DONATE LIFE ORGAN DONATION AWARENESS- PORTLAND, OREGON

Cycle of compassion

6 strangers donate kidneys in intricate web of transplants

By Melissa Navas / The Oregonian

PORTLAND — In the hospital’s tiny waiting room, Corrie Oliva taps on her laptop, but does little work. She fidgets in her chair, makes small talk with her father and listens for any updates on her mother, Julie Bergeron.

Three floors below, a surgeon walks down a hall with a kidney smothered in ice from Operating Room 2 to Operating Room 4 — a gift to Bergeron from a stranger.

The donor traveled for the transplant from Southern California to Legacy Good Samaritan Medical Center. His donation triggers a chain of transplants that will allow his brother-in-law in Tulsa to receive a kidney from another stranger.

Back in the waiting room, Joan Nolan sits and waits for news of her brother, John Nolan, on the operating table in Room 2.

His donation is just one of six paired transplants across the country over several weeks. Six strangers give kidneys to six recipients in this intricate web, which requires precise timing, travel and healthy donors — even the common cold can throw a wrench in the plan.

In the middle of the kidney transplant downstairs, Joan Nolan meets Bergeron’s family. They hug. The Bergeron family hands her thank you cards, a small gesture of their appreciation. Now, the families are in it together.

Oliva is surprised, but glad to meet her. She likes the idea of Nolan and her family sharing surgery updates.

The 36-year-old will be back at the hospital just a week later so doctors can remove one of her kidneys, which will go to a Washington woman. But for now, her mind is on her mother.

Paired donations

Bergeron first learned of her kidney disease in July 2006. Toxins must be filtered out of the blood by kidneys — one healthy one is enough to do the job — or people face dialysis or a transplant. Or death. But both of Bergeron’s kidneys continued to fail until she needed dialysis in April 2008. By January 2009, her name was placed on the official national database for a kidney transplant. Early on, Oliva volunteered her kidney, but a test showed she was not a match for her mother.

Waiting seemed Bergeron’s only option.

She struggled more and more with fatigue. She adopted a bland diet that prevented her from indulging in cheesy pizza or meatball subs. A dialysis clinic became her home away from home for three days a week, three-plus hours each time.

“It was quite a process to accept the disease and its entirety,” says Bergeron, 64.

Oliva kept pushing, and asking questions. Another e-mail to Legacy early this year led Oliva to a different nationwide program, Alliance for Paired Donation, that gave hope to her family. It meant a possible kidney for her mother. The catch: Julie Bergeron needed to find someone to donate on her behalf.

Despite her mother’s concerns — and against her wishes — Oliva signed up.

“I was pretty much determined to be a donor,” she says.

Several factors

Last year, about 4,600 people died in the United States while waiting for kidney transplants. About 16,800 transplants took place.

When people need a kidney, most put their names on a national waiting list for a new cadaver organ or try to find their own donor. Several factors determine who gets one when from that list: the severity of kidney failure; where someone who donates their kidneys dies; where someone lives and how many other people in a particular region are also waiting.

There’s a shortage of kidneys available for transplant. To help meet the need, health care professionals in the late 1980s and early 1990s began to promote live kidney donations, says Dr. William Bennett, medical director for Legacy Transplant Services.

Research also shows that recipients live longer — in some cases twice as long — when they receive kidneys from live donors. There is a lower rejection rate, and fewer anti-rejection drugs are needed. Doctors say a live donor even trumps a “perfect match” between a cadaver donor and recipient.

The goal of the Alliance for Paired Donation is to get more kidneys to more people who need them. Since the first match in 2007, the organization has found kidneys for 62 people.

It works like this: A loved one, willing and healthy enough to give a kidney, doesn’t match mom — just like Oliva and Bergeron. But someone matches Bergeron, like John Nolan. He tried to donate to his brother-in-law but wasn’t a match. The Alliance put those two together from their web of participants and kidney connections were made.

“I think that’s the No. 1 thing, is that it shortens the wait time,” says Laurie Reece, executive director of the Alliance. “It allows people who don’t stand much of a chance on the national list to get a kidney.”

Once a month, the Alliance’s computers assign points for various factors: Are participants willing to travel? What is the maximum body mass of a donor that the recipient is willing to accept? The system also looks for compatibility of blood and tissue type.

Thirty states have transplant programs that participate in the Alliance, including Legacy Transplant Services in Portland. In Oregon, OHSU Hospital and the Veterans Affairs Medical Center in Portland also offer kidney transplants. Bergeron’s kidney transplant is the first Alliance match in Oregon.

“It’s a huge process, but now it’s pretty well-established, and it’s starting to gain steam around the country,” Legacy’s Bennett says.

‘Make a new life’

After Bergeron spent 18 months on the national waiting list, her daughter signed up for paired donation with the Alliance last June.

A month later, the family got word: a possible kidney match.

Bergeron’s husband, Chuck, has the best news from Operating Room 4.

“It went well.”

Joan Nolan, whose brother’s kidney is expected to keep Bergeron alive and off dialysis, gives the father and daughter a long embrace.

“How amazing the whole process is,” Chuck Bergeron says, “to take a part of somebody else and make a new life for somebody.”

The families say their goodbyes and promise to check in on one another — but at this very moment, they want to head to separate hospital rooms to see their loved ones.

Two days after her mother’s transplant, Oliva is back at the hospital, waiting for her pre-op appointment. The pretransplant coordinator approaches Oliva and asks if she’d like to meet her kidney’s recipient.

By fluke, both Oliva and Cindy Lonborg end up in the room at the same time. Normally, donors and recipients don’t meet until after the surgery.

Lonborg, 68, has traveled about 100 miles from Oakville, Wash., for her pre-ops. She signed up for a paired donation in the spring. In September, she found out she had a match.

Oliva turns around and Lonborg is immediately at ease. Yes, she’s healthy, but more importantly, a quick conversation reveals that Oliva has no reservations about the surgery.

“It’s nice to be able to tell her thank you,” Lonborg says. “Now I worry about her, too. She’s just such an open, caring, loving person.”

Oliva reminds the Lonborgs of their 39-year-old daughter, who lives in Portland and will donate her kidney in California today. “She’s not a stranger anymore. She’s not an ‘it.’ She’s a real person,” Cindy Lonborg says.

Oliva says she’s not worried, but wants to get the surgery over with so she can get home and plan for the holidays.

“When I started this whole journey, it was just about my mom,” Oliva says. “I just think it’s so great that in addition to my mom getting a kidney, so does somebody else’s mom.”