Jenny Curry was in the room with her sister and brother-in-law, Traci and Andy Cordle, when the doctor told them that Andy was in kidney failure.
“It was devastating," said Jenny, a fitness instructor from the Abingdon, Virginia, area. "Your mind doesn’t know how to process the news.”
Kidney failure, also called renal failure, is a condition where the kidneys function at only a fraction of their normal capacity. People with end stage renal failure live days to weeks if the disease isn't treated.
“I wanted to know what my options for treatment were,” said Andy, a bank vice president, also from the Abingdon area. But, the physician explained, with kidney failure, there are only two paths: dialysis, or a kidney transplant.
All of the living donor transplants at The University of Tennessee Medical Center are special, because the gift the donor is willing to give is so profound.” – Alex Cantafio, MD.
Jenny said, “After the doctor left the room, I told them, ‘If you need a kidney, I’ll donate.’ I felt in my bones it was the right thing to do."
Alex Cantafio, MD, is a surgeon at The Center for Transplant Services at The University of Tennessee Medical Center. He said that all of the living donor transplants at The University of Tennessee Medical Center are special because the gift the donor is willing to give is so profound.
And while every donor is sure of their decision, many still experience some uncertainty or fear. "For Jenny there wasn't an ounce of that," he said. "When I first met her it was overwhelming how sure she was. It's amazing to be that confident."
Living donors fill the gap
Brent Hannah is the administrative director of the Center for Transplant Services at The University of Tennessee Medical Center. "In my role," he said, "I have the privilege of seeing the impact this life-saving gift has on people in need."
And there are many people in need. More than 116,000 people are on the national transplant list, waiting for organ donation. Of that number, more than 90,000 are waiting for a kidney.
On average, people wait three to five years for a kidney from a deceased donor. But, because the living donors are usually family or friends, the wait can be less than a year for a living donation.
Where transplants from deceased donors require emergency surgery, transplants from living donors can be planned around everyone's schedule.
"The number of people who need a kidney is much higher than the number of kidneys available from deceased donors," said Hannah. "Living donors are critical to filling the gap."
The Center for Transplant Services understands how difficult it is for people needing a kidney to be on the waiting list. Oscar Grandas, MD, a surgeon at the Center for Transplant Services said, “It’s challenging for our patients not to know when they’ll get a transplant.”
It’s also challenging, he said, to ask someone to be a living donor. “There are many people willing to donate,” he said. “We want to help our recipients make the connection.”
What is Kidney Failure?
Kidney failure happens when your kidneys stop working properly. In the United States, the two main causes of renal failure are diabetes and high blood pressure. Other diseases that contribute to it are:
- Infections
- Kidney stones
- Polycystic kidney disease, an inherited disease where cysts form on your kidneys
- Chronic glomerulonephritis, a disease where the filters in your kidney become inflamed and scarred
When you hear “kidney disease,” the first symptoms that come to mind are changes in urination or pain in the kidney area. But there are also some that you might not immediately associate with kidney failure. For example:
- Extreme thirst
- Nausea, vomiting or loss of appetite
- Insomnia and fatigue
- Mental fog
- Muscle cramps
- Swollen feet and ankles
- Itching that won’t stop
- Chest pain and shortness of breath
- Eye problems (blurry or double vision, dry eyes, pain)
Andy didn’t know that his vision problems, itching and fatigue were signs of kidney disease. “I chalked them up to work stress,” he said.
In the beginning, his symptoms weren't alarming, so he didn't go to the doctor right away. His wife, Traci, eventually became so concerned about Andy’s blood pressure, that she made a doctor's appointment for Andy and encouraged him to go.
While high blood pressure can cause kidney disease, it can also be a symptom. In fact, it’s often one of the first symptoms of polycystic kidney disease, which is the disease that caused Andy’s kidneys to fail.
How Dialysis Works With Organ Donation
Once Andy was diagnosed with kidney failure, he started dialysis right away.
Dialysis is a treatment that uses machines, or sometimes medicine, to filter the blood. It does 10-15 percent of healthy kidneys’ work, but it doesn’t do the other things kidneys do, like make hormones. Because of this, people's health gets worse on dialysis, over time.
People can live for many years on dialysis (five to 10 on average, though many live 20 to 30), but a kidney transplant can help them live even longer. Many, like Andy, are on dialysis until they can get a kidney.
Dialysis takes hours per session, and most patients have three or more sessions per week. This schedule can make it difficult to travel or work.
Andy, who was on dialysis nine hours a day, said, "I'm thankful for dialysis, but my whole life was scheduled around it. For me, it wasn't an end game."
How Does Living Donation Work?
The Center for Transplant Services at The University of Tennessee Medical Center is the area's only kidney transplant program. They are experts at caring for kidney donors and recipients.
Friends and family members are the most common donors, though some people do receive living donations from strangers. Family members are the most likely to be compatible, but anyone who is compatible can donate.
Living donors go through an in-depth testing process. Every transplant center has its own requirements, but there are some basics. For example, you must be at least 18 years old and in good mental and physical health.
The University of Tennessee Medical Center requires living donors to be:
- Between 18-70 years old
- Mentally healthy (no psychiatric conditions)
- Physically healthy (no high blood pressure, diabetes, heart disease, kidney disease or infections, like Hepatitis C)
The donor undergoes a range of tests to find out if they're a good match with the recipient.
Jenny said her testing process was extensive. “My health was the team’s number one priority during that time,” she said.
The Risks and Rewards of a Kidney Transplant
Andy was diagnosed in January 2018. In August 2018, Cantafio performed the donor procedure while Grandas performed the recipient operation. Cantafio said it was a successful surgery without any problems.
