," Cristy said.
Lives diverge at 18 months

Eighteen months after being born prematurely, Jenny began to face health problems, said their mother, Maggie Purky of Franklin.

"She's had kidney failure for many years," said Stanley Lee, Jenny's doctor and medical director of the renal transplant program at St. Thomas Hospital in Nashville. "It's been ongoing for most of her life."

With one kidney functioning, Jenny was able to live like any other child, being monitored by doctors semiannually. But as she got older, her other kidney started failing.

Compatibility tests determined that her sister was a perfect match, but the family opted to take a different route. In 2001, Maggie, a four-out-of-six match, donated a kidney to her then-18-year-old daughter.

Human Leukocyte Antigen matching is a means for determining how well the donor's tissues match the recipient's. Generally, HLA matching looks at six primary antigens. A perfect match is sometimes referred to as a "six out of six match."

"I was a very good match, and (Cristy) was still quite young," Maggie said. "Most people who need a transplant will need more than one in their lifetime. So, we, and her doctors, were saving the best for last."

After graduating from Centennial High School, Jenny and Cristy went off to college and found jobs. Cristy works in customer service at Bed, Bath & Beyond, while Jenny worked as a medical assistant until her mother's donated kidney was rejected almost seven years after the operation.

Reluctantly, Jenny went on peritoneal dialysis, a treatment that she said performs only 15 percent of a kidney's regular function.

"She was very frail," Maggie said of Jenny, who was spending 10 hours a day on dialysis. "I don't think her body would have lasted much longer. . . . Jenny had some serious health issues and transplant surgery was not possible during those times."

Although Cristy had anticipated what would happen next, the healthy sister was hesitant about the inevitable operation.

"I had never had surgery or stitches or anything," Cristy said. "It was really hard for me to know that I was going to be doing that."

In the end, her choice was simple: save her sister, her best friend.

Jenny was unprepared to accept such a significant gift from her twin.

"I wasn't quite ready for (Cristy) to give me the kidney, because I didn't want her to go through that," Jenny said. "I wanted to make sure she was ready to do it."

Still time to 'say no'

As the June 28 date for the procedure approached, everyone involved went on an emotional roller coaster.

"We were in the operating room and I told her, 'You can still say no. It's OK,' " Jenny said. "I didn't want her to feel like she had to save my life, but I'm glad she did."

Although fear was ever-present, a feeling of tranquility spread over both sisters just before the surgery. Relief overwhelmed them when it was over.

"There was a lot of anxiety at first, and then a calm," Jenny said. "You know what you need to do, and you're going to do it."

The operation went as planned. Maggie, who was updated throughout the surgeries, said, "The kidney started immediately working, right there on the table."

Robert Taylor, a nephrologist and part of the St. Thomas transplant team, said because they are twins, Jenny and Cristy's immune systems are a close match, genetically — an important component to a successful transplant.

"(Jenny) has an extremely well-matched kidney that is functioning as well as could be expected," he said. "It's hard to explain how this impacts her life over the long term, both physically and psychologically."

Mother, daughters become 'triplets'

With the transplant completed and the twins recovering, Cristy says she would do it all over again.

"For two people in my life to give me a second chance is really overwhelming," Jenny said. "I don't know how to put it into words. It's a long process to realize that someone is willing to give up that much for you."

Mom and daughters consider themselves triplets, each having just one kidney, and the bond between the twins has never been stronger. The three wear silver, kidney-shape necklaces to commemorate their unique situation.

Cristy is expected to make a full recovery by the end of August, but most likely it will be two years before Jenny fully recovers and her body completely accepts a foreign organ, the family said.

The Purkys are remaining optimistic of the kidney's 20-year "half-life," meaning half of transplants will be rejected before 20 years after the transplant and half will work fine beyond that, Maggie said.

"Really, you can't put a number on it," St. Thomas' Lee said. "It's an excellent long-term outlook."

Taylor agrees the outlook is positive.

"Forever," Cristy said. "That's what we're going for."

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