06/06/2016
Organ Donation: How Christina Saved 11 Lives
By Marina Khidekel
22, 2010
On any given workday, Christina Do puts in eight or more hours making real estate investments at a New York City firm, then hits a gym class (she likes Spinning and yoga) and spends her evening with friends at a favorite bar. But Tuesday, December 2, 2008, wasn't like any other day. Do, then 36, left home at 5:00 A.M., took a sleepy cab ride to NewYork-Presbyterian/Weill Cornell Medical Center and checked in. Soon her abdomen was marked up with black ink to show surgeons where to cut. By 8:00 A.M., Do was out cold and doctors had sliced into her belly with surgical knives, creating three short incisions. Through one, they inserted a tiny camera so they could watch their handiwork on TV monitors. Through another, they removed one of Do's kidneys. By 4:00 P.M., Do had awakened in the recovery room, groggy, sore and minus one vital organ.
Medically speaking, Do's kidney removal was about as risky as an appendectomy. Her wounds healed within three weeks, and her remaining kidney would eventually grow enough to make up for the loss of the other. Yet Do's surgery was extraordinary for a simple reason: She didn't need it. She had volunteered to donate a kidney—not to her mom or best friend, but to a total stranger. As Do went under the knife, a seriously ill patient waited in a nearby operating room to receive a precious gift: a perfectly healthy kidney and another chance at life.
The ripple effect of Do's good deed was just beginning. Thanks to a revolutionary new approach to kidney transplants known as a kidney chain, not one but 11 lives would be saved. With donors like Do leading the way, experts say, a true medical miracle could be within reach: that no American, ever again, will have to die because he or she couldn't get a new kidney.
Desperately Seeking Donors
About 83,000 people in the United States are on a waiting list for a kidney—and about 4,500 of them die every year, says the United Network for Organ Sharing. Of the 15,000-plus transplants that take place each year, roughly 10,500 use kidneys from deceased donors. The rest come from the living, often family and friends of patients.
It's no secret in the medical community that doctors prefer using live donor kidneys; they can last twice as long—up to 44 years—as cadaver organs. But for most kidney patients, lining up a live donor is beyond difficult. An organ transplant works only if the donor and recipient have compatible blood types and antibodies. Surprisingly, close relatives—the people most likely to offer an organ—are not always sound matches. That leaves thousands of patients in a frustrating, life-threatening dilemma: Those willing to save them are helpless to do so. In the past, patients were doomed to wait possibly years for a cadaver kidney—or for the rare Good Samaritan like Do. (Around 100 such donors step forward each year.)
Incredibly, Do's selfless act set off a series of transplants that would become the longest kidney chain started by a woman, and the second longest ever, as of press time. Here's how a chain works: Someone who needs a kidney is matched with a stranger willing to donate one. To get the kidney, the patient must find a friend or relative who's willing to donate one to someone else. Chains can easily break; one person may get sick before surgery, for example, or a donor may pull out. The chain started by Do ultimately spanned 22 people—11 donors and 11 recipients—and four New York-area hospitals over seven months.
Some experts say they could create virtually endless chains of well-matched donors and recipients, alleviating the growing waiting list for kidneys—if only enough potential donors and recipients would join the pool. "In 10 years, it will be rare for living donor kidney transplants to take place outside of donor chains," predicts Garet Hil, founder of the National Kidney Registry (NKR), a nonprofit organization that has facilitated 13 kidney chains so far. (Hil expects to arrange at least 200 kidney transplants in 2010.) Says Sandip Kapur, M.D., chief of transplant surgery at NewYork-Presbyterian Hospital/Weill Cornell Transplant Center, "Donor chains have not only revolutionized the way kidney transplants are done, but have the potential to solve the kidney shortage crisis in the United States if applied on a national scale."
That all depends, of course, on heroes like Christina Do who selflessly volunteer to be the critical first link in the chain.
A Radical Act of KindnessWhy would a healthy, happy young woman give an organ to a stranger? For Do, it started with a news article about the desperate agony of kidney patients.
For most patients, kidney failure is the result of diabetes or an inherited kidney disease. To survive, they require dialysis—a grueling procedure that involves being attached to a machine that cleans the blood, then flows it back into the body—usually three times a week, four hours at a time, for the rest of their lives. "For most people, being on dialysis is absolute misery," says Dr. Kapur. Their only other hope is a kidney transplant.
Christina Do never forgot reading about such suffering. "I'm lucky that I'm healthy," she says. "It was so awful to know these people were struggling." Perhaps ironically, the recession also helped motivate her. Do's field had been hit hard. "So many people were upset about losing money," she says, "but what I got out of it was, there are more important things than money. It made me think about what kind of person I really wanted to be. And I decided that I wanted to really help someone. Donating a kidney wouldn't really change my life, but it could save someone else's. I couldn't think of a good reason not to do it."
From researching the topic online, Do learned that the health risks of giving a kidney are, for healthy people like her, surprisingly low. The chance of complications from kidney removal surgery is only about 2 percent, experts say; in fact, research shows that kidney donors even tend to outlive the average person.
Dating but unattached, Do also considered how donating might affect her future, and any future family. "I did wonder, What if I ever had kids and one needed a kidney?" she says. "But kidney failure doesn't run in my family. I realized it was silly for me not to do this because of a bunch of what-ifs."
That attitude is typical among Good Samaritan donors, experts say. "Most I've met are compelled by a desire to do enormous good and accomplish something greater than themselves," says Dr. Kapur.
