‘What’s the alternative, to let someone you love suffer?’
The number of Canadians being treated for kidney failure is soaring — and it includes Toronto police Chief Mark Saunders
When Nancy Cameron, Nagamani Turaga and Amanda Kemery woke up from their surgeries, they all wanted to know the same thing: did it work?
Never mind their own stitches. They were asking whether their kidneys were doing what the organ is supposed to do in the bodies of their loved ones.
All three have given up one kidney to someone who needed it. For Cameron, it was her son three years ago. For Turaga, her husband in May. For Kemery, her stepfather in August.
All three were moved to learn this week that Toronto police Chief Mark Saunders and his wife, Stacey Saunders, were joining their community of living kidney donors and recipients.
Cameron, 68, even sent best wishes to the chief and his wife, along with a photo taken at Toronto General Hospital of the moment she and her son were reunited after their surgeries in January 2014.
“You can only imagine what the feelings were when I saw him,” Cameron said in an interview. “And I realized that a part of me — an actual physical part of me — was in him, making him well.”
There are 1,600 people on the waiting list for an organ transplant in Ontario, according to the Trillium Gift of Life Network. Most require a kidney. Every three days, someone on the list dies before getting a transplant. The number of available organs lags far behind the demand.
An alternative to the years-long wait for a deceased donor organ is to find a living donor — a relative, friend, acquaintance or anonymous person willing to give up a kidney.
Advocates have been trying to encourage more people to consider the surgery by highlighting its relatively low risks, and the rigorous testing that donors must undergo to be approved. But while the number of organs from deceased donors has risen steadily in Canada over the past decade, the number of living donors has remained the same.
Meanwhile, the number of Canadians being treated for kidney failure has tripled over the past 20 years, according to the Canadian Institute for Health Information, and is expected to rise further, in part due to higher rates of diabetes and renal vascular disease.
It’s fair to say the news about the police chief’s health was a surprise to many. Saunders revealed first to CTV News last week that he had been born with only one kidney — a fact he only learned as an adult — and that his single kidney was failing.
For 15 months, Saunders had been undergoing nightly dialysis at home, while continuing to perform the duties of his job as chief of Canada’s largest municipal police force and showing no signs of ill health in public.
Those who have suffered through kidney failure say his ability to keep working in a high-profile and demanding job while undergoing dialysis is admirable.
“I’m impressed,” said Scott Cameron, 38, who spent five years doing nightly dialysis at home before his mother finally convinced him to accept her offer to donate. “It’s a testament to his overall health, the way he’s managed his symptoms.”
Dialysis cleanses impurities from the blood when the kidneys have stopped working properly. It requires being connected to a machine either in hospital or at home. It is a life-saving treatment, but one that requires sacrifice.
“When it’s what’s keeping you alive you’re grateful for it,” Cameron said. But it is draining and restrictive, not to mention stressful having to operate the equipment if you choose to do it at home.
“It basically consumes you,” said Cameron, a senior safety consultant with the TTC who, like Saunders, continued to work full time while on dialysis.
“It’s a 10-hour process. You do eight hours of treatment, an hour of setup and an hour of cleaning at the end. You are remarkably restricted in what you can do.”
Saunders and his wife were expected to be in hospital for about a week after their surgeries, which took place on Monday.
For Nagamani Turaga, 44, watching her husband suffer through dialysis — seeing the impact it had on his state of mind and his ability to spend time with her and their two teenage children — is what motivated her to get tested. Once she knew she was eligible to donate, the decision was easy.
“The scary part was not donating my kidney. The scary part was his health issues before,” and the prospect of a future without him getting a new kidney, she said.
It is not uncommon for pairs without a genetic connection to be a suitable match; spouses accounted for roughly 17 per cent of living organ donors in Canada in 2015, according to the Canadian Institute for Health Information.
In order to be a suitable candidate, the donor must have a blood type that is compatible with the recipient’s. Medical professionals assessing suitability also look at whether the recipient has antibodies against the donor’s tissues that would cause their immune system to immediately attack the new organ.
“The donors are very carefully screened,” said Dr. Darin Treleaven, medical director of the renal transplant program and head of nephrology at St. Joseph’s Healthcare Hamilton.
