Nov. 4, 2021 — From the time they were young, Amy DeAngelis and her younger sister Laura Johnson knew that Laura would need a new dialysis, the young patient was in an urgent situation. No one in her family was a match. Some members in the chat filled in online donor candidate forms to see if they might be. Waters, now age 33, ended up being the one.
After a series of blood tests and a battery of health exams, much like the ones Drake described, Waters had her kidney removed for donation in March 2019. The surgery took about 3 hours.
After the transplant, the recipient’s kidney function went from extremely low to almost 100% within a day, Waters says. Her own hospital stay was only a night, and her recovery was event-free, allowing her to return to work within 2 weeks. She and the recipient are now close friends.
Removing a major organ from the body has become less invasive but remains a major procedure.
Surgeons have shrunk the cuts they use to just the size needed to remove the kidney and insert instruments, says Samuel Sultan, MD, an assistant professor of surgery at the Weill Cornell Medicine Division of Transplant Surgery Kidney & Pancreas Transplant Program in New York City. In some places, surgeons may still use a hand rather than instruments for removal, which requires a slightly larger opening. And some institutions have turned to a robotic approach, controlling the instruments while watching them on a screen, “kind of like a video game,” says Sultan.
Regardless of the method, several steps are involved. Although the kidneys lie at the back of the body, surgeons now get to them through the abdomen, which requires filling the space with gas to see internal organs clearly. To reach the kidney from this entry point, surgeons must carefully move the sensitive large intestine out of the way to avoid damage.
A Ticking Clock
When it comes time to disconnect the kidney, there are three major connections to deal with: a large artery that runs from the aorta, a vein that drains blood from the kidney into the vena cava, and the ureter, which drains a ventilator. The kidney was not transplanted internally but attached to the patient’s body, where it seemed to start functioning normally. But despite this promising breakthrough, so-called pigney transplants are still likely years away.
The Long Wait
Without a living donor match, a patient needing a kidney will likely have to wait for years. A dozen such patients die every day while waiting. For the hundreds of thousands of people on dialysis who need kidneys, says Waters, “there’s not a kidney shortage, but a lack of education about donation.”
Patients in kidney failure must have dialysis to stay alive, hooked up several times a week to a machine to filter their blood for them. Drake says that as part of his recovery process, he spent time in a ward where people were having dialysis, “and it was horrendous. The fact that they went through this three times a week, sitting there for hours.”
A living kidney donor doesn’t have to be a special kind of person, says Waters, noting that she’s tired of this perception.
“It just requires you to have a kidney,” she says, echoing an essay she wrote about her experience for TheDallas Morning News: “I felt like there was a kid in the ocean drowning and I was the only one there at the time who could do something about it.” And she did.