Gift of love ushers in new era in transplantation

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What a difference a year makes. Twelve months ago Barb Smith never felt worse. Her health had deteriorated to the point where she just wasn’t the same person or the same wife and mother that she used to be. Smith, who is in her forties and lives with her husband Dan and two teenagers in Sault Ste. Marie, Ontario, felt she was starting to lose her 16-year battle with kidney disease. Dialysis became part of her life six years ago. Smith says, “Kidney disease and dialysis affect everyone in the family. You have to think twice about everything you’re doing and everything you’re planning. Ultimately, there are some things you can’t even do.”

Barb and Dan knew it was time for a kidney transplant.

Without hesitation, Dan knew he wanted to be the one to give Barb a kidney, even before they were sure he would be a match. Amazingly enough, all the tests came back giving the green light for Dan to donate his kidney. Dan Smith says, “Even before we had the test results, I just knew that this would work. My decision to donate my kidney was a little selfish too, because I wanted my wife back.”

Barb was overwhelmed by the whole thing and says, “I never asked Dan or anyone else to donate. Dan was just determined that the kidney I needed was going to be his.” Barb knew how fortunate she was not having to wait for a cadaveric donor. Now it was just a matter of when the surgery would take place.

Then word came that the transplant would happen in July at London Health Sciences Centre ( LHSC) in London, Ontario. It would be a summer to remember, not only for the Smiths, but also for LHSC’s Multi-Organ Transplant Program (MOTP).

On July 26, 2001, the Smiths, together with their doctors, Dr. Patrick Luke, Urologist, and Dr. Douglas Quan, Surgeon, made history after successful completion of the first laparoscopic donor nephrectomy at LHSC.

Unlike the traditional operation to remove a kidney from a living donor, where a large incision is made, a laparoscopic donor nephrectomy is minimally invasive. Through small “key hole” openings, the kidney to be donated is separated from all the tissue and organs surrounding it and removed through a four centimetre (less than 2 inches) incision below the belly button. Surgeons are able to have a view inside the patient through the use of a laparoscopic camera which is inserted into the belly button.

The benefits to the donor of a laparoscopic donor nephrectomy are less pain, a faster recovery, and only a minor scar. The hospital stay and recovery time for the donor is also cut in half with this new procedure.

Dr. Patrick Luke says, “We are really pleased with the success of our first procedure. The fact that this is minimally invasive provides a wonderful, less demanding option for kidney donors.”

Dr. Quan adds, “This will likely be the standard of care for living donor kidney retrieval in five years. However, anatomical differences in people may prohibit this type of procedure being used in everyone.”LHSC’s transplant team expects to do between ten and 20 laparoscopic donor nephrectomies this year.

Living kidney donors have been used for more than three decades because they can safely donate one of their two kidneys and still live a healthy life. Among the other advantages of living kidney donation, patients receive their transplant within a year, compared to a two to a five-year wait for a suitable cadaveric donor. Living kidney donation also means fewer complications following the transplant. Last year 78 kidney transplants were performed at LHSC and 21 came from living donors.

As for the Smiths, they’ve never been better. Both had a great recovery from the transplant operations. Dan was off work for a couple of months following the surgery because his job involves heavy labour, but he’s been back to work since last October. Barb is back to cross-country skiing, with the transplant allowing her to really go the distance. Barb says, “Ever since the transplant, I can’t wipe the grin off my face. It’s been such a wonderful change for the whole family. We have our life back, and it’s brought us closer together as a family.” With that grin turning to a big smile, Barb adds, “How do you ever say thank you for such a wonderful gift?”