The Day I Decided to Become a Kidney Living Donor | Nancy Rowe

On August 16, 2018, my right kidney boarded a non-stop flight from Newark to San Francisco. A little over five hours and five thousand miles later, it was doing its new job for a 30-year-old woman whom I had never met.

My donation story started in 2017, on my 47th birthday. I woke up to the realization that my child-bearing years were all but over. I never had kids…not by design, just by circumstance. I remember feeling guilty that day, that I had not used the health I was blessed with to benefit another human (i.e., a baby!). Suddenly, I knew I needed to bring forth life some other way. Living donation of a kidney seemed to be the perfect solution.

The Road to Donation: Making up My Mind and Making the Time

Even though I had made the decision to donate, the stars still had to align logistically. My job in corporate marketing kept me on the road a lot, which would not work well with a donation schedule. Then, in early 2018, my company was sold, and I was out of a job. At that point, I decided to make a drastic career change, which required going back to school. Having a flexible student schedule was perfect for donating, and on March 9, 2018, I sent the living donor application in to Penn Medicine.

I tried not to get my hopes up too much since I had no idea if it was hard to get approved. A few weeks later, I received a call from the living donor coordinator at the Penn Transplant Institute. I remember feeling like I had won the lottery! The first question I was asked was if I was sure I wanted to donate non-directed (also called “altruistic”). Yes! I did not know anyone personally that needed a kidney and I felt very confident about letting UNOS make the match between my kidney and the over 100,000 people on the waitlist for a donated kidney. UNOS, the United Network for Organ Sharing, is a non-profit organization that manages the nation’s organ transplant system to make lifesaving organ transplants possible every day.

Getting the Green Light to Give Away My Kidney

And then, I was approved…pending six months of testing, that is! Throughout the evaluation and screening appointments, I never felt a moment of hesitation. My only fear was that at any moment I could be removed from the donation process for any biological, psychological or medical reason.

At one point I asked a nurse something along the lines of: Isn’t an “ok” kidney better than no kidney when so many people will die without getting a transplant? That is when I had the “ah-ha” moment that so much of the evaluation and testing was for me, not just the recipient. The Penn transplant team was my team, and their job was to make sure I was mentally, physically, and emotionally fit to donate; AND that my body and remaining kidney had the best chance to live a long, healthy life.

Here is the list of my appointments and tests from March until my donation in August:

• Three Independent Donor Advocate calls
• Six meetings:
  • Transplant coordinator
  • Finance specialist
  • Psychologist
  • Social worker
  • Surgeon
  • Surgical floor RN
• 23 total medical tests:
  • 24-hour urine collection* (x2, because I messed one up!)
  • Blood, blood and more blood!
  • Glucose tolerance
  • EKG
  • X-rays
  • Pap smear (at my PCP)
  • Mammogram (at my PCP)
  • MRI
  • Cat scan
  • Radioactive CT with Lasix (kidney flow test because I had 3 renal arteries)

Deciding on a Donation Day

Sometime in July, during a routine blood draw appointment, I was asked what dates would work for me to donate. Whoa! The day was finally coming! Since I was still in school, I decided the month between summer school and fall semester would be ideal, and August 16th was chosen.

Because I was a non-directed donor, I was going to start a paired kidney exchange, meaning that my donation would begin a chain where a number of people would be getting a kidney on the same day, like a domino effect. However, that also meant there were so many more balls in the air, increasing the chance that something could go wrong leading up to what I called “The Big Day” - one recipient or donor along the chain could get sick, one person could change their mind, or who knows what else behind the scenes. I was super nervous that it wouldn’t happen, as by now I was so invested and very excited.

The Big Day: Sharing My Spare (Kidney)

On August 15th, I got a call asking if I could come in that night since my surgery was so early. Soon, I was in an Uber and headed to Penn in Philadelphia check-in at the Hospital of the University of Pennsylvania (HUP). I received a very large, private room, since I was a donor, which I thought was a really nice touch! It was very strange to become a patient while feeling as healthy as ever.

My wake-up call was to be 5 am for a 6 am transport to the O.R., but I couldn’t sleep. Around 4 am I got up and walked laps around the unit. I kept count, and with the distance math the nurses gave me, I walked three miles! I am sure the staff thought I was crazy, but I figured that was the last exercise I would be able to do for a while.

Before I knew it, I was in pre-op holding. All I really remember while there was the anesthesiologist encouraging me to get an epidural for pain. I declined. I did not want to put any more drugs into my body than absolutely necessary.

Once in the O.R., I tried hard to stay alert for as long as possible. I was really interested to see all the activity since it was my first time inside an operating room. My surgeon, Dr. Naji, came over to thank me for my gift, and ask if I still wanted to donate. That is incredible, donors can change their mind right up to the moment of anesthesia! Dr. Naji held my hand while I was put to sleep, a small act of kindness that I will never forget.

My first activity after I woke up was to check my phone. I hoped they remembered my request for a picture of my kidney. My heart skipped a beat when I saw the email entitled, “it’s a beauty!” That whole day, I felt good and was happy everything went well. Boy, did coffee taste good when I was finally allowed to have some. I thought…this surgery was not bad at all!

The Road to Donor Recovery

Then sometime that night, I got a migraine headache, my stomach was upset, and I felt awful. Also, the painful heparin shots started, making matters worse! After a rough night and following day, things started to look up little by little. On day three, I was discharged. On my way out, Dr. Naji told me that the transplant surgery out in CA had been a success.

Over that first week, I napped a lot, dealt with abdominal pain, and struggled with constipation. It was a frustrating week at times, but I had to remind myself that my body was in shock, as it had never been through such “trauma” before. My body had gone to sleep healthy and work up “sick” so to speak. But I kept thinking of Lori, the recipient of my kidney, who had gone to sleep sick and woken up healthy. On Day eight, I started to feel like myself. I could walk longer distances, was relatively pain free, and was off all meds (yay!). From then on, my body bounced back very quickly.

Back to Normal Routine, No Regrets

Within about six weeks I was back to most of my normal life and routine.

Three months later, I received a hand-written thank you card from my recipient. She wrote: Immediately after my surgery, your kidney started working beautifully. I learned that she had spent five years hooked up to a dialysis machine every night, and now she had her life back. I keep that card displayed to this day.

I went back to the Penn Transplant Institute for UNOS-mandated post-donation checkups at two weeks, six weeks, six months, and one year. Everything part of this process ensures that the donors receive exceptional care beginning to end! On 8/16/20, the two-year mark, I officially “graduated,” although I am able to follow up with my transplant team if any needs arise in the future. Also, if I ever do need a kidney transplant myself, I would be priority listed, as a donor.

Living with one kidney required some minor life style changes to protect my remaining kidney, including only taking Acetaminophen products (Tylenol), avoiding supplements, staying hydrated, and watching my protein intake (eating moderate levels). Physically, I have some residual numbness at the surgery site. Other than that, I sometimes forget I only have one kidney!

Looking back, I have zero regrets. In fact, I often wish I could do it again. In the grand scheme of things, I barely remember the hard or painful parts. Those moments seem fleeting.

When people hear that I gave a kidney to a stranger, “hero” is a common response. However, I am a normal, everyday person who found donating a kidney to be very do-able. I believe that by normalizing living donation and taking “heroics” out of the equation, more people will consider giving away their extra kidney. This is why I tell my story.