Couple a perfect match, but not for kidney transplant

Couple a perfect match, but not for kidney transplant
Published 5:23 pm, Tuesday, April 29, 2014

Jack H. met Janette E. through an online dating service. In Jack's words, "We were a natural fit," and soon they were engaged and living together. Later, when Janette discovered she had kidney failure, the Internet provided a different kind of matching service - for a kidney.

This time the date was for the operating room.

When blood tests indicated that both Janette's son and Jack were incompatible with her, her transplant team turned to the National Kidney Registry ( www.kidneyregistry.org), the largest paired donation organization in the country.

The registry uses the Internet to connect incompatible pairs at different transplant centers and forge them into transplant chains. Jack donated a kidney and Janette received a kidney, but not directly from him to her. Janette's kidney came from a donor in Los Angeles and Jack's kidney went to a patient in Cleveland, but more on that later.

For most patients, a kidney transplant improves the quality and length of life. The wait can be five to seven years for a kidney from a deceased donor. Kidneys from living donors last longer and function better.

It is easy to understand why a close relative would want to donate, but what about unrelated, living donors, such as a friend, co-worker or church member? They may be motivated by seeing the lifestyle changes in a person with kidney failure. From my experience, more than half of the donors are unrelated to the recipient.

Harder to understand, and far rarer, is the altruistic donor, who has no connection to a recipient. Generally, these donors have had a life experience that connected them to kidney failure. Some, like a woman named Kelly, worked in hospitals and had seen their share of kidney failure patients. Others conclude that if they are willing to donate after they die, why not now?

The special thing about altruistic donors is that they often start a transplant chain so that multiple people are able to receive a kidney. Janette's chain was started by such a donor, whose decision to step forward ultimately led to seven recipients receiving a healthy kidney. Ironically, Jack's kidney went back to his hometown of Cleveland, a place he had sworn never to return to.

All donors, altruistic or not, face risks associated with surgery, psychosocial issues and potential financial expenses, including travel, lodging and unpaid leave from work during weeks of recovery - though many qualify for disability insurance.

Potential donors must pass a rigorous screening process, ensuring that the long-term risks are as low as possible. Those who clear this process and then donate should have a normal, healthy life thereafter. Many potential donors don't qualify because their risk is elevated. Fortunately, the cost of screening and surgery is paid for by the recipient's insurance.

In her online account of her decision to become an altruistic donor, Kelly wrote, "A few people I told about my decision completely FREAKED OUT; they actually thought I was completely nuts." However, most people say after donation that it was a positive experience and are happy they did it.

The Internet and an altruistic donor started a chain that encircled Jack and Janette. Jack felt that his "scars would be like medals and I would wear them proudly." He summed up his experience: "We are doing so much better than I would have expected. ... There is time. There is time, and energy, to pursue our dreams and our life together."

Dr. William Bry is a kidney transplant specialist at Sutter Pacific Medical Foundation, San Francisco, and surgical director of the Kidney Transplant Program at California Pacific Medical Center. For more information on donations, contact the transplant program at (415) 600-1700, or visit www.cpmc.org/advanced/kidney. For more stories from donors, see www.livingdonorsonline.org, and to learn about how to become an organ donor, see www.donatelife california.org.

http://www.sfgate.com/health/article/Couple-a-perfect-match-but-not-for-kidney-5439993.php