6 strangers, 6 recipients in kidney donation web

[okarol]

6 strangers, 6 recipients in kidney donation web

Oct. 10, 2010, 11:07 a.m. PDT
The Oregonian

PORTLAND, Ore. (AP) — In the hospital's tiny waiting room, Corrie Oliva taps on her laptop, but does little work. She fidgets in her chair, makes small talk with her father and listens for any updates on her mother, Julie Bergeron.

Three floors below, a surgeon walks down a hall with a kidney smothered in ice from Operating Room 2 to Operating Room 4 — a gift to Bergeron from a stranger.

The donor traveled for the transplant from Southern California to Legacy Good Samaritan Medical Center. His donation triggers a chain of transplants that will allow his brother-in-law in Tulsa to receive a kidney from another stranger.

Back in the waiting room, Joan Nolan sits and waits for news of her brother, John Nolan, on the operating table in Room 2.

His donation is just one of six paired transplants across the country over several weeks. Six strangers give a kidney to six recipients in this intricate web, which requires precise timing, travel and healthy donors — even the common cold can throw a wrench in the plan.

In the middle of the kidney transplant downstairs, Joan Nolan meets Bergeron's family. They hug. The Bergeron family hands her thank you cards, a small gesture of their appreciation. Now, the families are in it together.

Oliva is surprised, but glad to meet her. She likes the idea of Nolan and her family sharing surgery updates.

The 36-year-old will be back at the hospital just a week later so doctors can remove one of her kidneys, which will go to a Washington woman. But for now, her mind is on her mother.

Bergeron first learned of her kidney disease in July 2006. Toxins must be filtered out of the blood by kidneys — one healthy one is enough to do the job — or people face dialysis or a transplant. Or death. But both of Bergeron's kidneys continued to fail until she needed dialysis in April 2008. By January 2009, they placed her name on the official national database for a kidney transplant. Early on, Oliva volunteered her kidney, but a test showed she was not a match for her mother.

Waiting seemed Bergeron's only option.

She struggled more and more with fatigue. She adopted a bland diet that prevented her from indulging in cheesy pizza or meatball subs. A dialysis clinic became her home away from home for three days a week, three-plus hours each time.

"It was quite a process to accept the disease and its entirety," says Bergeron, 64.

Oliva kept pushing, and asking questions "a cute pitbull" is how her mom describes her. Another e-mail to Legacy early this year led Oliva to a different nationwide program, Alliance for Paired Donation, that gave hope to her family. It meant a possible kidney for her mother. The catch: Julie Bergeron needed to find someone to donate on her behalf.

Despite her daughter's unquestioning enthusiasm, Bergeron worried. What if her daughter wanted more children in the future? What if something happened to her during surgery?

Despite her mother's concerns — and against her wishes — Oliva signed up. She had two beautiful children and the risk, if any, was small. The two had always been close. She and her husband and children found a house near her parents in Lake Oswego and they talk at least four times a day.

"I was pretty much determined to be a donor," she says.

After four long hours on the day of the transplant Dr. Michael Kaempf enters the waiting room and finds Joan Nolan.

"He did fine."

Tears slide down her face. She clasps her hands as if she's praying.

An hour later the phone rings at the reception desk. It's for Chuck Bergeron, Julie's husband. It's the first report from Operation Room 4.

Last year, about 4,600 people died in the United States while waiting for a kidney transplant. About 16,800 transplants took place.

When people need a kidney, most put their names on a national waiting list for a new cadaver organ or try to find their own donor. Several factors determine who gets one when from that list. The severity of kidney failure; where someone dies who donates their kidneys; where someone lives and how many other people in a particular region are also waiting.

There's a shortage of kidneys available for transplant. To help meet the need, health care professionals in the late 1980s and early 1990s, began to promote live kidney donations, says Dr. William Bennett, medical director for Legacy Transplant Services.

Research also shows that recipients lived longer, in some cases twice as long, when they receive kidneys from live donors. There is a lower rejection rate and fewer anti-rejection drugs are needed. Doctors say a live donor even trumps a "perfect match" between a cadaver donor and recipient.

The goal of the Alliance for Paired Donation, founded in 2006, is to get more kidneys to more people who need them. Since the first match in 2007, the organization has found kidneys for 62 people.

