Note from the author: I recently donated a kidney to a person I didn’t know. People seem amazed at this and kept asking me what was involved, and why I did it. In this article, I try to answer those questions. I’ve also included excerpts from a letter I received from the daughter-in-law of the person who received my kidney. These excerpts (below, in italics) give insight into how a transplant affects the hearts and minds of my recipient and his family.
On Nov. 17, 2017, a good friend of mine, Heidi Miller, donated her kidney to another friend, Bruce Cook. Following their story on Facebook, I was amazed to see how the gift of a kidney from a petite 5-foot-3 woman turned out to be the gift of life to a 6-foot-5 man who was in final stage renal failure.
Perhaps the most vivid image in the Facebook story was a photo of Heidi lying in her hospital bed covered by a blanket that had a design of a Superwoman outfit on it. That image may have seemed fitting. But to me, Heidi was the real thing, not some imaginary comic book hero.
Following the transplant, I witnessed how Bruce Cook was virtually resurrected from a very sick man suffering from the debilitating effects of long-term dialysis to one who could now live a normal life.
My father-in-law, Jose Tolento, felt trapped and chained down due to dialysis. He was on dialysis for 6 years and scheduled 3 times a week; Tuesdays, Thursdays and Saturdays for 4 hours each day. This impacted him not only emotionally, physically but financially as well. After getting home from dialysis, he would feel drained and tired and would just lay in bed. That was out of the ordinary because before he got sick, he was on the go all the time, working in his garden or tending his doves. Dialysis made it difficult to travel. We had to make sure to set up dialysis appointments when we would travel to his hometown in Mexico. He hated this. He was on vacation, and not even he could escape his reality.
Heidi, admittedly a very fit woman, recovered quickly following the transplant. Within a month, she was back running several of her businesses, doing community and philanthropic work and leading a vibrant social life. Given her rapid recovery, I couldn’t help but think, “If Heidi Miller could give the gift of life to a fellow human being, why couldn’t I?”
When I discussed this with my wife, Lynne, she was initially apprehensive. Although Heidi and Bruce’s experiences showed that the benefits of donating a kidney appeared to dwarf the seemingly insignificant costs, Lynne was concerned about the long-term effects to one’s expected lifespan from having one kidney instead of two.
The most comprehensive national study relating to this question was conducted at The John Hopkins University School of Medicine and involved 80,000 live kidney donors as compared to a control group of more than 9,000 people. The findings showed that after five years, the mortality rate was similar for both samples and after 12 years, the kidney donors’ mortality rate (1.5 percent) was actually lower than the control group of non-donors (2.9 percent).
Since I am 72 years old, however, I was concerned these findings that applied to a wide range in ages of donors wouldn’t necessarily apply to a senior citizen like me. Fortunately, I found another Johns Hopkins study conducted by Dr. Dorry Segev and published in the Clinical Journal of the American Society of Nephrology. Dr. Segev and his research team found that 219 living people over 70 years of age who donated a kidney in the U.S. between 1990 and 2010 lived longer than the control group in the same age group with both kidneys. The 1-, 5- and 10-year survival rates among kidney donors 70 years old and older were 99.5%, 95.8% and 90% respectively. Those survival rates compared to 99.1%, 91.8% and 73.0% for a similarly aged control group.
With these reassuring findings, Lynne gave me the OK to apply to UCI Health (University of California Irvine) to consider my candidacy as a donor. But when I added my birth date on page one of the online applications, a message automatically popped up on the screen informing me, “You must be between the ages of 18 and 70 to proceed.” Since I was 72 years old and therefore past the cut-off, that would have been the end of the story had it not been for an article I read several months later. Turns out that a Brit by the name of Nicholas Crace became the oldest living person to donate a kidney at the age of 83.
At 72, I figured I was a spring chicken compared to Crace. I’ve also never smoked and have exercised regularly including running marathons. So, I decided to contact UCI Health by phone and speak directly with Dr. Uttam Reddy, the director of the kidney transplant team. His first response was to tell me how very grateful he was that I would consider donating a kidney. He added that while no one over 65 has ever donated a kidney at UCI, he and his team would evaluate my candidacy to become a donor if I were willing to go through a rigorous battery of tests and consultations to assess my overall health.