They undergo rigorous medical testing to ensure their safety. They are informed of the possible negative outcomes, including the research that suggests a risk of death in three in10,000 kidney donor surgeries.
It took Amanda Kemery, 56, nearly a year to undergo the testing required to confirm she was a match for her stepfather. Making the decision to do it, she said, was the easier part.
“I had to talk to my family and my kids and everybody,” said Kemery, who lives in High River, Alta. “They were a little nervous, you know, they don’t want to lose a parent either. But I mean, what’s the alternative, to let someone you love suffer?
“Some people thought I was crazy. They said, ‘Why would you do that? You’re gonna give up a healthy part of you.’ Some people said I was unselfish. I said, ‘Actually, I am selfish because I don’t want to lose him.’ ”
Her stepfather, Terry Coleman, 71, was living with kidneys that functioned at 5 or 6 per cent. Coleman has a law enforcement background in common with Saunders; he is a former police chief of Moose Jaw, Sask., who now works as a public safety consultant.
“I was told that if I didn’t have a donor it would be eight or more years to get one,” Coleman said. “I’ve told her so many times, but words don’t express. I am extremely grateful. It was really generous of her to do that and for her family to support her.”
If Stacey Saunders had not offered a kidney to her husband, he too may have faced a long delay: the average wait for a kidney in Ontario is five years.
On the day of the surgery, both donor and recipient must be in optimal health.
“We want to make sure they have the best possible outcome,” said Dr. Anand Ghanekar, a transplant surgeon and codirector of the kidney transplant program at University Health Network.
At UHN, the donor goes under the knife first. Most surgeries take two to three hours and are performed laparoscopically, Ghanekar said.
To begin, the surgical team makes several small incisions in the abdomen, through which they insert a camera and cutting instruments. The surgeon separates the kidney from the organs it is attached to and removes it through an eight- to 10-centimetre incision in the lower abdomen, similar to the cut used for a caesarean section.
The kidney is usually about the same size as the fist of the human it came from and shaped like its bean namesake. A healthy kidney is smooth and pink.
The donor kidney is flushed with a preservation solution, and then triple-bagged and placed in a well-marked cooler full of ice at about 4 C.
In the recipient’s surgery, the failing kidneys are usually not removed. The donor kidney is nestled into a new spot in the lower abdomen.
“Aside from not functioning, they’re usually not causing any harm to the person so there’s no advantage to removing them,” Ghanekar said.
In 98 per cent of surgeries the new kidney begins to function almost immediately, Ghanekar said.
In the months since his surgery at St. Joseph’s Healthcare Hamilton, which was live-streamed to raise awareness about kidney disease, Bhargav Turaga’s kidney function rose from 6 per cent to 80 per cent, his wife said.
Turaga, 45, now has the energy to go on outings with his family. He can travel again. He is happier.
The recovery time is roughly six to eight weeks for both the donor and recipient.
“It’s not unbearable pain,” Nagamani Turaga said. “It’s manageable pain.”
Amanda Kemery, still recuperating after her stepfather’s Aug. 9 kidney transplant at Calgary’s Foothills Medical Centre, is tired and eager to get back to work, but said she has had worse surgeries, including procedures on her back and knee.
Nancy Cameron likened it to recovering from a caesarean, but without a baby to take care of afterward. To Saunders and his wife, she wrote: “Certainly you have a little physical pain, but you are on such an emotional high that the pain seems trivial.”
All three donors are doing well, as are the loved ones living with their kidneys. The surgery has a good success rate, with 89 per cent of kidneys transplanted into adults from living donors still functioning five years after the operation, according to 2015 data from the Canadian Institute for Health Information. Kidneys from deceased donors were still functioning in 84 per cent of cases.
“It is a new life,” said Scott Cameron, who has been living with his mother’s kidney for nearly three years. “You feel like you’re — I don’t want to say born again, but you’re rejuvenated. It’s kind of like a Cinderella story. You don’t have to be home anymore when the clock strikes midnight.” Or 8 p.m., in his case. On dialysis, you lose control of your life. “When you get it back,” Cameron said. “It’s a huge relief.” With files from Wendy Gillis