Paired kidney donations save two lives, enrich two others

Paired kidney donations save two lives, enrich two others
9:39 PM, Jun. 30, 2011 | 5 Comments
Written by
REID FORGRAVE

Iowa Methodist Medical Center

This is what life had become for Helen Drake, a 61-year-old Ames woman, after she contracted a virus two years ago that decimated her kidneys' ability to filter her blood:

All she wanted to do was sleep. There was no more of the active life with her husband, their two sons and four granddaughters - no more bike rides, no more swimming, no more scuba diving. She lost interest in gardening, her favorite hobby. She went on medication for depression, she didn't want to eat, and she threw up when she did. Helen and her husband canceled a cruise to the Caribbean. She lost 35 pounds, down to a skeletal 85.

Simply put, this was no way to live, sitting on the waiting list for a transplant, going downhill.

And then, a year ago, a savior appeared.

His name was Rod Simpson. He worked at Iowa State University, and he was friends with one of Helen's three sons, Brian. He was playing pool with Brian one day when Brian told of his mother's struggles to find a kidney donor. "Would she want one of mine?" Simpson asked.

The surgery was set for March. She was ecstatic, a new chance at a normal life. Then, the day before the procedure, bad news: A test showed Helen's blood had developed antibodies that would make a donation from Rod impossible.

"It was like running into a wall," Helen said. "It was resignation, the belief that God said this was not the right time."

And then, the same week her transplant was canceled, another man came walking into Iowa Methodist Medical Center's transplant center in Des Moines. He was tall and thin, with a big, kind heart, and more important, two big, strong kidneys. The stranger was Helen's second savior.

Debilitating dialysis, or wait for a transplant

When you suffer from renal failure, the kidneys cease to properly filter toxins from the blood. There are two options. You can go in for dialysis, a mechanical filtering system that takes several hours per appointment, several times a week. It's a debilitating process that simply slows down the survival clock as renal failure takes its toll.

Or you can get in the long line for a kidney transplant.

Half a million people nationwide are on dialysis, which costs about $100,000 a year. A kidney transplant costs about $68,000, said Dr. Qasim Chaudhry, the medical director of Iowa Methodist's transplant center.

Here's the problem: The national waiting list for kidney donations has nearly 90,000 people, according to the nonprofit United Network for Organ Sharing. About 7,000 "cadaveric donors" - corpses that kidneys can be salvaged from - are available each year, Chaudhry said. At two kidneys per corpse, that means about 14,000 kidneys are available annually, a small portion of the need.

That need is on the rise, doctors say, as increasing rates of hypertension and diabetes put stress on the state of the American kidney. For many people, it's a life-or-death matter. About a dozen people die daily because there aren't enough kidney donors, according to the Alliance for Paired Donation.

"The whole push now is for living donors to make up the difference," Chaudhry said.

The problem with kidney transplants? Finding a compatible donor.

"We don't want you to put on a billboard that you need a kidney, but short of that, go for it," said Nicole Patterson, transplant coordinator for Iowa Methodist's transplant center, which does about 25 kidney donations a year.

Sometimes, a willing donor turns out to have a blood type that lessens the probability of success for a transplant. It's like being tossed a life preserver, then having the rope snap - hope turns into hopelessness. That's what happened to Helen.

That hope can be preserved, however, through paired donations. That's when someone who needs a kidney finds a donor, typically a family member, sometimes a friend, but the kidney isn't a match. The donor agrees to give a kidney to a stranger, with the understanding that another kidney will be found for the donor's loved one. It's like paying a kidney forward.

In Helen's case, one year ago, she didn't really know Rod Simpson. She was grateful for his selflessness, and she was heartbroken when the transplant was canceled.

Then a man named Marvin Harger - a 60-year-old Urbandale man whom Drake had absolutely zero connection to - kept thinking of a film he'd seen called "Seven Pounds," where a man sought redemption by offering his organs to seven worthy recipients. Marvin was a person who, after a friend who was an avid platelet donor died in an accident a few years ago, signed up for his first apheresis platelet donation the day after his friend's funeral. He's donated platelets in his friend's honor twice a month since then.

