Julie Stitt begged her husband for years to let her donate her kidney as he spent nearly a decade in dialysis, through two failed transplants. Last year, he relented.
It was a difficult decision. Her husband, Chuck, didn't want her to make the sacrifice. And she knew her father, Richard Kern, would need a transplant eventually as nearly five decades of diabetes wore on his kidneys. That time came about a month after her decision.
"It was a hard place," Julie Stitt said. "I wanted to give to my husband, but I knew my father would need one."
She volunteered to donate to a stranger, getting her husband on a donation exchange waiting list. But it was "fate," she said, that had a way of working things out for both men in her life.
When Kern arrived at the University of Maryland Medical Center earlier this month for his transplant, his daughter was there, too. As he prepared for the surgery, his doctor stepped out to visit the donor — Kern's wife, Donna, followed. To Julie's room.
In what the family considers some sort of divine timing, Julie's donation not only allowed for her husband to receive a transplant from a stranger, it also came as her father reached the top of the transplant list. While it's relatively common for relatives to donate to each other, in transplant chains that make more surgeries possible, the serendipitous donation was a rarity that hospital officials said highlights the potential for a paired kidney exchange program to promote more transplants.
The chain of events dates back nine years, when Chuck first suffered kidney failure. He underwent two transplants since then, both of the organs from cadavers. But neither functioned well for long. His wife wanted to help, but he was reluctant to let her.
"I had offered from the beginning, but he just did not want to put me through the process," Julie said.
"I would have felt guilty asking her," Chuck said.
But she finally convinced him in February 2012. "She pretty much told me I was going to accept," he said.
The Jessup couple signed on to the paired kidney exchange program at the University of Maryland. While the Stitts weren't a match — matching depends both on blood type and antibodies in the recipient's bloodstream — Julie could donate to a stranger, instead, to get her husband on the program's list.
Nearly a year later, a kidney became available that was a match for Chuck, and he received the transplant in December. Such transplants, coming after earlier transplants, are tricky because the body builds up antibodies that can attack foreign tissue. But it was successful — Chuck has recovered and is healthy, now with five kidneys in his abdomen — only one of them functioning well.
Meanwhile, a transplant became necessary for Kern in March 2012. The 73-year-old Frederick County resident has lived for 48 years with diabetes, the most common factor in kidney failure. The disease lowers the kidneys' ability to filter waste out of the blood.
Donating directly to her father wasn't an option for Julie since she was obliged to give her kidney to someone on the paired exchange list. Kern joined the waiting list, and the families moved on.
Enter what Julie called fate or "someone watching over."
As a second-grade teacher in Prince George's County, Julie could donate only during the summer, and the summer of 2012 was too soon, given all the testing and other hurdles required. So she waited until this summer, as her father spent a year on dialysis.
The family asked the transplant program officials if it might be possible that the father and daughter could be paired, but for privacy reasons, the program's rules do not allow sharing details about the donor and recipient unless they agree to it after the surgery.
When both got word to be at the hospital July 16, they had a strong inkling. But it wasn't confirmed until that morning, when the family saw the same doctor visiting both patients. They both waived their privacy rights after the surgery to find out for certain.
"It worked out like a miracle," Julie said.
They faced odds that suggest as much. They were helped by the fact that both father and daughter had type AB blood, a trait found in only 1 percent of the population, said Dr. Stephen T. Bartlett, surgeon-in-chief for the University of Maryland Medical System, who performed the second half of the transplant surgery on Kern.
That they faced the option in the first place arose from even slimmer odds, Bartlett said. Of about 16,800 kidney transplants in the United States last year, about 3,000 involved donors and recipients who were related, according to the National Kidney Foundation. About 700 involved spouses or life partners.
"The odds of any one person getting kidney failure, the incidence is 1 in 3,000," Bartlett said. "The chances of two people who aren't related, but are related to you, it's one in 9 million. It's such an incredibly rare event."
Bartlett said the coincidence just shows the "enormous potential" of paired transplant programs, which are designed not just to allow for more transplants overall, but to improve the chances for those who face difficult odds of finding a match for a successful transplantation.
The kidney exchange program has been in place at the medical center for four years, helping make connections for about 50 to 60 transplants in that time, said Dr. David Leeser, chief of kidney and pancreas transplantation. About 1,200 people are on the program's waiting list, among nearly 97,000 awaiting kidney transplants nationwide.
Organ donations allow for complex transplantation chains like the one that ended with Julie's donation, he said — it involved six transplants in all.
"The thing is, we definitely have less supply than demand, which is challenging," Leeser said. "Any avenue that you can take that will increase the number of patients that get off the list is a benefit."
The Kern and Stitt families count that benefit and their luck as invaluable, saying it has drawn them closer together.
"It shows you how important family are," Julie said.
twitter.com/ssdanceCopyright © 2015, The Baltimore Sun