Transplant: Both donor and recipient encourage living organ donations

N.B. man donates kidney to friend in need
Both donor and recipient encourage living organ donations
BY JENNIFER AMATO

Three years ago, Ken Budrow went to have routine blood work done at the doctor's office.

Otherwise healthy and living an active lifestyle, he thought it was a routine checkup.

Instead, the North Brunswick resident was diagnosed with IgA nephropathy kidney disease, which is a breakdown of the kidneys over a prolonged period of time. His protein levels indicated renal failure and he was told that within five to 10 years he would have complete kidney failure.

Budrow said the doctors do not know why he got sick, or if he could have prevented it.

"By the time you are sick, you don't even realize you're sick, and by the time you do realize it, you're in a crisis in the hospital," he said.

Instead of holding out for at least five years, this past December, Budrow's condition began to decline. In order to be put on a transplant list, his kidneys had to be at a 25-percent functioning rate, and he began preparing to find a match by having chest X-rays, CAT scans and blood work done to develop his makeup for a possible match. However, statistics show that a transplant patient does not receive a kidney for about 4½ years.

From January to April his health continued to decline steadily, with creatinine levels rising and chemicals building up in his body. His kidneys could not eliminate excess vitamins and minerals so he could not eat rich fruits and vegetables; levels of potassium, phosphorus and protein built up so he had to eliminate other foods; excess fluids would not be excreted and instead would build up and cause extreme bloating in the face and feet, so he was limited to 16 ounces of liquids per day; and red blood cell production decreased because the kidneys could not signal the bone marrow to make more, so anemia set in, causing sensations of cold and lethargy.

"It's kind of silent. You don't realize you're getting sick when you are," Budrow said.

In the meantime, the 46-year-old father of three began dialysis. He started with three days of hemodialysis for 4½ hours each day, going after work to be attached to a machine that would filter toxins out of his blood.

He also had a catheter surgically inserted into his stomach to enable peritoneal dialysis, which he could instead do for nine hours each night at home. A glucose solution would filter through his blood while he was asleep.

Although the suitcase-sized machine enabled him to travel more easily and didn't interfere with his work schedule as much, he was always cautious of infections.

"It was very draining. It was a very difficult process," he said. "For some people, they prefer the method because it's not as traumatic to the body as hemo is … because PD is nine hours a day every day, it's a slow, gentle healing, so it's less impactful to your body."

He said his supervisor, Charlie Sams, director of dining services at Rutgers University, told him to make his health a priority and encouraged him to be aggressive in his treatment.

So Budrow applied for a kidney at the Kidney and Pancreas Transplant Center at Robert Wood Johnson University Hospital in New Brunswick, as well as in the region of Philadelphia. He said that 20 percent of those on the waiting list will die before they get a kidney, which is why the need for living donors is so great. He said that only 30 percent of the operations performed at RWJUH are from living donors instead of cadavers.

Budrow had seven of his relatives tested, but they were each eliminated because of blood-type mismatches or other issues.

Sam DeStefano, 44, of North Brunswick, a friend since 1987, said he kept asking Budrow if he wanted him to get tested, but Budrow kept holding off. The two began working together at the Somerset Hilton and then the Short Hills Hilton as banquet captains, and Budrow's wife introduced DeStefano to his wife.

"I hated to see that. He's got three kids," DeStefano said of helping his

friend.

"It's a big thing to ask of somebody, and it's not easy to do," Budrow commented.

DeStefano finally went to get tested and he was confirmed as a match.

"I was ecstatic. I never gave it a second thought," the father of two said, mentioning that his family was nervous but very supportive of his decision.

DeStefano spent about 15 hours at the hospital, having tests done and learning about every step of the transplant process. He said the kidney transplant center at RWJUH was very professional and spoke honestly about every step of the procedure, both pre- and post-operation.

He also said that the recipient's health insurance company covers all costs for the donor, so donors are treated very well. He said that because of the extensive medical testing, the donor will find out if he or she has any underlying health issues.

"You'll know if you're healthy — for free," he said.

Two weeks later, on June 30, DeStefano began his surgery around 7:30 a.m. with Dr. David Laskow, the head transplant doctor at the hospital. He found out three days before the surgery that it would not be laparoscopic and would instead be a full cut, so he would experience a longer recovery time. Yet he said his employer, Hormel in New York City, was very supportive of his needs.

Almost two hours later Dr. Adena Osband, a transplant surgeon, began Budrow's surgery in a separate room. The kidney was taken out of DeStefano, put on ice, flushed out and then inserted into the front of Budrow's stomach, to the right of his belly button.

Budrow's two kidneys were left in place, he said, because the kidneys are so well-protected by the body that it could be dangerous to remove them, and that doctors have not found any disadvantages to leaving the nonfunctioning kidney inside. He said he met a patient in the hospital who had four kidneys in place.

"It was kind of unreal," Budrow said of the five-hour process. "From the time I found out he was a match to the time I found out we were having the surgery, I was numb, I guess. … What a transplant is, it's like an instant cure. A donor can very instantly alter the course of what is a debilitating disease … and this is one example of a perfect remedy."

Budrow left the hospital within three days, and DeStefano was discharged after four days. The only long-term side effects are that DeStefano, as a donor, cannot take aspirin. If he needs a kidney of his own at any point in the future, he will automatically be placed at the top of the waiting list and could see a kidney in just a week or two.

For Budrow, his improvement was instant.

"When they wheeled him into my room, I knew he was better because he had color. I noticed right away because , he was gray," DeStefano said.

Budrow now should be healthy for the rest of his life. There is an average success rate of 98 percent for the first year.

He has no more dietary restrictions, and healthwise he is in the same condition as two years ago, which was "perfectly normal," he said. He does have to take immunosuppressant drugs for the rest of his life to make sure his body does not reject the kidney. He is more susceptible to picking up germs and must be careful in the sunlight because the medication causes a 10-times greater risk of skin cancer. He also cannot have grapefruit juice or pomegranates because they counteract the effects of the medication.

"How grateful I am to Sam," Budrow said, considering the minor prescription-related inconveniences.

DeStefano said that there is "no reason that if you know someone, they can't be tested" and that everyone should check off the organ donor option on their driver's license. He said that donating to a random stranger as a living person can be a remarkable experience as well.

"When it comes down to it, there is no reason there should be a 4½-year wait for a kidney," he said.

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