It works like this. A loved one, willing and healthy enough to give a kidney, doesn't match mom — just like Oliva and Bergeron. But someone matches Bergeron, like John Nolan. He tried to donate to his brother in law but wasn't a match. The Alliance put those two together from their web of participants and kidney connections were made.

"I think that's the No. 1 thing is that it shortens the wait time," says Laurie Reece, executive director of the Alliance. "It allows people who don't stand much of a chance on the national list to get a kidney."

Once a month, the Alliance's computers assign points for various factors: Are participants willing to travel? What is the maximum body mass of a donor that the recipient is willing to accept? The system also looks for compatibility of blood and tissue type.

Thirty states have transplant programs that participate in the Alliance, including Legacy Transplant Services in Portland, which signed on last year. In Oregon, OHSU Hospital and the Veterans Affairs Medical Center in Portland also offer kidney transplants. Bergeron's kidney transplant is the first Alliance match in Oregon.

"It's a huge process, but now it's pretty well established and it's starting to gain steam around the country," Legacy's Bennett says.

A national pilot program, backed by the government and aimed at expanding paired donations, combines efforts from four coordinating centers, which will partner with 77 transplant centers. That also includes the Alliance for Paired Donation. Together, they will work with the pool of candidates in the United Network for Organ Sharing, the national transplant database.

After Bergeron spent 18 months on the waiting list for the national waiting list, her daughter signed up for paired donation with the Alliance this past June.

A month later, the family got word: a possible kidney match.

Bergeron's husband, Chuck, has the best news from Operating Room 4.

"It went well."

Daughter Corrie Oliva and other family and friends in the waiting room can exhale. Soon after, Dr. Viken Douzdjian also stops by to fill in the gaps on Bergeron's surgery and her recovery.

"It was routine. The kidney looked really good."

Joan Nolan, whose brother's kidney is expected to keep Bergeron alive and off dialysis, gives the father and daughter a long embrace.

"How amazing the whole process is," Chuck Bergeron says, "to take a part of somebody else and make a new life for somebody."

The families say their goodbyes and promise to check in on one another — but at this very moment, they want to head to separate hospital rooms to see their loved ones.

Two days after her mother's transplant, Oliva is back at the hospital, but this time waiting for her pre-op appointment. The pre-transplant coordinator approaches Oliva and asks if she'd like to meet her kidney's recipient.

By fluke, both Oliva and Cindy Lonborg end up in the room at the same time. Normally, donors and recipients don't meet until after the surgery.

Lonborg, 68, has traveled about 100 miles from Oakville, Wash., for her pre-ops. She signed up for a paired donation in the spring. In September, she found out she had a match. She hopes her bouts of fatigue will end with Oliva's healthy kidney.

Oliva turns around and Lonborg is immediately at ease. Yes, she's healthy, but more importantly, a quick conversation reveals that Oliva has no reservations about the surgery.

"It's nice to be able to tell her thank you," Lonborg says. "Now I worry about her, too. She's just such an open, caring, loving person."

Oliva reminds the Lonborgs of their 39-year-old daughter, who lives in Portland and will donate her kidney in California on Tuesday. As parents, they also worried when she first volunteered to donate to her mother. Katrina Lonborg, just like Oliva, wasn't a match with her mother, but she soon agreed to try paired donation.

"I've had 68 years of living," Cindy Lonborg says before a long pause. "If anything happened to her."

Cindy Lonborg gets emotional standing before Oliva.

"She's not a stranger anymore. She's not an 'it.' She's a real person," Cindy Lonborg says.

Oliva is spending this last weekend with her family. She's not worried, but wants to get surgery over with so she can get home and plan for the holidays.

Her mom is on the same page.

Bergeron already decided where she'll place the two Christmas trees in her house and what kinds of food she'll eat.

The real gift this holiday season is more time.

"When I started this whole journey it was just about my mom," Oliva says. "I just think it's so great that in addition to my mom getting a kidney, so does somebody else's mom."

On Monday, Oliva will fulfill her promise. In an operating room at Legacy, surgeons will remove one of her kidneys. And in an operating room a couple of doors down, a former strange will receive a gift.

___

Information from: The Oregonian, http://www.oregonlive.com

http://www.oregonlive.com/newsflash/index.ssf/story/6-strangers-6-recipients-in-kidney-donation/6dfae28571ba419c9573dfdc78f85219