Local couple defines compatibility
Husband provides ‘life-giving’ kidney for wife’s transplant
By Jan Galletta Staff Writer
For Joyce and Jackie Lewis, it’s been a love match since they met in the ’70s after his big brother married her older sister. The younger pair discovered many shared interests and wed in 1979. In April, the Sale Creek couple reached a new level of compatibility when Mr. Lewis, 59, donated a kidney to Mrs. Lewis, 58. They said the transplant, which wouldn’t have been possible before recent advances in anti-rejection drugs, is a gift that adds poignancy to the family’s Father’s Day festivities today. Plagued for decades with kidney problems that doctors suspected were caused by a blood pressure disorder, Mrs. Lewis started dialysis last fall and went on the transplant waiting list. She said she resisted the idea of her husband as an
organ donor when tests showed he was a suitable candidate. “He was healthy. I didn’t want him taking that chance,” she said. “You can’t just look at somebody you love and say, ‘By the way, can I have a body part?’” But Mr. Lewis said he never had a second thought. “Organ donation wasn’t in the wedding vows, but I’d seen what it (kidney disease) was doing to her,” he said. “I was going to do anything that I could. I’m stubborn.” TRANSPLANT ADVANCES The couple’s pre-transplant talk would have been hypothetical just a few years ago, according to Misti Thach, registered nurse and clinical transplant coordinator at Erlanger hospital, where the Lewises underwent surgery. She said the hospital’s first spouse-to-spouse transplant took place in 1994. Before that time, medical specialists determined the compatibility of prospective donors and recipients by examining their genetic makeup. Clinicians looked for a total of six antigens that were known to play a part in each individual’s immune-system response, she said. Those with matching antigens were approved as potential partners for an organ-transplant operation. But Ms. Thach said such genetic similarity isn’t required today. “Over the past 13 years, there have been advancements in immunosuppression medications that allow for less side effects and less acute rejection of the transplant,” she said. “With proper immunosuppression, the antigen match can be zero.” The new generation of antirejection drugs comes at a time when about 17,000 kidneys are transplanted in the nation each year, according to the Organ Procurement and Transplantation Network. However, 70,000 names remain on the waiting list for kidneys, according to the network’s Web site. Transplants such as the Lewises’ that involve biologically unrelated donors and recipients could whittle the waiting roster by 15 percent, according to Ms. Thach. “In 1996, there were 3,790 living kidney donors with only 15 percent of those being from a spouse or other unrelated donor,” she said. “In 2005, there were 6,895 living donors with 33 percent being from a spouse or other related donor.” Organs from living donors lead to more successful transplants than their cadaver counterparts, according to the United Network for Organ Sharing. The average cadaver kidney lasts 11 years, but a kidney from a living donor typically functions almost twice that long, according to statistics on the network’s Web site. Mrs. Lewis said her urologist, Dr. Rohit Gupta, first discussed transplant in September when drugs for her high blood pressure failed to curb the problem and her kidney function dropped to 11 percent. With her diagnosis of end-stage renal disease came Medicare approval for transplant coverage. For months, Mrs. Lewis took three-hour dialysis treatments three times a week and was hospitalized twice for blood-pressure readings in excess of 200. The blood-cleansing dialysis treatments filtered body waste, but they also removed vitamins and minerals, she said. “I couldn’t grow fingernails. I had no energy,” she said. “I had to push it to do household chores, and many times I had to hold onto a wall to get to the bathroom.” At the Erlanger transplant center, the Lewises learned the average time to find an exactmatch donor is two to five years. Mr. Lewis was the first family member to be tested. “The further I went along (in tissue-testing), the better it was looking for me to give her a kidney,” he said. “I had two of six possible matching antigens.” LESS-INVASIVE SURGERY The laparascopic surgery that removed Mr. Lewis’ kidney entailed tiny incisions instead of the large flank incision of earlier days, according to Ms. Thach. This new approach typically lessens donor risk, trims hospitalization time, reduces postoperative pain and permits quicker recovery, she said. Before the hourlong operation was over, the transplanted kidney was working. “By the next day, I could tell the difference in her color and facial expression,” Mr. Lewis said. The surgeons, Drs. Michael Roe and Daniel Fisher Jr., placed the new kidney into Mrs. Lewis’ lower left abdomen without removing her two original kidneys. Her scar is smaller than the one she got with her Caesarean section, she said. Three days after the transplant, three of her five blood-pressure drugs were discontinued. The next day the couple was discharged, and within three weeks Mr. Lewis resumed working as a purchasing shop supervisor at R&R Concrete Erectors. Since the surgery, Mrs. Lewis has returned weekly to the transplant center for follow-up care and intravenous therapy to ward off infection risk. She said she may remain on anti-rejection drugs for the rest of her life, but she expects longer intervals between future follow-up visits. Last week, doctors gave her the approval to visit with the couple’s three grandchildren. That license to hug, plus her new lease on health, shapes up to make this Father’s Day a happy occasion, she said. “I already worshipped the ground he (Mr. Lewis) walked on, but how do you repay someone for giving you life?” Mrs. Lewis said. “Saying ‘thank you’ doesn’t seem enough.” E-mail Jan Galletta at firstname.lastname@example.org BY THE NUMBERS 70,000 — Names on nation’s waiting list for kidneys 17,000 — Annual kidney transplants in America 2,025 — Kidney transplants in Tennessee through March 31 1,476 — Names on Tennessee’s waiting list for kidneys 187 — Spouse-to-spouse kidney transplants in Tennessee through March 31 18 — Kidney transplants at Erlanger in 2006 Source: United Network for Organ Sharing
Staff Photo by Dan Henry Joyce Lewis sits outside her home with her husband, Jackie, who donated one of his kidneys to her.