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When the Goralski sisters were looking for a way to honor their father, who had recently died of kidney failure, they thought about how he was always helping others. And they thought about how they didn’t want other families to go through what they did.
The Illinois sisters realized it was in their power to relieve the suffering of other families while giving a special gift in memory of their father. So they gave their kidneys to strangers.
About a day apart in March, about six months after their father died, the 24- and 25-year-old women underwent transplant surgery. The sisters made what’s called an “nondirected” donation, also known as “altruistic.” This means they didn’t specify a recipient.
These types of donations are rare, but the most common reason someone donates a kidney to a stranger is because they’ve watched someone suffer through organ failure, said Bobby Nibhanupudy, MD, medical director of abdominal transplant at the AdventHealth Transplant Institute. He’s been a transplant surgeon here for more than 15 years and has conducted more than 1,000 transplant surgeries.
Watching a loved one live with organ failure can change a person, Dr. Nibhanupudy says.
“It causes a very, very slow decline in life. It’s very insidious and eventually catches up to you,” he said. “There’s always a waiting time for an organ, and a sense of helplessness because you don’t know if your loved one is going to die while they’re waiting.”
Altruistic donors like the Goralski sisters often want to be able to help in any way they can, he said. That was indeed the sisters’ motivation.
"We just want to make sure two less families had to go through what we went through," one sister, Bethany Goralski, told Good Morning America.
The kidney donation process is designed to make it as easy as possible for living people to donate their kidneys. Here’s how it works.
How Altruistic Donation Works
First, a living donor doesn’t have to worry about the financial burden of donating. All of their costs — from initial testing to the surgery to any follow-up care they need, even years later — are paid for by the recipient’s insurance company, Dr. Nibhanupudy says.
“Any living donor, whether they’re donating to someone they know or not, has a medical team that evaluates them,” he said. That includes a patient advocate who has nothing to do with the transplant team.
A donor also doesn’t have to worry about being more vulnerable to disease because they have only one kidney.
“As long as the person is relatively healthy, there is not an increased risk of kidney disease down the road,” he says.
Only about one in 10,000 people who have donated a kidney need a transplant down the road, Dr. Nibhanupudy says. But if that incredibly rarity occurs, a kidney donor has top priority if they need a new kidney themselves.
At our transplant institute, donors don’t have to worry as much about scarring. We are the first transplant program in the state to use a single, minimally invasive incision to remove kidneys from donors. The result is a single inch-long scar through the belly button.
Like other living donors, the Goralskis may eventually meet the people who received their kidneys. Dr. Nibhanupudy says. Our transplant center will pass on a letter from the recipient to the donor, who can then contact the recipient.
“Most of the time, they do want to meet,” he says.
As you may know, a living donor has to be a good blood type match with their recipient. But, thanks to altruistic donors, it’s possible to help a loved one even if they’re not a match for you.
Starting a Chain
A kidney donation from an altruistic donor like the Goralskis can be given to a recipient in one of two ways, Dr. Nibhanupudy says.
It could simply go to the top person on the waiting list.
But it could also start what’s called a “kidney transplant chain,” which could ultimately mean many people — perhaps several, perhaps more than a dozen — get kidneys. Here’s how a small chain works:
Imagine you have a person who needs a kidney and a willing living kidney donor, perhaps their spouse. But if they’re not compatible, the donation can’t occur.
That’s where altruistic donors like the Goralski sisters come in. If one of the sisters were a match for our imaginary recipient, she could donate. Then the spouse of the recipient could give to another unrelated person. Then, that recipient could find a donor willing to give to another recipient, and so on.
It’s a bit complicated and if you don’t fully understand how it works, you’re not alone. (This story includes a helpful image describing how transplant chains work.)
The women don’t know if their gift started a chain. But they think about it.
"I am definitely in my prayers every night and thinking about the people that received my kidney," she said. "And thinking about the possible chain that this started."
Yes, kidney transplants save lives, Dr. Nibhanupudy says, but they also transform them. A recipient can go from needing dialysis several times a week to near-normalcy virtually overnight.
“I get a great deal of satisfaction in bringing patients as close to a normal life as possible, something we all take for granted,” he said. “It’s about more than just saving lives.”
At the same time, an organ transplant is a journey. Our philosophy is to help our patients meet their emotional and spiritual challenges while doing everything we can to get them to a transplant and then to living a full life beyond it.