COLUMBIA — When Kortni McFarlin discovered that her mother needed a second kidney transplant, she could have reacted in a number of ways. Fear. Anger. Confusion. Sadness.
Instead, she was absolutely convinced that her mother would find a kidney to keep her alive.
“Our first thought was that we need to hurry up and get the process rolling,” said McFarlin, 34, who lived in Fort Worth, Texas, at the time.
Seventeen years ago, after both kidneys failed, Denise McFarlin's donor was her sister.
“I figured if my aunt was compatible the first time, somebody else in the family would be compatible as well,” Kortni McFarlin said.
Immediately after friends and family became aware of the recent kidney failure, Kortni said they began to line up, begging to be tested in hopes of a match.
“Everybody was like, ‘put me on the list!’” McFarlin said.
In the end, she moved to Columbia, and her kidney is now the one that could save her mother's life.
Thousands need transplants, many won't get one
Denise McFarlin, 61, is among several thousand people in the United States who will receive a kidney transplant in 2010.
In 2009, the Organ Procurement and Transplantation Network reported that 15,401 kidney transplants were performed, a number that has slowly declined since 2006.
Yet it hardly makes a dent in the waiting list.
As of 4:49 p.m. on Feb. 23, the list of those seeking a healthy kidney numbered 83,467 people — nearly 79 percent of patients awaiting any type of organ transplant.
Five years from now, hundreds on that list may no longer be alive.
When a patient has end-stage kidney disease, there are only two choices — dialysis or a transplant.
For those with acute kidney injury, dialysis mimics the function of the kidneys with a machine that removes waste and excess water from the blood. Though dialysis can take the place of a kidney, health risks may develop over time.
Denise McFarlin faced the reality of those risks when she began the treatment in May 2009 for the first time. She did not have dialysis before the first transplant, and she was both nervous and afraid to begin.
“It’s a scary thing when you know that you have to be on dialysis to save your life," she said. "If you don’t, anything can happen."
Other patients didn't provide any comfort.
"They said 'you’re going to be tired all the time, you’re not going to want to do anything, and the whole quality of your life is going to change,'” she said.
Without her daughter's kidney, dialysis would allow her to buy time, but each day was never a guarantee.
Ties that bind a mother and daughter
Last year, 12,429 people in the United States donated a kidney to someone who needed one.
Of that number, 5,740 were still living. Sixty-eight lived in Missouri.
This year, Kortni McFarlin will be one of them.
Giving her mother a kidney is a family responsibility, she said, a reason to move to Columbia and submit to serious surgery.
“We scratch each other’s back through thick and thin,” McFarlin said about her mother.
Willing donors must undergo a series of tests to examine their physical and mental health, and to determine transplant compatibility.
This is established through blood crossmatch tests that evaluate whether a donor’s white blood cells will “get along with” the recipient’s.
University Hospital is the only medical facility in Columbia that performs kidney transplants, and it has been doing so since 1972.
The hospital has one of only a handful of kidney transplant centers in Missouri; the rest are in Kansas City, Springfield and St. Louis.
Patients receiving kidneys from living donors tend to have better long-term outcomes, said Andrew Webb, University Hospital's transplant coordinator.
He listed advantages of a living donor transplant:
- The kidney recipient does not have to rely on transportation because the donor's kidney is removed in an operating room within the same hospital.
- The kidney goes directly from donor to recipient with no need to store the organ on ice for at least six hours before the transplant.
- Living donor kidneys tend to work more quickly in the recipient.
Perhaps the biggest advantage is that an organ from a living donor can lower the number on the waiting list, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
“It can make a dramatic difference in someone who is having kidney failure,” Webb said.
From a decision to the conclusion
Kortni McFarlin's decision to donate a kidney was easy. Getting to the operating room has been more challenging.
When doctors finally decided her kidney was a match, McFarlin said she couldn't have been more excited. Immediately her next thought was, "Good. Let's do this."
That was more than six months ago.
Recent medical complications have made a date for her mother's surgery uncertain.
Just when it seemed possible to schedule the transplant, another incident would cause a setback.
First, a mass was found on her mother's heart — the reason McFarlin decided to relocate to Columbia in August.
Next, the doctors discovered a cyst on her mother's thyroid.
Then her mother had a stroke, which led to the discovery of a level 5 aneurysm.
"(The doctors) said that she should have died, that it should have killed her immediately," McFarlin said.
These events have kept McFarlin rooted in Columbia.
While waiting, she decided to help her sister, Kimberly Mahaney, open a store in November on the corner of Range Line Street and Wilkes Boulevard to sell perfume, accessories and women's apparel. They named the store G.O.A.L.S. — Gods Over All Living Souls.
“The whole purpose for the shop is actually for my mother,” Mahaney said. “As she gets better, this will be for her.”
'Good Samaritan' donations
McFarlin is a living donor for a blood relation, but others may donate organs to co-workers or friends.
Tina Rickard, human resource administration coordinator at Woodhaven in Columbia, gave her kidney to a co-worker in June 2005. When Rickard learned that her colleague could not find a compatible match among family members, she was elated to find herself compatible.
“I think a lot of people probably thought I was nuts,” she said.
After nearly five years, she remains in perfect health with the remaining kidney, and said she has no regrets.
“I wish it would inspire more people to do it,” Rickard said. “It was a wonderful feeling.”
Peace refers them to a donor bank where they can begin testing for a match with a patient on the waiting list.
Like Rickard, Kortni McFarlin said she feels privileged to be a living kidney donor, especially for someone she loves so much. She would encourage others to consider the option.
“The reality of the whole thing is that it’s saving a life,” she said.