Dr. Reddy seemed particularly pleased that I intended to be an “altruistic donor.” That is a donor who does not have a particular person in mind for the donation but rather will let the transplant team decide on the best fit. And that’s usually someone at the top of the transplant waiting list most in need of a kidney.
Seeing my father-in-law’s health decline, put a strain on us all. We saw his stress and frustration at not being able to do what he wanted. The fear of the unknown had a grip in all of our lives. I think he felt like he was a burden (of course he isn’t and never will), but I know he felt like it. He couldn’t work his full schedule due to dialysis. His children and wife had to help out financially to make ends meet. We couldn’t plan weekend outings together because he had to be back on time for his treatment. He wasn’t given a time frame for his life span. It was more like “take good care of yourself, follow all the instructions and hope for the best.” My father-in-law is overall healthy. He doesn’t have diabetes or other health issues. It was just the lack of a healthy kidney holding him back from living his life to the fullest.
The “rigorous” tests that Dr. Reddy referred to was an understatement. The tests I was required to complete, some of which I had to repeat several times, included blood and urine samples, upper and lower abdominal ultrasounds, EKGs, CT angiogram, upper and lower CT scans, dobutamine stress test and readings from a 48-hour blood pressure monitor I wore over a weekend.
On one of my early urine tests, microscopic blood was discovered. That could have been a deal breaker. But as I suspected, the presence of blood was caused by my running 10 miles at a fast pace the day before I gave my sample. Actually, it’s fairly common for blood to appear in a distance runner’s urine. It’s called “Joggers Hematuria.” Subsequent tests, sans running, were blood free.
In addition to the physical tests, I also had consultations with other members of the kidney donor team, including Dr. Reddy, several of the surgeons, the transplant coordinator, a social worker, nutritionist, nephrologist, cardiologist, living donor advocate, urologist and a psychiatrist. These professionals answered all my questions and seemed genuinely grateful for my intentions to be a donor. They’d also form the committee that would evaluate my health and ultimately decide on my candidacy.
When they met in December 2018, I was elated to receive the news that the committee had approved me to be a donor. Now it was time to wait for the team to find my recipient. That involved finding a match of my blood type as well as multiple other blood markers that pointed to an optimal fit.
When my father-in-law was notified that he would be on the waiting list, he had mixed emotions: It was excitement, anxiety, nerves. He knew many people on the waiting list that waited anywhere from 10-15 years. The doctors told him it might take years, decades, or he might never get a kidney. I don’t think any of us expected what came next.
In March, Dr. Reddy called to tell me that they found a match. Although privacy laws didn’t allow him to give me a name, Dr. Reddy was able to tell me that the recipient was a man in his early 50s with a wife, children and grandchildren. He also told me that the surgery was scheduled for March 18.
I cannot express enough how our family felt the day we got the news. My father-in-law walked in from work about 2:30 p.m. and said in calm voice (I think it was shock), “I got a call from Dr. Reddy who told me, we have a donor, a living donor.” A donor, my God….a donor!
After a morning run with my dog Angel, Lynne and I arrived at the hospital at 5 a.m. As I was wheeled into the surgery room, I remembered being told by everyone on my transplant team that I would be able to change my mind at any time before surgery. I was reminded of an episode of “Curb Your Enthusiasm” where Larry David was also on his way to surgery when he suddenly decided against giving his kidney to his pal, Richard Lewis. His kicking and screaming were to no avail as they wheeled him into surgery. Smiling to myself as I recalled that scene, I was simply happy that the long wait was finally over and that we were getting on with it.
As they wheeled my father-in-law into surgery, I remember seeing his eyes filled with tears. To be honest, I was trying to hold it together for him and my mother-in-law. I felt his tears were not just his nerves. They were tears of happiness and joy. He knew this was about to change his life dramatically.
