No match? They solved problem

No match? They solved problem
Two Bucks families couldn't donate to their relatives, so they swapped organs

By Tim Darragh, OF THE MORNING CALL
10:24 p.m. EDT, June 9, 2011

Call it divine intervention, fate, happenstance or just an awesome case of good luck, but something special brought together the Kulscar and Marcano families.

Whatever it was, it visited two homes that were troubled by serious illness, and today, two people who were facing the prospect of lives curtailed by kidney dialysis now can expect happier, healthier futures.

The two families reunited Thursday at Lehigh Valley Hospital-Cedar Crest to tell the media their "paired" transplant story. Such transplants occur when two donors essentially trade kidney recipients because neither was a match for the relative they intended to help. This paired transplant was a first for LVH.

"It's really a wonder to think about," said LVH President and CEO Ronald Swinfard.

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The families' story started about 50 years ago, when Elizabeth Marcano of Perkasie developed diabetes that would damage her kidneys. Meanwhile, Frank Kulscar of Doylestown was a young man also suffering from kidney trouble. It got so bad, he needed a transplant — and got one, from his father. "Thirty-seven years and four days ago," he said.

But by 2003, the regular testing that transplant recipients have to undergo showed that Kulscar's body was beginning to reject the donated organ. By 2006, the decline was accelerating. Marcano's health also was beginning to fail her and in 2010, both people went on LVH's transplant waiting list.

Marcano said dialysis was rough on her. Her daughter feared she was nearing the end. "Some days, I thought she was just going to give up," Elise Marcano said.

But the families fought on. Kulscar's wife, Carleen, sought to donate one of her healthy kidneys to her husband, and Elise Marcano did the same for her mother. Both tests, however, showed that they were not compatible.

Carleen Kulscar did not give up. She boned up on transplants and contacted LVH lead transplant coordinator Sonja Handwerk about a paired transplant, offering to donate her kidney if someone could be found to match Frank Kulscar's. "She was relentless," Frank Kulscar said.

Tests then buoyed the hope: Carleen Kulscar was a match for Elizabeth Marcano and Elise Marcano was a match for Frank Kulscar.

They first met through LVH on April 28 and less than a week later, three operating rooms were ready. Thirty people worked on the team that removed Elise's and Carleen's kidneys, took out the failing ones and then transplanted the healthy organs to Frank and Elizabeth. The operations took six hours, doctors said.

Doing a live organ transplant — as opposed to harvesting organs from recently deceased people — and transplanting them is "a minor triumph," said Dr. Michael Moritz, LVH's chief of transplant surgery. "Doing that with four patients is a major triumph."

He also noted that Elise Marcano's and Carleen Kulscar's generosity helps more than their opposites in the paired transplant. It takes two people off LVH's transplant list and frees up two kidneys for other needy people, who typically would wait an average of 33 months at LVH for a transplant.

"The numbers are not large, but the impact is," Moritz said.

The donors said they were confident the transplants would go well and credited Moritz, transplant surgeon Lynsey Biondi, Handwerk and the LVH transplant team for walking them through the process. In the Kulscars' case, concern over living with only one kidney was nonexistent, since Kulscar's father, who had given his son a kidney 37 years ago, was there to see Frank Kulscar through his recuperation.

"I felt there was very little risk there," Carleen Kulscar said.

The donors were discharged three days after the surgery and the recipients were home in five days.

At the media event, it was impossible to tell that any of them had undergone surgery just over a month ago. The Kulscars and Elise Marcano said they are back to their respective jobs. Elise Marcano also let it slip that she was back at her gym, against doctors' advice.

The recipients were simply grateful for the lucky pairing. "I feel like my life is working much better," said Elizabeth Marcano through tears.

Added Frank Kulscar: "I feel like I'm the luckiest person in the world."

tim.darragh@mcall.com

610 778-2259

http://www.mcall.com/news/local/mc-allentown-paired-transplants-20110609,0,2987250.story