During the surgery, Jenny's kidney was removed and placed into Andy's body. With living transplant, because the kidney is without blood supply for such a short time, it usually begins functioning immediately. Kidneys from deceased donors can take days or even weeks, to get back to full capacity.
There are some risks with a kidney transplant. As with any surgery, there's a risk of infection or death. There's also about a seven percent chance the transplant will fail, though 93 percent of transplants are working at the end of a year.
And, of course, donors give up a kidney, and must adjust to life without one. "But donors feel called to do that and they find the opportunity to help save someone's life personally gratifying," said Cantafio.
What's Life Like After a Kidney Transplant?
After surgery, most donors go home within three days, while recipients may stay in the hospital a little longer. Because Jenny and Andy live two hours outside Knoxville, they stayed in the hospital five days, then remained in Knoxville until their one-week checkup.
After his transplant, Andy said he has restored energy and appetite, and freedom and flexibility without dialysis. He will be on medication, probably for the rest of his life, to help reduce the risk of complications from the transplant.
Donors can also live a normal life after donating. In fact, because living donors are healthier than most Americans, many live longer than average. Their remaining kidney picks up the slack to do the work of two. After donating, donors can still have children.
From a public health standpoint, the benefit of living donation is, as Cantafio said, "massive."
"Not only does a living donor, like Jenny, save a recipient's life," he said, "now a deceased organ will be there for someone else."
How One Transplant Saved Two Lives
During the donor testing process, Jenny had a test called nuclear imaging. That is where small amounts of radioactive materials are put into the bloodstream. Called radiotracers, these materials travel to the area being examined and give off energy. Special cameras pick up the energy and use it to create images of the inside of your body.
The radiotracer was meant for Jenny's kidney, but instead, it went to her gallbladder. "We don't know why it lit up my gallbladder, but it did, and it showed I had gallstones."
Cantafio said Jenny had a lot of gallstones for a young person, which could cause health issues. He recommended she have her gallbladder removed. He offered her the opportunity to wait up to a couple of years after the transplant, but she decided to do it as soon as possible.
"I had the same feeling of certainty about that surgery as I did about the transplant," Jenny said. The transplant occurred in August 2018, and in November of that year, Jenny had gallbladder surgery.
"I started out doing this to save Andy's life," said Jenny. "But in the end, I may have saved my own, too."
During surgery, the surgeon found that she had a bile duct cyst. "These cysts have a 15-20 percent lifetime risk of developing a dangerous cancer, which doesn't have a lot of good treatment options," said Cantafio.
As a result, he recommended that Jenny come back in 2019 for a third surgery, to remove the cyst.
"I started out doing this to save Andy's life," said Jenny. "But in the end, I may have saved my own, too."
Why Choose the Center for Transplant Services?
Cantafio said there are benefits for both donors and recipients to choosing The University of Tennessee Medical Center's transplant program. It's the only transplant program in East Tennessee. It also gives our area access to the same high-quality care and skilled surgeons available at larger hospitals. "But in those larger medical centers, patients can get lost," said Cantafio. "Here, we offer high-quality care, with a personal touch."
The program focuses on kidney transplants and, while they perform the same number of transplants as larger programs (more than 1,300 since the center started in 1985), the staff is kept small.
"We get to know all of our patients well," said Cantafio. "As patients walk through our halls they can say hi to everyone, from the coordinators to the surgeons."
Andy heard about The University of Tennessee Medical Center from his physician, who had good professional experiences with the staff.
And after his experience, Andy said he would recommend the Center for Transplant Services to anyone who needs a transplant. He said the team is excellent to work with and they go above and beyond to help patients and their families during the whole process. "It's been a roller coaster of a ride,” he said, “but I'm in a brighter spot now."
Nearly six months after the surgery, the whole family is glad to have "their" Andy back.
"You know, when you're sick, you're just not yourself," said Jenny. "Now Andy's son has his dad back and my sister has her husband back. All our puzzle pieces are in place again."
Consider becoming a life-saving living kidney donor. For more information, contact Living Donor Coordinator Ashley Dennis the Center for Transplant Services. Email her at ADennis@utmck.edu or call 865-305-5340.
The Benefits of Living Donation
During a living-donor kidney transplant, physicians take a healthy kidney from a living person and put it in someone whose kidney doesn’t work properly. The Organ Procurement and Transplantation Network says that about 6,400 living-organ donations occur each year in the United States. The majority of kidneys come from deceased donors, about 14,700 in 2018.
Living donation has several benefits:
- It shortens the waiting time for a kidney and lets someone else on the transplant list move up the list faster
- Kidneys from a living donor last longer than ones from a deceased donor (on average 18 years versus 13 years)
- The transplant recipient knows who they're getting the kidney from, usually a friend or family member
- The surgery takes place at a convenient time (rather than being scheduled on an emergency basis when a kidney from a deceased person becomes available)
- Kidneys from living donors start working right away, instead of hours or days later
- Less medication is needed after surgery
According to Oscar Grandas, MD (photo, left), from the Center for Transplant Services, living donation is considered a first-line option for patients on the kidney transplant waiting list. “Living donor recipients have an overall better long term outcome,” he said. “They return sooner to enjoying life with their families and loved ones.”
Living organ donation surgery is very safe, said Grandas, and The University of Tennessee Medical Center has an excellent record for successful donation and transplantation.
“We provide support and resources for patients who are working to find a living donor through the Living Donor Champion program here at the medical center,” said Grandas. “We honor the gift of life that the living donors provide for our recipients.”