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Jul 26, 2023

Five kidney donors and their recipients make up a chain of life : NPR

Scott Simon Ten people are linked in a life-saving kidney swap - one that involves living donors. We bring you a close look at the complex chain of surgeries from Houston Methodist Hospital. DAVID

Scott Simon

Ten people are linked in a life-saving kidney swap - one that involves living donors. We bring you a close look at the complex chain of surgeries from Houston Methodist Hospital.

DAVID FOLKENFLIK, HOST:

Scott Simon is off the show this week, but he brings us an important story out of Houston about a group of strangers connected by a life-saving decision.

MICHAEL WINGARD: Howdy. I'm checking in.

SCOTT SIMON, BYLINE: Michael Wingard, a rangy young man with a small brown scrub-brush of a beard, checks into Houston Methodist Hospital. He's in fine health, and he's about to have his left kidney removed. It'll be sewn into the body of a total stranger. It is the day before Michael Wingard turns 20.

M WINGARD: Yeah, it is. But I've barely even thinking about that (laughter). So no cake, unfortunately. It'll be like Jell-O or something like that.

SIMON: The Wingard family is from Kerrville, Texas, about four hours west of Houston. Michael's parents, Adrien and Ed, are with him, and their eyes moisten above their masks. Michael's mother tells us...

ADRIEN WINGARD: So I'm very, very nervous and scared and all those emotions, but I'm so proud of him. So when I asked him, he was like, Mom, if I don't do this, no one will. So he knew that his friend needed a kidney and had to do whatever it took to make it happen.

SIMON: Michael Wingard is the first link we met in a 10-person chain of life. He's donating a kidney because Kaelyn, his friend in Kerrville, has one that's failing. Michael's kidney doesn't match her blood or tissues, but transplant specialists at Houston Methodist know Michael's kidney can go to Heather, 30-year-old woman in Dayton, Texas, whose kidneys cannot clear waste from her blood.

She and her twin sister Staci already have identical tattoos in Gaelic, but they have some incompatible antibodies. So a 43-year-old woman named Lisa, who dotes on her family and their bulldogs, will donate her kidney to Kaelyn, so her 72-year-old mother, Barbara, a great-grandmother, can receive a kidney from a 67-year-old year old man, David. And Staci can give her kidney to a 47-year-old man named Javier so lives can go on. No one in the swap knew the identity of their donors and could choose to keep it that way, but they're bound in a chain of life. We asked Adrien Wingard.

You're a mother. You're a parent. The last thing we want for any of our children is for them to be hurt in any way.

A WINGARD: Yeah.

SIMON: Did it ever occur to you to say, don't? Please, honey. This could be - I know the odds are small, but, my God, it's serious surgery.

A WINGARD: Yeah. It actually didn't. You know, his mind was set, and we knew that we wouldn't want to change that. He gets to show people by example of how to be a good person.

(SOUNDBITE OF MUSIC)

SIMON: Houston Methodist Hospital is one of the leading transplant centers in the world. The music we're hearing, by the way, is played live on a piano in the lobby of the hospital. There are now about 90,000 people nationally on a waiting list for a new kidney. Many wait years. Some die waiting. Transplanting kidneys from live donors greatly increases the number of kidneys available, and such transplants are performed every month at Houston Methodist. This 10-person procedure is rare. With all the complexities to be synchronized - matching antigens, patient health and COVID - this kidney swap has already had to be postponed three times since December, but no longer.

Dr. Richard Link, Michael's surgeon, arrives early the next morning as the sun climbs the Texas sky and Adrien and Ed Wingard blink out blurriness and a few tears.

RICHARD LINK: We're going to take out the left side today, and the left side and the right side are very similar for you. They're very similar in size, but the left side is a little...

SIMON: Dr. Link explains that with laparoscopic surgery, they can remove a kidney through a two-inch long incision.

LINK: And I've probably done more than a thousand that way at this point. You'll be surprised that we can get a kidney out of the size of the hole that we make. It's a little bit of a magic trick. It's really the only magic trick I know how to do.

SIMON: Well, it's funny you say a magic trick. It's also - I mean, this whole story is kind of a miracle, isn't it?

LINK: It is. It is. This is emblematic of really an incredible gift, obviously, for you and also just an incredible system that now exists to allow this type of swapping to facilitate getting kidneys for so many people.

UNIDENTIFIED PERSON #1: So at this point, you can give, like, hugs, kisses, high fives.

