MUSC celebrates its first internal living donor kidney transplant chain
Barely 40 hours after major surgery, Christine Thompson slowly made her way over to the man in the wheelchair, all but ignoring her pain. Their hug lasted but a few seconds, but it spoke volumes.
“I love you,” Christine told him, punctuating the silence. Her husband, Bruce, sat on the edge of his own hospital bed, wiping away tears.
“I love you, too,” Dareus Brown replied, his voice cracking with emotion. His wife, Renee, tenderly patted his shoulder, knowing that thanks to Christine’s sacrifice, this was the beginning of a life they would share together. It was a welcome relief after such a long journey — one that saw the couple marry on Oct. 1, unsure of what the future held for them.
Just two days earlier, Dareus and Christine were complete strangers, but they shared something few ever will: a kidney. But as special as that was, they weren’t the only ones, because fortunately, there was also a miracle in store for Bruce, who had been on the kidney waiting list since February of 2017.
While Christine had originally hoped to give one of her two healthy kidneys to Bruce, the couple, also newlyweds, received disappointing news — she was not a match.
Thankfully, the story didn’t end there. Christine made a compassionate decision — one that ultimately would save Dareus — a man who certainly had had a rough time waiting for the gift of life.
“Initially, I wanted to donate a kidney to keep Bruce alive,” she said. “But I thought if I can’t help the man I love, still, there’s a person out there who might need it.”
After discovering a match had been found for Bruce, Christine decided to pay it forward.
“In a really strange way, it was almost better that I wasn’t a match for Bruce,” she said. “I knew by him getting help, I could help at least one other person.”
Luckily for Bruce, good Samaritan Mindy Runk always knew in her heart she wanted to help another person in a meaningful way. When she found out she was a match for Bruce, that wish came true. Not bound by family or friendship, Mindy selflessly gave one of her kidneys to a man she had never met. On the same day Mindy answered Bruce’s prayers, Christine donated her kidney to Dareus.
On Jan. 10, four people — two recipients and two donors — were wheeled back to surgery, creating the first-of-its-kind internal living-donor kidney transplant chain at MUSC, an act that saved two lives and created countless friendships.
A kidney chain is an altruistic approach to living donor transplantation. When an anonymous donor comes forward to donate a kidney to a person he or she has have never met, it initiates a special chain of events — one where logistics require meticulous planning, said Satish N. Nadig, M.D., Ph.D., the transplant surgeon and living donor program director who oversaw the coordination of the kidney chain and performed Mindy and Christine’s laparoscopic kidney removals.
Nadig said the surgeries went wonderfully. In just a matter of days, the patients would feel well enough to be released and resume life.
But before that would happen, the patients were eager to meet each other.
On Jan. 12, three couples — the Browns, Runks and Thompsons — met face to face in the Thompsons’ shared hospital room.
“Welcome to our home, our little apartment,” Christine said to the burgeoning group of patients, family members, friends and doctors congregating in their room.
After teary introductions and warm embraces, Dareus asked Mindy, who is credited with being the first donor, thereby kicking-off the donor chain, what made her become a kidney donor.
Before finally conceiving her daughter and son, Mindy and her husband, Ben, had a tough time trying to get pregnant. As a result, she thought she might want to help other couples by acting as a surrogate. But they decided that plan wasn’t a good fit for their family, she explained.
“I just thought I needed to do something to help someone. So we started thinking about living donation. My friend has a friend who has a daughter who needed a kidney,” Mindy said. “He was posting on Facebook about his little girl. I saw her, and she almost looked like my daughter. She was a sweet looking little girl.”
She was touched by how sad the situation was.
“She’d already had one transplant, and it had been very difficult for her. If it were me, and I had to basically beg strangers on Facebook to try to help my daughter — well, it broke my heart a little bit. I knew I had to go get tested for her.”
But Mindy wasn’t a match for the little girl. So when a transplant coordinator asked if she would be willing to consider a good Samaritan donation, she agreed. Mindy is particularly knowledgeable about organ donation through her work with Sharing Hope SC, where she serves as the quality coordinator.
So when she was a match for Bruce and, subsequently, Christine a match for Dareus, it created an internal chain, meaning doctors did not have to go outside MUSC for recipients or donors, allowing them to control the external factors that affect their patients.
“You’re not at the mercy of timing or mercy of having the organs travel long distances,” Nadig said. “You can control all those variables, which makes it very fulfilling for the surgeon and ultimately, and most importantly, better for the patients.”
