A Gift to Last a Lifetime

A Gift to Last a Lifetime

Man's Donation of a Kidney Made His Wife Eligible to Receive a Kidney from an Anonymous Living Donor

By RALPH GARDNER JR.
Dec. 23, 2013 11:17 p.m. ET

Jerry Sullivan gave his wife, Lorraine, a kidney for Christmas.

"It's not as if I'm giving up a kidney," he joked, moments before he was wheeled into an operating room to do just that.

"I'm so spoiled," Lorraine deadpanned.

"Merry Christmas, Mom," said their daughter, Elizabeth.

Mr. Sullivan, a 59-year-old utility executive, wasn't a match for his wife, a retired 59-year-old educator, who was born with polycystic kidney disease and has been on dialysis since both her kidneys were removed in 2012.

However, he agreed to give his kidney to a stranger, Claudette Parnell, a 52-year-old U.S. Department of Housing and Urban Development employee who suffers from chronic kidney disease and has been on a deceased donor list for five years.

His donation made Lorraine eligible to receive a kidney from an anonymous living donor as part of a national kidney exchange. Essentially a swap.

Indeed, Mr. and Ms. Sullivan and Ms. Parnell were part of a chain of kidney donations that occurred over two days starting on Dec. 17: eight donors and eight recipients in seven states.

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The couple share a moment before surgery Philip Montgomery for The Wall Street Journal

Mr. Sullivan went into surgery about 7:30 a.m. at New York-Presbyterian/Weill Cornell Medical Center; the operation was expected to take approximately three hours. Ms. Parnell was just across the hall awaiting his kidney. Ms. Sullivan would receive her kidney that afternoon. It would arrive from a New Jersey hospital, through the Holland Tunnel, at noontime.

The next time I saw Mr. Sullivan he was under general anesthesia as Dr. Jim Kim, a kidney transplant surgeon, performed laparoscopic surgery by inserting a harmonic scalpel, a device that simultaneously cuts and coagulates tissue to prevent it from bleeding, through a tiny incision.

"There's a lot of fat," Dr. Kim observed as he maneuvered the scalpel and watched his progress on a monitor suspended over the operating table. "More than a normal donor."

However, he noted that didn't mean the patient or his kidney, which should be approximately the size of its owner's fist, were in any way compromised. "Generally men tend to have fat on the inside," he explained nonchalantly. "Women tend to hold fat on the outside."

"I'm moving the left colon off the kidney," he added.

All three patients consented to have me observe their surgeries to draw attention to the need for more living kidney donors. About 100,000 people nationwide are on the waiting list for a kidney, but only about 17,000 kidney transplants were performed in 2012, a third of them from living donors.

New York-Presbyterian, the nation's busiest transplant program with 130 living kidney donor implants this year, has 2,868 people on its waiting list, said Dr. Sandi Kapur, the hospital's chief of transplant surgery and Ms. Sullivan's surgeon.

"Some people can wait four or five years," Dr. Kapur explained.

To an observer, it seemed that the greatest challenge during the procedure might be finding the kidney. It felt as if you were descending into a gloomy cave, and able to see only as far ahead as the light from your miner's lantern shone.

"I know what should be in certain places, even though everyone is different," Dr. Kim explained.

Also, patients undergo such extensive work-ups before to surgery, including a CT angiogram and a 3D reconstruction that the surgeon not only had a good idea of his patient's anatomy but the size, shape and health of his organs.

"It's rare to run into something unexpected," the surgeon said.

The kidney is attached through a vein, an artery and the ureter, a tube that propels urine from the kidney into the bladder. The challenge is to remove them, along with the kidney, in perfect condition.

"These three things have to be sewn into the person getting the kidney." Dr. Kim explained.

As Paul Simon's "Graceland" played speakers, Dr. Kim said that if he felt any stress it was only that he was operating on a healthy person.

"It's one of the few surgeries we do from a healthy person who doesn't need an operation," he explained. "There's no room for error."

Everything seemed to be going smoothly until it came time to remove the kidney. That's accomplished by making an 8-centimeter incision on the lower abdomen and then inserting a tool that resembles a swimming pool skimmer to pocket the kidney.

But the organ was encased in so much fat that the scoop couldn't surround it. After several attempts, Dr. Kim had to reach into the body with his hand and retrieve it himself.

"If everything went smoothly we'd just be technicians," he told me calmly a few moments later, as we stood in the operating room of Dr. Anthony Watkins, Ms. Parnell's transplant surgeon, and watched Dr. Watkins and his team prepare to install the kidney in his patient's body.

The most arresting sight in a day filled with them may have been the substantial well that had been created in Ms. Parnell's midsection and clamped open as she slept peacefully under anesthesia.

I'd been slightly worried about my reaction to watching live surgery for the first time, but the easygoing professionalism of the surgeons and nurses and the festive background music—Dr. Watkins lowered Mr. Sullivan's kidney into Ms. Parnell and stitched away to "Rudolph the Red-Nosed Reindeer"—made it seem like another day at the office.

I visited all three patients the following afternoon. They were in good shape, excellent spirits, and most important of all, the proud owners of well-functioning kidneys. Mr. Sullivan was going home the next day and both Ms. Sullivan and Ms. Parnell were expected to be released before Christmas.

"I feel wonderful," said Ms. Sullivan, on the first day in a long time that her destiny wasn't controlled by a dialysis machine. "I couldn't sleep last night. I'm running on raw energy."

—ralph.gardner@wsj.com

http://online.wsj.com/news/articles/SB10001424052702304020704579276660104404576