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Iowa City woman donates kidney through ‘swap’ program to help Dubuque teen
National Kidney Registry another transplant option besides deceased donors
Erin Jordan
Jan. 22, 2024 5:30 am, Updated: Jan. 22, 2024 8:14 am
IOWA CITY — Whoever said that laughter is the best medicine wasn’t giving advice to a transplant patient with abdominal stitches.
But Kathi Anderson laughs, clutching a kidney-shaped pillow to her incision site, as she tells the story about toting a jar of urine in her backpack as she went through tests to see if she could donate a kidney.
Anderson, 54, of Iowa City, passed the tests and on Jan. 4 donated her right kidney for Christopher Turnis, 19, of Dubuque. But Turnis actually got someone else’s kidney, which is exactly how the National Kidney Registry works.
The program allows people to donate a kidney that isn’t a match to help a loved one, friend or stranger receive another kidney that is a match.
“I wanted him to have the best possible kidney,” said Anderson, a mother of three and a physical therapist in the Neonatal Intensive Care Unit at the University of Iowa Hospitals and Clinics in Iowa City.
The registry has facilitated more than 8,300 kidney transplants across the United States. UIHC, which joined the network in 2019, has had 36 kidney recipients through this program.
The registry runs separately from the United Network for Organ Sharing deceased donor program, which started in the 1980s. Recently, that network has faced criticism for changes some say give preferential treatment to patients in big cities at the expense of patients in more rural areas, like Iowa.
For Turnis, the kidney he received Jan. 4 is his second kidney transplant. A birth defect caused damage to his kidney and bladder and, at age 6, he wanted nothing more than a new kidney so he didn’t have to undergo daily dialysis.
“On my sixth birthday, when I blew out my candles, I wished for a new kidney,” he said.
A week later, his family was notified there was kidney available through the deceased donor program. That kidney lasted 13 years, allowing Turnis to have a fairly normal childhood that included being a Kid Captain at a UI football game in 2018.
But by the time he was a junior at Dubuque Hempstead, the transplanted kidney was wearing out.
“The main thing about my kidney declining was fatigue,” said Turnis, who slept 16 to 18 hours a day during that time. “It really hindered me to do the things I wanted to do, such as go to college.”
Most people with kidney disease will need several transplants over the course of their lives, with transplanted kidneys often lasting between 13 to 20 years, explained Lyndsay Harshman, a UIHC pediatric nephrologist who has worked with Turnis for six years. She was a medical student when he had his first transplant.
“Transplants themselves are not a cure,” she said. “It's simply starting the life cycle of chronic kidney disease again.”
Transplant coordinators put Turnis on the deceased donor network waiting list in 2021, but Turnis’s mother, Kristina Turnis, also put out a plea on Facebook for a living donor. Anderson, who had met the family before and has a mutual friend in Dubuque, saw that November 2022 message.
“It was just heartbreaking for another medical mom to hear there’s a kid that needs something,” Anderson said, apologizing as her voice catches and she wipes her eye as she talks.
Anderson and her husband, Mike, have a son, Mateo, who was born prematurely with birth defects. He now is a thriving teenager, but, like the Turnises, the Anderson family also has spent many days and nights at UIHC.
Anderson decided to start the process to see if she could donate a kidney that could be “swapped” for a kidney for Turnis.
“We do a very thorough evaluation,” said Brittany Hohoff, a kidney transplant nurse coordinator at UIHC. “I always tell the donors, ‘Our main job is your safety’.”
The transplant team looks at the prospective donor’s kidney function to make sure the donor can continue to thrive with only one kidney — which isn’t all that unusual. One in 1,000 people are born with only one kidney, Harshman said.
Transplant surgeons typically remove the left kidney because it’s on the opposite side from the liver, which makes the surgery less complicated. But in Anderson’s case, they learned her left kidney was slightly larger and they wanted to leave her with that organ, Anderson said.
“I just trusted the doctors,” she said. “I also reached out to a colleague who donated a kidney a few years back. They said ‘you’ll be fine’.
Donors through the National Kidney Registry go to the top of the deceased donor list if they ever need a kidney transplant, as do designated family members, Hohoff said. This means Anderson’s son, Mateo, will have better odds if he ever needs a transplant, Anderson said.
The registry was able to find a unique donor to provide a kidney for Turnis, who also battles eosinophilic esophagitis, a complicated digestive system disorder that causes his body to attack some foods like a poison. A new medicine is keeping that disorder under control, but Turnis still has antibodies against transplants from about half the population, Harshman said.
“If we would have gone through the deceased donor pool, his options become limited,” she said. “Through the National Kidney Registry, we can look at different swaps. The national data suggest there is a distinct living donor advantage.”
When surgery day arrived, Anderson was first in the operating room. Turnis and his father, Ron, saw who they believe was the courier who took Anderson’s kidney to Chicago O’Hare International Airport, where it was flown to the Southwest to be transplanted into another recipient. A few hours later, that same driver brought another kidney back from O’Hare for Turnis.
Less than a week after their surgeries, Turnis and Anderson met at the Ronald McDonald House, where Turnis’ family stayed while he was in the hospital.
“Now that I’ve got this new kidney, I’m on the road to recovery and hopefully, let’s let this kidney last as long as it can,” Turnis said.
“My plans are to do a few years at a local community college and eventually transfer to the University of Iowa to get an education in Child Life Specialties. Being in a children’s hospital all my life, I could bring a different perspective to the profession.”
The UIHC transplant team will monitor Anderson for two years, but Hohoff said she’s available as a resource long after that. Anderson knows she needs to make sure she’s drinking plenty of water, which she does anyway, and be wary of how some drugs, including ibuprofen, can affect her remaining kidney.
She wears a T-shirt that says “Share your spare” and “Recycle your parts” as a way to advocate for being a living donor.
“We want to take the best care of them possible because they are providing the ultimate gift to this patient,” Harshman said.
Comments: (319) 339-3157; erin.jordan@thegazette.com