After watching the film, Marvin couldn't get organ donation out of his head. He researched organ donations. He read websites where people discussed how much they hated dialysis.

He thought, "I can do this." As a Christian, he had this overwhelming spiritual tug, as if someone else's name were written on one of his kidneys. The decision was easy.

The same week that Helen's transplant fell through, Marvin contacted the transplant center, timing that Helen would come to see as more than coincidence. It was God's hand at work.

"This whole thing should have never happened," Patterson said. "But it did."

Successful surgeries, and a special meeting

At first, Marvin's kidney wasn't supposed to go to Helen. Marvin was matched with Victoria Mena-Amaya, an El Salvadoran native who works for the Iowa Lottery. But the transplant center saw that with a kidney switcheroo, both Helen and Victoria could get good matches. Marvin's kidney would go to Helen. Rod's kidney would go to Victoria.

Doctors set the surgery for May 10. It went perfectly. The day afterward, Helen's son Brian looked at her and said her face was flushed a vibrant rosy color instead of a pale yellow.

On Thursday morning at Iowa Methodist, the two donors and the two recipients walked in for checkups, which the transplant center scheduled at the same time: a reunion.

Chaudhry walked into a clinic room, where Marvin was waiting. Marvin's creatinine blood levels, a measure of kidney health, were right where the doctor wanted them to be, about two-thirds of the kidney function that he'd had before the surgery.

"It's just like it never happened," Marvin told the doctor. "I can't even tell I donated."

"I always worry about the donors more," the doctor said. "The primary thing is nobody wants to have anything bad happen to the donor, who came in here without any problems whatsoever. The first rule of medicine is do no harm."

Marvin walked into a conference room, where Helen - her new kidney a squishy, small bump above her left hip - was waiting with Rod. Helen and Marvin hugged. They joked about Marvin telling her she'd develop an affinity for ice cream; he plows through five quarts a week.

After a few minutes, Victoria walked in, followed by Helen's husband. Victoria smiled broadly: Life had improved so much. She was off dialysis, had energy, and could eat chocolate and her favorite El Salvadoran food, pupusas.

"I feel like I've been born again, thanks be to God," she said through an interpreter. "These people are like my family. My heart, I just can't keep it in my chest, it's bursting out."

For this unlikely quartet - two giving the gift of life, two receiving it - the relationship would not end here. They plan to meet every few months for dinner.

And Helen had just had an appointment with her heart doctor the day before. The doctor had cleared her to go scuba diving. This weekend, she might go swimming with her granddaughters for the first time in a long time.

And Helen and her husband are planning a trip to an island off the coast of Venezuela to go scuba diving. They'll invite some special guests, too: Marvin, and Rod, and Victoria, their new extended family.

About paired donation

HOW IT WORKS: Someone who needs a kidney finds a donor, often a family member, but the kidney isn't a match. The donor agrees to give a kidney to a stranger, with the understanding that another kidney will be found for the donor's friend or loved one. Paired donations help widen the pool of potential donors.
HOW MANY PERFORMED: The first paired donation was performed in 2000. Iowa's first was at Iowa Methodist Medical Center in 2004. To date, nearly 1,300 paired kidney donations have been performed in the United States, according to the Organ Procurement and Transplantation Network, which is operated under contract with the U.S. Department of Health and Human Services by the United Network for Organ Sharing. The paired donation process has gained steam as a way to match donors with recipients who have closer blood matches.
POTENTIAL TO GROW: The process is still in its infancy, but it has the potential to add 3,000 living donor kidney transplants a year in America, according to the Alliance for Paired Donation.
•No sales allowed
Organ transplants must be done for humanitarian reasons. The National Organ Transplant Act of 1984 made it illegal to purchase or offer for sale an organ for transplant. Only recognized organ procurement organizations are authorized to procure and disseminate human organs used in transplants.
•Interested in organ donation?
Call the Iowa Methodist Medical Center's transplant center at (515) 241-4044.

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