by Christopher Bachler
Ed. Note: Every year about 4,500 Americans with kidney disease die because they were unable to get a kidney transplant. Many of those undoubtedly did have relatives with a matching blood type but who chose not to donate a kidney to their relative. Christopher Bachler, on the other hand, did not hesitate to donate one of his kidneys to his sister when she was in desperate need of one.
My sister Nancy’s health problems began in 1971, when she was 21. A medical exam revealed that she had lupus, a potentially deadly disease that affects vital organs and connective tissues. Two years after her diagnosis, a family friend died of complications due to lupus. She was 45.
As the years passed, Nancy’s problems continued. On several occasions, she was hospitalized. A major episode in 1980 damaged her kidneys, though they barely survived that attack.
But in 1993, disaster struck. This time, Nancy’s kidneys had failed altogether and her only hope for survival would depend on a lifetime of dialysis treatments. Dialysis cleanses the bloodstream of impurities that build up on a daily basis — a function normally served by the kidneys.
Treatments last several hours, and are administered three times per week. Recommended diets severely restrict food and fluid intake. Patients often experience tremendous thirst and food cravings.
Dialysis is no cure, but rather a thin veil between a hard life and a premature death. For many patients, fatigue, worry and a rash of physical complaints become a way of life. As many as 10 percent of dialysis patients die each year.
For Nancy, the crisis couldn’t have come at a worse time. Only two months before — after 20 years of a childless marriage — she and her husband had adopted a newborn baby girl.
I offered her one of my kidneys, but she said nothing. I wasn’t sure how to interpret that silence. But I understood her reluctance to ask a relative for a kidney.
By November matters had worsened. “Nancy’s having problems with the dialysis,” my mother told me. “Her veins are small, and they’re having trouble inserting the needles. They had to put a catheter into her chest. There’s no telling how long that will last.”
At this point, a transplant seemed in order. But kidneys are hard to come by. First, there’s a long waiting line. Then there’s the difficulty of finding a suitable match.
Everyone in my family offered to donate, but none was eligible. My mother was ineligible because of her age; my brother because of his high blood pressure; and my eldest sister, because of her Multiple Sclerosis. I was the only viable donor.
I was surprised to learn that successful kidney transplants had been done for several decades at that point, and that success rates neared 95 percent. (According to Wikipedia, “The first kidney transplantation in the U.S. was performed on June 17, 1950, on Ruth Tucker, a 44-year-old woman with polycystic kidney disease, at Little Company of Mary Hospital in Evergreen Park, Illinois. Although the donated kidney was rejected 10 months later because no immunosuppressive therapy was available at the time — the development of effective anti-rejection drugs was years away — the intervening time gave Tucker’s remaining kidney time to recover, and she lived another five years.)
The major threat to the transplanted organ is the body’s immune system which is designed to attack foreign matter, including transplanted organs. To prevent rejection, organ recipients must remain on a lifelong regimen of immunosuppressant drugs. Failure to adhere to that very precise regimen will result in organ rejection and possible death.
The news for donors is also encouraging. Decades of study confirm that donors face no greater risk of suffering kidney failure than any other healthy person suffers; one kidney seems to be as good as two. The procedure is also safe for both donor and recipient.
Even blood transfusions aren’t a problem, since blood is rarely needed. Recovery periods for both donors and recipients vary, depending on the patient’s general health. Typically, each can expect to spend less than a week in the hospital. While strenuous physical activities may be limited for several weeks, patients may resume light office work within a week or two.
Following a series of tests that confirmed my suitability as a donor, I flew to Nancy’s home near Denver, and on Monday, Feb. 7, 1994, our surgery was performed.
For nearly four years, the transplant appeared to be a success. But then Nancy’s immune system began rejecting the transplant. “The doctors weren’t sure why the transplant failed,” she explained. “Some thought it was recurrent lupus, although I had no other lupus symptoms.
Others thought that I wasn’t getting enough anti-rejection medication. I was put on a chemotherapeutic drug to save the kidney, but it didn’t work. My kidney continued to fail; I got sicker, lost energy and appetite, and was retaining fluid. By late 1997, I was put on the transplant list, and I started dialysis in December, 1998.”
While waiting for an organ, Nancy’s hopes had been raised and dashed on three separate occasions when she had received calls about available kidneys, only to later learn that none were suitable.
The harshness of dialysis treatments, three times a week for 13 months, was bad enough. The endless waiting, and hoping against hope, was even worse. And this time, I could not help her.
Nancy had waited for a new kidney for nearly two years. Still no word. Then a stranger appeared. His name was Mike.
Then 38 years old, Mike was the father of two children and worked for a home remodeling service. Sounds ordinary enough. But there’s much more to this modest man.
Mike is a dedicated giver. “I enjoy working with high school youth through my parish in Aurora,” Mike told me when I first talked to him, many years ago. “One of our favorite group activities is an annual summer event called Workcamp. Between 55 and 60 camps are set up during the summer for eight weeks, nationwide.
“We had the opportunity to go to American Indian reservations for the last two years. This year, we will be going to an elderly, inner-city area to help repair their homes.” Mike and his wife were also active in their church’s “Marriage Prep Ministry,” which worked with engaged couples.
But how did Mike enter Nancy’s drama? One day in October, 1999, Nancy happened to answer a phone for a fellow employee who was at lunch. She was just about to leave for lunch, herself. But something told her to pick up that phone.
The caller was Mike, who worked for a man who was a close friend of Nancy’s boss, then chairman of the Department of Surgery at the Hospital of the University of Colorado. Mike’s diabetic boss needed a kidney transplant, and Mike was calling to get information on behalf of his boss.
PART TWO next week. A total stranger donates his kidney to Nancy. Christopher Bachler writes “The Thinker,” an occasional column for the Local.