SIMON: And when Michael Wingard is wheeled down a hall for surgery, his parents hold on to him, then on to each other's hands.

ED WINGARD: Alright, buddy. Rock it.

M WINGARD: Yeah. Come here, mama. I love you, mama.

LISA JOLIVET: So I give up one of my kidneys to help someone, and someone else will give a kidney to help keep my mom going.

SIMON: Lisa Jolivet of Houston, is 43, and her COVID mask can't conceal some of the same ebullience of her three teen children. She says her 72-year-old mother was at first opposed to her donating a kidney to a stranger to help her.

JOLIVET: You know, she kind of threw in the towel and was just like, this is my faith. And we're like, absolutely not.

SIMON: Lisa says her mother worried that her daughter's act of love might be risky for her health and her own children.

JOLIVET: I think she was more against it because I have my own family, right? She feels as though I'm in the prime of my life. But, you know, after, you know, we researched, I provided confidence in her, like, hey, you know, this works.

LINK: So this is the kidney right here.

SIMON: We were able to be present at the hospital for most of the 10 surgeries. Each one is amazing and intricate, but you begin to see why surgical teams call them routine. The territory inside a body becomes familiar. They know all the stops, turns and shortcuts.

LINK: So this is the renal vein right here, this blue structure. That's an important - obviously important structure for the transplant. So we're going to preserve it.

SIMON: Dr. Link slices through skin and tissue around muscle and toward the left kidney. He steers a laparoscope with a tiny light and camera to guide the snips made with a harmonic scalpel that cut and cauterizes in the same slice, through red veins small as wisps and globs and smears of yellow fat.

LINK: So we're looking - now we flip the kidney over, and we're just kind of looking behind it just to see if there's anything else that needs to come.

SIMON: The journey to the left kidney is captured in 3-D images that dramatize the colors, and the view is other- as well as inner-worldly. The spleen looks like a smooth pink bean designed by a big-name architect. The stomach walls are whorls light pink and ivory like a great cathedral. You are reminded of Shakespeare's phrase, what a piece of work is man.

LINK: So let's see. Do you have for us our stuff for the extraction? Do you have...

UNIDENTIFIED PERSON #2: Yes, sir.

LINK: ...fifteen bag, up and ready? We've got two loads on the stapler. You've got to clip applier, scissors.

UNIDENTIFIED PERSON #2: Yes, sir.

LINK: Perfect.

OSAMA GABER: So can I explain? Hi.

SIMON: Dr. Osama Gaber, head of the Houston Methodist's transplant program, sits ready at a silver bowl packed with crushed ice. When the fist-sized kidney has slipped out through a slit that looks about as wide as the edge of a credit card, it's rinsed and placed in the bowl. The crushed ice begins to melt against the kidney and turns the bowl slushy and red like a summertime treat.

GABER: The major problem with transplants is as you take organs outside of the body, they die very quickly. So cooling is one technique, and the other one is to put fluid inside the kidney, No. 1, lowering the temperature because that's cool, but No. 2, you're also getting all the blood out.

SIMON: And then he takes off down a hallway with a human kidney packed in a plastic bag inside a white plastic ice bucket of the kind you might find in the room of a chain motel. Most of the time, Dr. Gaber balances the bucket that holds the kidney with one hand. No one he encounters in the hallways stops to chat.

GABER: They know me. If I'm carrying something, it has to be an organ.

SIMON: Kidney is received and sewn into place in the front of the lower belly, where it can be protected by abdominal muscles. When the ureter of the new kidney is connected in the body, it spurts out a few drops of urine.

HEMANGSHU PODDER: That was urine, actually. Sometimes they shoot like a little baby boy.

SIMON: Dr. Hemangshu Podder and the surgical team sound as delighted as parents of a newborn over a crib.

HEATHER O’NEIL: Apparently, I peed all over the table as soon as he hooked it up.

SIMON: Heather O'Neil told us the day after she got her new kidney.

O’NEIL: I was like, oh, that's great (laughter).

SIMON: And she'd be happy to meet the whoever it is whose kidney is now hers and working well.

O’NEIL: I'll be kind of awkward, though, I think, but I feel like I should meet whoever gave me their kidney...

SIMON: Yeah.

O’NEIL: ...And thank them.

SIMON: Next week on our show, participants in Houston Methodist’s 10-way live donor kidney swap meet each other in an emotional face-to-face reveal. Scott Simon, NPR News.

FOLKENFLIK: This story was produced by Samantha Balaban and Gabriel Dunatov and edited by D. Parvaz.

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