Three-way kidney swap saves multiple lives

David Labocki’s donated kidney from his brother was shutting down.

Nan Botbyl’s kidneys also were failing.

Labocki of Copley, Ohio, and Botbyl of Sandusky, Ohio, were both in desperate need of a kidney transplant, but their spouses, loved ones and friends did not match.

Today, Labocki and Botbyl have new kidneys — but not from the likely sources.

They were part of a three-way kidney swap involving six people.

The whole life-saving chain was made possible because of an “altruistic” anonymous woman who started the chain, said Dr. Alvin Wee, a Cleveland Clinic urologist and surgical director of the Renal Transplantation Program. The woman was a perfect match for her friend, who also has asked to remain anonymous. But when doctors asked the donor if she’d be willing to go into the National Kidney Registry, which matches recipients and donors, to start a chain of donations, she said yes. That started this chain: › Her kidney went to David Labocki, 44, and a father of three.

› Labocki’s wife, Danae, 36, donated her kidney to Nan Botbyl, 56.

› Botbyl’s husband, Gregg, 58, was to donate his kidney back to the friend of the original donor. But that woman’s kidney functions improved by the time Gregg’s kidney was harvested. So his kidney went to an anonymous man in California, and the original intended recipient became what’s called an “advanced donor recipient.” She received a raincheck from the National Kidney Registry when she needs a kidney.

Three surgeons were involved in the surgeries at the clinic’s main campus in Cleveland, Ohio, over two days, and Wee was the surgeon to take all the donated kidneys.

“It was God’s grace that the first patient was a match for David and she gave it to David,” said Wee. “Then for the second pair — their blood type is reversed so the husband couldn’t give the kidney to Nancy. We then had Danae give her kidney to Nancy and Gregg gave the kidney to John Doe.”

Wee said the first recipient’s donor could have backed out from the kidney swap once she was no longer in immediate need.

“She said: ‘No, there’s two people who want to benefit from me. I can’t do that,” Wee recalled. “She’s the hero.”

Three-way kidney swaps happen, but it was the first time the Cleveland Clinic had a triple swap with all six patients associated with the hospital. Two-way kidney swaps are the most common.

The National Kidney Registry said the record chain of people who participated in a kidney swap — at multiple hospitals across the country — included 35 kidneys.

THE LABOCKIS’ STORY

At age 18, David Labocki began swelling without explanation. He was diagnosed with nephrotic syndrome, a kidney disorder that causes the body to excrete too much protein in the urine. Doctors didn’t know the cause. Labocki was put on medication, which worked until age 37. Later tests revealed he had an autoimmune disease, which causes his body to produce too many antibodies that attack his kidneys.

At age 37, his kidneys began shutting down. He received a donated kidney from his younger brother, Mat Labocki.

The donated kidney did well for seven years with various treatments, but gradually last year, David’s body started rejecting his brother’s kidney.

David not only needed a donor with a blood match, but also antibodies. Doctors told him he had a 4 percent chance of finding a donor.

David’s sister and his wife of 16 years, Danae, were both blood matches, but David had antibodies that would fight their kidneys.

Just after Christmas, the pastor at the Labockis’ church, Redemption Chapel in Stow, asked if friends would get tested to see if they were a match. More than 30 people got tested, but no one was a match.

Shortly after Easter this year, Wee told the couple they could increase David’s chances of finding a donor kidney if he and Danae would enter the National Kidney Registry (http:// www.kidneyregistry.org). To participate in the registry, a willing donor must register with the person who’s seeking a kidney.

“At that point, we’re like, ‘We’ll try anything,’ not realizing it would go so fast,” Danae said. “When he explained it, it was more like, ‘Oh wow, other families can be helped?’

“We feel like it’s a total God thing. How else could this have happened the way it did?”

The couple prepared for their surgeries — Danae on April 30 and David on May 1.

THE BOTBYLS’ STORY

Nan Botbyl began experiencing kidney problems at age 30 from polycystic kidney disease, a life-threatening genetic disorder. In the last five years, her health worsened. She had several mini strokes, leg issues, general malaise and no appetite and her thoughts were cloudy.

Last summer, doctors put Nan on the national registry for deceased donors, but she was told it could be a four- to 10-year wait. She didn’t have that long.

She found the National Kidney Registry during a Google search.

She and her husband, Gregg, worked with her Cleveland Clinic doctors to enter the registry, which could take six to 18 months to find a donor.

This spring, Nan was told she needed to start dialysis. She begged doctors to give her one week to think about it. In the meantime, Gregg was pushing Nan to have a real wedding ceremony. (They met online in 2015 and had a commitment ceremony last year.)

Nan still can’t believe how it all worked out, but she found a cancellation on the weekend they wanted to get married — April 22 — at Landoll’s Mohican Castle in Loudonville. It was an all-inclusive wedding.

Around the same time, Gregg got a call that they found a match for Nan. The surgery could wait until right after their wedding. Nan’s surgery would be May 1 and Gregg’s on May 2.

HEALTH IMPROVES

The transplant surgeries were all successful. Nan is feeling great and even sneaked across the hospital campus — against doctor’s wishes — to see her recovering husband after their surgeries.

David Labocki had some severe complications after the surgery, spending two weeks in the hospital. His new kidney from the anonymous donor was not “waking up” and his brother’s kidney was still working. David has been taking treatments to help his new kidney work properly.

“Signs are showing that it is,” he said. He is feeling good, he said.

Danae also had some complications, as she was allergic to anesthesia and pain medications.

David is hopeful he may be able to personally thank his donor someday. She originally said she’d like to meet, but the Labockis want to respect her wishes.

“I think it would have been amazing if I could have given Dave my kidney, but it’s even better that other families were helped,” Danae said.

Danae and Nan will meet for the first time, when Nan is in Cleveland for a doctor’s visit.