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Two Kidneys, Two Lives

Machla Abramovitz

For some patients, finding a kidney donor is a relatively simple process. For those with complications, it can take years. Many have died while waiting for a compatible match. How the revolutionary new “swap” system is changing all that, plus the health risks that every donor needs to know about.

Wednesday, August 24, 2011

When Ross Bloom was wheeled into a hospital operating theater in July 2009, he and his family were elated. They had waited more than two years for this moment — finally, a kidney had been found that would save Ross’s life.

For nearly two decades, Ross had struggled with end-stage renal disease (ESRD/kidney failure), a condition he developed after being diagnosed with diabetes. Ross, now fifty-seven, spent five years on dialysis, a machine tethered to his abdomen filtering impurities and toxic fluid from his blood. He watched helplessly as his wife and two young sons adjusted their lives to care for a desperately ill husband and father. Ross’s health drastically improved when he received a kidney transplant. Yet the kidney gave out after nine years, propelling him, once again, into a serious state of ESRD.

The only solution was another kidney transplant — but finding the right match turned out to be a challenging, anxiety-producing endeavor. In September of 2006, his doctors were in a state of alert, ready to perform a transplant on a moment’s notice, only to be informed at the last minute that the cross-match that determines tissue compatibility between Ross and the intended cadaver kidney was not a match. “We never allowed ourselves to get excited,” admits his wife, Fern. “We understood that, in all likelihood, it would not work out.”

But this time was different. The medical staff at the Ronald Reagan Hospital of the University of California at Los Angeles (UCLA) were ready to operate. The cross-match was almost perfect, and the fifty-nine-year-old live male donor had no intention of backing down.

What made this moment so remarkable was that, by all accounts, the chances of Ross finding a compatible kidney were almost zero. Of those suffering from kidney failure, some — like Ross — exhibit high levels of antibodies that fight a donor’s tissue and, as such, complicate their prospects of finding compatible cross-matches. Ross’s antibodies weren’t just high — they had skyrocketed. In fact, they had reached 99.9 percent, meaning that his body would reject 99.9 percent of all kidneys. Even more astonishing was that the compatibility between his tissue and that of the donor kidney was so good that no “desensitization” (treatments that are applied to the recipient to help decrease the antibodies) were necessary. “It was the proverbial needle in the haystack,” Fern says.

Today, two years later, Ross is a different person. “Although he still suffers from diabetes, there is no comparison between his life on dialysis and the life he is privileged to live today,” says Fern. “Being on dialysis is not a life; it is an existence. My five-foot-ten-and-a-half husband used to weigh 145 pounds. He suffered from anemia, so he was consistently tired and, when not sleeping, lethargic. He had surgery on his eyes because of blood-vessel hemorrhaging, his bone density had diminished, he walked like a hunchback, and his face and body were gray and bloated. I don’t know how much longer he could have lasted.

“Now,” she continues, “Ross’s skin color is normal and he stands tall. He looks healthier and younger; he’s energetic. Because he’s no longer tied to daily eight-hour dialysis regimes, we have the luxury of doing things on the spur of the moment. Indeed, we take advantage of every minute. We are humbly aware of just how precious life is.”

The Blooms also know that, given Ross’s astronomical antibody count, this may be the last kidney he will ever receive.

 

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