In August 2008, Do took the plunge, signing up with NKR, which connects potential donors with transplant centers all over the U.S. After completing the required physical and blood work, Do underwent psychological screening. Doctors say this is key; they want donors who are truly emotionally ready to make such a major commitment. One red flag doctors look for, says Pat McDonough, living donor transplant chain coordinator at Montefiore Medical Center in the Bronx, New York, is unrealistic expectations. "For example, a girl wanting to give a kidney to her boyfriend hoping that it will result in a proposal wouldn't be approved," says McDonough. "Neither would anyone hoping for a strong bond with their recipient. If that bond develops, fine, but it's not fair to either person if a donor has such hopes from the outset."
After all, the last thing doctors want donors to experience is regret. "The rewards of donating are huge," McDonough says. "It's not often that you get to make a miracle happen for someone."
Once Do was approved as a potential donor, NKR kidney chain mastermind Hil immediately went to work, trying not only to match her with a patient who needed her kidney, but also to use her as a launching point for a chain. (The registry attempts to start chains with every Good Samaritan donor, Hil says.) After sifting through his extensive database of possible donors and recipients registered with transplant centers all over the country, Hil found several suitable matches in the New York area.
In November, Do received a call from NewYork-Presbyterian/Weill Cornell Medical Center. They had found a recipient who matched her blood type and antibodies. "I was a little overwhelmed by how quickly it happened, but more than anything I was happy that someone who needed a kidney was about to get one," she says. It was then that Do gave her family the news. "They thought I was crazy at first and worried about my safety. My mom wouldn't stop asking, Why are you doing this?'" Her family ultimately supported her. Still, not wanting to have to defend her choice again and again, Do told only a few close friends. "I understand why other people wouldn't do this, but I thought it was the right thing for me," she says. "And when I make my mind up about something, I don't backtrack."
During the weeks leading up to her operation, Hil coordinated with patients and doctors to arrange for four surgeries to take place on one day in December 2008, beginning with Do's. That cold winter day, Do woke up in the transplant center recovery room, groggily realizing she had accomplished what she'd set out to do. Later, as Do was recovering in her room, four surgical residents she recognized from the operating room came by. "All I could think was that all these people had seen me naked!" she says, laughing.
Neither Do nor the patient who received her kidney wanted to learn the identity of the other. "I didn't want the person to feel any obligation toward me," Do says. "I did this with no strings attached." When the hospital called to let Do know her recipient was recovering well after a successful transplant, "that's all I wanted to know," she says. "And it was all worth it."
What Do didn't realize was that the benefits of her donation would continue for months through the record-breaking chain of transplants. Doctors had kept her in the dark, partly to protect the other patients' privacy, and partly because they had no idea the chain would grow as long as it did. Only when Glamour reported this story and told Do about the chain did she learn the full scope of her actions.
Total Strangers, Forever Linked
Do's transplant chain brought together a cast of characters worthy of an ensemble film: a New Jersey bass guitarist whose band opened a rock festival for Motley Crue; a hipster psychotherapist from Brooklyn; a volunteer nurse for Operation Smile; a globe-trotting Manhattan ad executive; and a Brooklyn hip-hop dancer, among others. The youngest recipient is a 20-year-old college student with a Facebook habit; the oldest is a 73-year-old retired teacher who has worked extensively with imprisoned teens.
Most of the chain's 11 recipients have had at least one prior kidney transplant that had either been rejected by the body soon after surgery or had failed years later—common outcomes when a poorly matched kidney from a relative is used out of desperation. Jesse Bilodeau, 30, had already endured three failed transplants before getting a kidney through Do's chain. "I was almost out of hope," he says.
Last November Glamour brought together 14 members of the chain—seven donors, seven recipients—in New York City (a few were unable to attend; others opted out for privacy reasons). As patients met their donors for the first time—and everyone met Christina Do—the scene was a blur of smiles, tears and thank-yous. Bilodeau greeted his donor, Rosa Fernandez, 55, with a long hug. She had donated her kidney so her husband could receive one from another donor in the chain. In exchange for Fernandez's kidney, Bilodeau's best friend, Mike O'Kelly, 28, who often drove his pal to dialysis, became a donor. During months of those dialysis trips, O'Kelly had asked Bilodeau's mom what else he could do to help, "and she said the only thing that would help Jesse was a new kidney. I knew right then I would give mine," O'Kelly says.
Bryan Harewood, a 21-year-old hip-hop dancer and choreographer, and the chain's very last recipient, gave the group a short demonstration of his dancing skills, then teared up as he hugged his donor, Paul Michael, 35. "Thank you, man," he said. "You don't get second chances often, but you gave me mine." The chain ended with Harewood because another pair had to pull out, likely due to illness.
As the participants gathered for a photo, Christina Do received a loud and long round of applause. "You are truly an angel," said Norrie Oelkers, 62, who had donated a kidney so that her sister, who is a cancer survivor, could receive one. "You've given so many people their lives back." Meeting the group made Do that much more proud and sure of her decision, she says. "Knowing even a little about the people I was able to help made the experience that much more moving."
And Do's commitment to helping others has only been strengthened: She's now training for her first Ironman triathlon this summer in Switzerland to raise money for Team Hole in the Wall, a camp for kids with life-threatening conditions. "I didn't do things like this when I had two kidneys!" she says with a laugh. And that, she says, is what she'd like others to learn from her experience. "People may think, What kind of life would I have after donating a kidney? Would I be as healthy as I was before? I'm living proof that it doesn't impact your health," she says. "Actually, I've only changed for the better." Knowing the good she has accomplished, she says, is an endorphin rush of its own. "It has shown me that one act can touch so many people."
