From Wall Street Journal, By STEVEN RUSSOLILLO
I married my wife on May 29. Three weeks later, I was lying in a New York City hospital recovery room. My new mother-in-law was a few beds away, my kidney flushing toxins from her body.
When my wife, Shelly Banjo, and I began dating six years ago, I learned that polycystic kidney disease ran in her family. It is a genetic disease where cysts grow on kidneys, eventually destroying them. Shelly’s mother, Batya Banjo, would eventually need a kidney transplant. Some day, Shelly also might need one.
Now, Batya refers to me affectionately as her new son and “kidney buddy.” I’ll be thinking about her, recovering back at her home in Texas, as I run the New York City Marathon on Sunday.
A year and a half ago, I proposed to Shelly on a bench in Central Park, where we have trained together for marathons. Soon after, I decided to get tested to see if her mother and I were the same blood type, the first round in qualifying as a kidney donor.
Batya is 69 years old and grew up in Israel. She met her husband, Chaim, at Hebrew University, where they were biochemistry lab partners. They got married, moved to Canada for medical school and then to Dallas, where they started a medical practice and raised three daughters.
In the summer of 2013, the whole family flew to Israel, where we piled in a van and toured the state for two weeks. Only then did I truly understand who kept the family ticking. Batya chimed in when Shelly’s dad forgot the punch line of a joke, sewed torn backpacks and jeans for her daughters, and never ceased giving her family advice—even when it wasn’t sought. That trip was the last time Batya felt healthy. Soon after, her kidneys started failing.
Currently about 120,000 Americans are on the waiting list for a new organ, according to the U.S. Department of Health & Human Services’ Organ Procurement and Transplantation Network. The majority of them need kidneys. More than 4,000 people died while waiting for a new kidney last year.
Finding a willing, qualified donor is difficult. Living donation rates have fallen steadily for the past decade, according to a study in the American Journal of Transplantation. Roughly half of all living donations in 2014 were from blood relatives.
Shelly and her family worked for three years to find a kidney donor. For a while, I mostly did what any supportive partner would do: I tried to be a good listener and provide comfort. At first, a handful of close friends came forward, but none qualified. We widened the search on Facebook and Twitter. My aunt graciously agreed to be tested, insisting her nephew’s children grow up with all their grandparents. She also didn’t qualify.
By the middle of 2015, Batya’s kidneys were functioning at only around 10%. Complete strangers volunteered to donate. That prompted me to step up. If someone could elect to give a kidney to a stranger, I could at least try to give my kidney to the woman who would soon be my new mother-in-law.
In June 2015, Shelly’s sister Hili got married, but Batya was too sick to walk her daughter down the aisle. Soon after, I got the results back from my first round of tests. My blood type, A-positive, was compatible with Batya’s. I could go on to round two.
A frustrating quirk of the hospital system is that only one potential donor at a time can go through the second qualification round. Several candidates were in the pipeline for further testing at that point. I stood down. [Read more]
Roger Dudley, owner of R & J’s Machine Shop in Lemoore, and his smog technician Rich Hines have more in common than just working together.
Hines, 44, donated a kidney to Dudley, 69, earlier this year. Dudley has polycystic kidney disease, a genetic disease where a group of cysts develop in the kidneys over time and cause major damage.
“I knew early in life that I needed a kidney,” Dudley said. “I’m thankful to the man upstairs that I never had to go on dialysis.
According to the National Kidney Foundation, people with kidney failure will either need dialysis or a kidney transplant.
Last summer, Dudley was placed on a waiting list for a kidney transplant. The wait time was estimated to be seven years.
Hines decided to undergo tests to determine if he was able to donate one of his kidneys to Dudley. Hines went to the California Pacific Medical Center in San Francisco and found out he was a perfect match after two days of testing. Dudley's two sons had undergone testing and were not matches for their father.
Hines said he gave one of his kidneys to Dudley “because [he] needed one” adding that he believes peoples' paths cross for a reason and helping Dudley was the right thing to do.
“We are both veterans,” Hines said. “We take care of our own.”
Dudley served in the U.S. Army during the Vietnam War, and Hines served in the U.S. Navy around the time of the Gulf War.
Hines has been working for Dudley for six years.
“I’m not that type or person to ask for anything,” Dudley said. “[Hines] was a perfect match which I’m very thankful for.”
After finding out the good news, Dudley had to get a coronary angiogram to ensure his heart was strong enough for surgery which was planned for August 2015. The transplant was postponed after the cardiologist found three blocked arteries.
Dudley had a triple bypass surgery a week later which improved his kidney function to the point where he was no longer eligible for a kidney transplant.
His kidney started to fail again a few months later and the transplant was rescheduled for Feb. 24 in San Francisco.
Dudley and Hines both said they had a positive mindset on the day of the transplant.
“Our faith in God is very strong,” said Dudley's wife, Jana. “He had led us to this point. We sat in the lobby with the donor’s mom and sister and we just all prayed together.”
She said Dudley and Hines were in the hospital for five days.
“The surgeon told us that he literally took the kidney out of Rich’s body and later put it in Roger’s body and it started right up,” she said.
Hines said he does not feel any different and is glad that he was able to do something good for someone.
“Rich, he’s just a fantastic guy,” Roger Dudley said. “He didn’t have to do this, but I am glad he did.”
Dudley said he is doing great and is “still kicking.”
Living with PKD
From The Lancet
Tung-Min Yu and colleagues1 showed, in a large cohort study, an increased incidence of kidney cancer in patients with autosomal dominant polycystic kidney disease (ADPKD) without end-stage renal disease and an increased incidence of extra-renal cancers, especially colon and liver cancer.
The link between ADPKD and cancer was first raised in the 1990s.2 In the subsequent decades, several insights into the pathogenesis of ADPKD were derived from molecular investigations. These findings highlighted a notable similarity between ADPKD and solid neoplasms. In a recent review, Seeger-Nukpezah and colleagues3 analysed similarities on a molecular level between ADPKD and pathological features frequently found in cancer. They raised “the interesting possibility that patients with mutations in PKD1 or PKD2 might be predisposed to kidney cancer” and also described differences in alterations of ciliary signalling and intracellular calcium and cAMP. Gargalionis and colleagues4 showed that an overexpression of non-mutated PKD1 and PKD2 genes are implicated in increased aggressiveness of colorectal cancer.
PKD1 and PKD2 encode polycystin 1 and polycystin 2, which are present not only in renal tubules. In ADPKD, mutations of PKD1 and PKD2 partly account for renal and extra-renal features of the disease,5potentially involving the kidneys, liver, seminal vesicles, pancreas, arachnoid membrane, vascular system, mitral valve, and abdominal wall.
These concepts lead us to ask if there could be an association between the presence of renal and extra-renal manifestations, secondary to ciliopathy, and the development of tumours. Yu and colleagues’ study provides an opportunity to explore a similar correlation. We suggest collecting data about the presence of phenotypical features of ciliopathy (extra-renal cysts, total kidney volume, intracranial aneurysms, mitral valve prolapse, aortic root dilatation and aneurysms, and abdominal wall hernias). Analysis of these data would reveal whether or not there is an association between degree of phenotypical expression of ciliopathy and oncogenesis in patients with ADPKD.
We declare no competing interests.
Immune system joint inflammation is the name given to a gathering of joint inflammation types where an individual's resistant framework assaults itself. The most widely recognized model is rheumatoid joint inflammation.
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