Ben shared with the group how he felt about Mindy’s plan.
“I have to admit, I thought she was crazy,” he said with a laugh.
“But a good crazy, right?” Mindy teased.
“Not many people would do what she did," he said, pulling his wife closer. "Both of our families are very proud — she’s just so courageous. So, yes, it’s been a good crazy. If you have to be crazy — this is the best kind,” Ben said, as everyone in the room burst into laughter.
“It’s like a two-for-one,” Baliga said, referring to double donors. “It’s kind of like having twins,” he said, adding to the levity in the room.
Even until recently, though, outlooks hadn’t been quite so optimistic. To joke around and laugh, well, that made things seems normal again.
Dareus had been through the ringer — he’d been on the kidney transplant list for more than two years and had undergone dialysis for three.
The kidneys are responsible for filtering waste products from the blood, and with him in end–stage renal failure, his weren’t getting the job done. When kidneys no longer function properly, a procedure called dialysis can act as a substitute for many of the kidneys’ normal functions. Three times every week, from 5 o’clock in the morning until 8:30, he would have his blood filtered, before reporting to his full-time job — taxing, to say the least.
On a very special day, he received good news.
“We got the call on his birthday that there was a kidney for him — it was an extra special birthday,” Renee said.
The week before surgery, he had his last dialysis treatment.
Nadig is thrilled with how well the first internal living donor chain went.
“It’s the most fulfilling, most satisfying thing you can do,” he said. “Taking somebody whose lifespan is cut down, because they’ve been on dialysis so long, and being able to give them the gift of life with someone’s kidney who is donating to them out of the goodness of their heart.”
He said this type of experience brings out the real humanity in medicine.
“Our field doesn’t run unless people are kind to each other — you have to donate your organs in order for people to get transplanted. This is just the epitome of that kindness. To be able to accomplish this with all of the patients being ours, on our list, and be able to help all of them at one time is pretty special.”
He hopes to have the opportunity to do many more. MUSC has one of the strongest organ transplant programs in the nation and is the only center in the state. Since 1968, surgeons and transplant specialists at MUSC have been helping kidney transplant patients from across South Carolina and beyond live happy and productive lives. In 2017, 276 adult and pediatric kidney transplants were performed.
MUSC’s outcomes and organ transplant survival rates are among the nation’s best, despite the fact that MUSC treats more than twice the national average of high-risk patients. The average waiting time at MUSC to receive an organ transplant is among the shortest in the nation.
Donor chains are becoming more widespread across the country, and good Samaritan donors are not as rare as one might think. People often hear stories about others in need, and those pleas touch their hearts. Kidneys transplanted from living donors last much longer and patients tend to do better postoperatively. When individuals are open to being good Samaritans, the transplant team actively looks for exchanges.
Baliga has big aspirations for the new internal exchange program.
“We will continue to exchange with other national exchange programs, where a kidney flies to New York, California or Seattle. But now, we’ve been able to develop an internal one. What facilitates an internal program is when you have a good Samaritan donor, which facilitates these chains. This is the first time we’ve done an internal chain. We’re really excited to do everything here.”
He said doing four back-to-back surgeries simultaneously on the same day was thrilling.
“The team was really excited. We’d absolutely love to do more. This is the fun part of it — seeing it being successful and making an impact on patients’ lives. It gives me more satisfaction than you’ll ever know.”
Mindy is ready to go home. She wants to be there when her kids — Mason, 6, and Ava, 9, get off the school bus.
In two weeks, Christine and Bruce would be moving to Washington, D.C. to start a new job. She thought she would soon be packing, but upon reflection, that seemed a little out of the question.
She plans to call Dareus in Savannah to check on her kidney.
“I would love that,” he told her.
Mindy warned Bruce that he might start craving Mexican food, as that’s her favorite. In fact, she added, that’s what they had for their celebration dinner the night before the surgery.
“When I crave Mexican, I will call you,” Bruce said, laughing. “We can all go to Juanita Greenberg’s.”
It was a date.
As the meet-and-greet began to wind down, the four patients were tired but grateful. They thanked each other again and admitted words could in no way express the depth of their feelings.
Bruce said he texted Christine before they were in a room together to thank her for paying it forward. “She didn’t have to donate…” he said, his tear-filled voice trailing off.
The text read, “You gave me a life and then gave me the gift of life.”
That’s what love does, the couples agreed.