UCI’s surgical procedure uses the most advanced and minimally invasive living donor nephrectomy procedure. It’s called a “laparoscopic living donor nephrectomy” where three quarter-sized incisions are made on the left side of the donor’s abdominal region. Special surgical devices that work through those incisions were used by my transplant surgeon, Dr. Hirohito Ichii, to cut my renal artery, renal vein and ureter, which allowed my now disconnected kidney to be removed from a 4-inch incision below my navel. As in most transplants, it was the kidney on my left side that was removed since it has a longer vein and artery that can then be more readily reattached to my recipient. After the kidney with its artery, vein and ureter removed, it was rushed over to my recipient who was being prepped in a surgery room next to mine.
Leaving my recipient’s nonfunctioning kidneys where they are, the surgeons placed my former kidney in an “open” space in his right lower abdomen and then connected the renal artery, vein and ureter.
I can only begin to imagine the scientific development, advanced surgical tools and incredible skills of the surgeons that were necessary to carry out this 3- to 4-hour miracle.
As I opened my eyes after surgery, I blearily saw Lynne and my transplant surgeon, Dr. Ichii, looking down at me. My first question was, “Is my recipient doing OK?” Dr. Ichii responded with a smile, “As soon as I released the clamps that allowed blood to flow, his new kidney turned pink again and started making urine.”
After the surgery, we asked, “Who is the stranger that just donated his kidney? Will we meet him? Is he OK?”
Two days later, Lynne and I walked into a special hospital room to meet my recipient, Jose Tolento, his wife and two children. Everyone was crying. It was all a bit of blur for me as I still had “brain fog” from the effects of the anesthesia. But one very clear memory that will be with me forever is when Jose’s daughter hugged me and wouldn’t let go. That single moment of shared joy made me realize that giving my kidney to Jose and his family was one of the best things I’ve ever done.
My father-in-law is at home recovering. After six years of dialysis, he is a free man. He goes for walks every day and is highly motivated to return to work full-time. We joke that he will be my new running partner since he now has a marathoner’s super kidney.
As for my recovery, I was able to take short walks around the hospital floor on the day following my surgery. The only real pain I experienced was getting in and out of my hospital bed. By the time I left the hospital a few days later, that pain had turned to only mild discomfort.
As soon as I arrived home, I was able to walk up and down stairs and take my dog, Angel, for mile-long walks in the morning and at night. One week after surgery, I was back at the office and teaching again at Chapman University, and to the frustration of my students, I didn’t miss any lectures.
My stretch goal was to run the Orange County Half Marathon six weeks after the transplant. I started training about a week after the surgery with short and slow jogs picking up the pace in subsequent weeks, even running a 5K by week five. On May 5, I ran that half marathon and accomplished my stretch goal. Although I didn’t set any speed record, I crossed the finish line.
I’ve now discovered that donating a spare kidney involved no major sacrifice on my part, especially when weighed against the transformative impact it had on the quality of life for another person and family.
So here is my call to arms. Until my transplant, UCI had never had a donor over 65 years old. That is pretty much the case at other transplant facilities. Yet, the population of people within the 65-to-74 age cohort is growing rapidly as the baby boomers born between 1946 (my year) and 1964 move into that bracket. Already it is almost 30 million men and women.
I know many of my fellow boomers are exploring new ways to make a difference in their lives. They are doing so by developing new and interesting hobbies, giving back to our communities in countless ways and providing help where help is needed. My transplant experience shows that all those boomers are not too old to consider helping in another way – saving another person’s life.
There are more than 100,000 persons currently on the kidney waiting list, a list that has doubled in size over the last ten years and continues to grow. While they wait, 5,000 people on the list die each year. Yet, the number of living kidney donors has remained about the same since 2004.
If even an infinitesimally small fraction of those boomers gives the gift of life to a fellow human being, it will reverse that trend. And for those that do, they will discover as I did that donating a spare kidney will have a profound impact on another person and that person’s family. In so doing, it will give a donor’s life new meaning and significance.
We cannot express in words what this transplant meant not just to my father-in-law but for all those who love him. It transformed our world from one of uncertainty and fear to one of promise.
I can only hope that my family’s experience will inspire more people to give the gift of life to others.
Source: Orange County Register