Anderson will help stepdaughter save her life

Anderson will help stepdaughter save her life
By Jesse Duarte
STAFF WRITER
Thursday, January 03, 2008

There may be no greater love than to lay down one’s life for another, but Angwin’s Craig Anderson is preparing to give his stepdaughter the next most precious thing: his kidney.

With two failed transplants and two pregnancies behind her, doctors say 36-year-old Trish Lopez of San Diego is a non-match for 85 percent of the population. But fortunately for her, Craig is a member of the 15 percent who do match, and has never had second thoughts about donating his kidney to her, even through years of alternating between high hopes and bitter disappointment.

Lopez was first diagnosed with kidney disease at the age of three and a half. For years she got by all right with regular doctor visits, but the problems worsened when she hit her teens.

She was placed on the waiting list for a cadaver kidney transplant, and received her first when she was 20. That kidney failed, as did a second transplant when she was 25. Each crushing failure sent her back to the dialysis machine.

“She’s the most amazing woman you’ll ever meet,” said her mother Barbara, Craig’s wife. “She has this really crappy life, and she smiles through it all.”

In 2002 doctors told Lopez the likelihood of a successful transplant was slim, and advised her to look for a live donor. Blood work revealed that Trish’s stepfather Craig shared her blood type and two out of six genetic markers, making him a possible donor.

Craig has been a part of Lopez’s life since she was 7, when he married her mother Barbara.

Lopez’s biological father has remained an important part of her life — to the point where both men accompanied her down the aisle at her wedding. But she and Craig have a special relationship.

“He’s the one who helped her with her homework, he’s the one who came to all her games,” said Barbara.

Not only was Craig a possible donor, but Lopez’s reactivity — which determines the likelihood of her body rejecting a new kidney as it would any other foreign object — was low.

“We wanted her body to react minimally to my tissue,” said Craig. “They concluded that her reactivity was low, and that it was worth the substantial expense to process me as a potential donor.”

Transplant scheduled

During early 2003 the family eagerly awaited the transplant, scheduled for June 20. But on June 10, a date the family remembers well, they got more bad news: the tests that had led doctors to believe Lopez was likely to accept Craig’s kidney had been skewed by anti-rejection medication that remained in her bloodstream from the last transplant.

The verdict: Lopez’s reactivity was very high, making it likely she would reject Craig’s kidney. The planned transplant was immediately scrubbed, and the family’s emotional roller coaster had taken another plunge.

“When everything came crashing down on June 10 it was devastating,” Craig remembered. “We didn’t know where to turn.”

But just weeks later, the family learned about a new experimental treatment that suppresses patient’s reactivity, making them less likely to reject a new kidney. The treatment is offered only at a few elite hospitals, including the Mayo Clinic, but if it catches on it has the potential to make virtually any organ donor compatible with any patient, perhaps making even blood type irrelevant.

Second attempt

After a flurry of grant writing and advocacy by doctors, Kaiser Permanente-Northern California agreed to undertake the treatment under the guidance of the University of California-San Francisco Medical Center, which would perform the actual transplant.

The treatment suppresses the body’s immune system to the point where it won’t reject a new organ. When the immune system reaches a certain level of passivity, the patient is “ripe” for a transplant.

But by that point the immune system is so weak that waiting for a cadaver organ to become available would leave the body open to numerous threats, so a live donor has to be ready to hop on the operating table on 48 hours notice. Once again, Craig was ready.

Lopez seemed to be responding well to the six-month treatment regimen until she developed peritonitis, an infection that sometimes results from self-performed dialysis.

“At that time, she got really frustrated and she decided to move back to Southern California, where she had lived before moving up here,” said Craig.

That move meant switching from Kaiser Northern California to Kaiser Southern California, which has no working relationship with UCSF and wasn’t willing to team up on the complicated treatment, said Craig.

New hope

Lopez’s case was right back where it had started: on the agonizingly long waiting list for a transplant. But in August 2007 she was referred to Cedars-Sinai Medical Center in Los Angeles, home to Dr. Stanley Jordan, the nephrologist who had developed the experimental treatment Lopez had been undergoing at UCSF.

Jordan had since refined the program so it would take just six to eight weeks, not six months. He took on Lopez as a patient — and that emotional roller coaster began another climb.

Lopez will undergo her first treatment Jan. 30. At the end of February, doctors will test to see if her reactivity is low enough to accept a new kidney. If it is, the surgery is a go.

Doctors at Cedars-Sinai have already planned the procedure so everything runs smoothly as soon as Lopez is considered “ripe.” Craig’s left kidney — “I get to keep the better one of the two,” he said — will be removed laproscopically and within moments transplanted into Lopez, who will be lying in an adjoining room.

After the surgery

Following the surgery, the two will be separated — not to discourage visits, but so their desire to see each other will motivate them to get up and walk around as soon as possible.

Aside from the four to six weeks it’ll take for Craig to fully recover, the donation should have a minimal impact on his life. Insurance companies will look upon him as a risky prospect, but doctors don’t expect his health to be affected.

Unlike the body’s other organs, the kidneys have incredible built-in redundancy: the average person could get by as long as just one kidney is operating at 15 percent of its full capacity.

While Craig will hardly notice any difference, Lopez’s quality of life is expected to improve dramatically. Within days of the transplant, while Craig is still recovering, Lopez should have an energy level and healthy aura that dialysis can’t deliver.

“I’ve been there for both her transplants, and on the first day she’s all wiped out and feeling horrible, but the next day you can’t keep her in bed because she’s so full of energy,” said Barbara.

Dialysis is a laborious process that must be performed several times a day, and it still can’t cleanse the blood as effectively as a functioning kidney can. A successful transplant would give Lopez a normal life for the first time in the last 30 years.

Lopez is studying business administration full-time, and hopes to move to St. Helena and get involved in winery management if the transplant is successful

Doctors say there’s a good chance it will be, but the family has been through too many ups and downs to get too confident. Craig and his stepdaughter are optimistic, but not unrealistically so.

“I’m hopeful, but I’m guarded,” said Lopez. “I’ve had things happen in the past where I’ve thought everything will be great, and then it doesn’t turn out. I don’t want to be let down like that this time, but I’m still very positive that it’s going to work.”

The gift of life

The other lesson the family has learned from Lopez’s ordeal is how few organs are available for so many patients, and how few people are willing to donate their organs.

“Medicine is moving forward. Now all we need is for human nature to move forward too,” said Craig.

But while offering to donate organs might not be a fundamental part of human nature, for people like Craig giving the gift of life comes naturally.

“I’ve told Trish, ‘Your dad and I gave you life the easy way,’” said Barbara. “’But Craig is giving you life in a much more difficult way and a much more treasured way. This is a precious gift he’s giving and he doesn’t have to do it, so you’d better cherish it.”

Barbara laughed. “I didn’t know I was marrying spare parts."

http://www.sthelenastar.com/articles/2008/01/03/news/local/doc477c3d897e750655414306.txt