Transplant heroes: First mom then sisterBy GRACIE BONDS STAPLES
The Atlanta Journal-Constitution
Published on: 07/02/08
That moment when the doctor walks into the room and says, "We have a match," already had come for Adam Cashin.
And so, as he sat the other day in his living room talking and laughing with his sister, Erin Nugent, the least of his worries was where his new kidney would come from.
It was as if the circumstances that had brought him to this moment in his life were as normal as breathing, and, in some ways, they were.
This wasn't the first time Cashin needed a kidney. The first time was 16 years ago.
He was 32 then, a man born with barely functioning kidneys, who up until then needed a bag tethered to his side to act as his bladder.
It was an awkward way to walk through life, but he managed. He was a fat, happy kid who was sick a lot — simple as that. He spent nearly as much time in the hospital as he did out. He wore diapers and rubber pants until he was 8 and doctors attached the bag to him.
He said his brothers beat him up and challenged him to "get tough and get over it."
And he did. As often as he could, he turned his illness to his advantage.
It wasn't unusual, for instance, for him to tell teachers he needed to go home to change his bag — even when he didn't need to. Permission was granted for that and just about anything else he wanted.
It was that way through high school and even his years at the University of Georgia.
But by summer 1992, Cashin wasn't feeling right. His energy level had been low his whole life but now he felt completely worn out. He kept a low-grade fever and had constant headaches.
Cashin needed a kidney.
His parents, Helen and John, and his siblings lined up to be tested.
That day, doctors sent Cashin to the hospital, where he started dialysis.
His mother wasn't a perfect match. But, at 67, she insisted on being the donor and for the next 16 years the kidney worked just fine.
Adam Cashin no longer needed the bag.
Sometime last fall, he noticed a metallic taste in his mouth.
It had been a long time, but he recognized that sensation and the low fever and the fatigue. His old enemies were back.
Blood tests showed the kidney his mother gave had failed.
His siblings were retested. Nugent, the youngest of the siblings, was the only one to pass all the test necessary to be a donor.
"I was very scared at first," she said last week, the day before the surgery.
Nugent, 46, has two children. She worried about whether a kidney would be available should one of them need one. "I prayed about it and got a peaceful feeling," she said.
Last Tuesday, as brother and sister lay in adjacent operating rooms, in that anesthetized world of life suspended, doctors removed Nugent's kidney and two hours later placed it inside her brother.
The surgery went well, Dr. Paul Tso said. Cashin is no longer beholden to the dialysis machine.
As transplants become more common and recipients live longer, Tso said, more people are getting second transplants.
This is particularly true for people who like Cashin receive organs from living donors early in life.
On average, Tso said, organs from living donors last about 18 years compared to 12 years from deceased donor, underscoring the need for more living donors.
Nugent gave the ultimate gift, he said. She's the real hero in all this.
And for that, Nugent said she thinks her brother planned "to get me a pedicure or something."
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