(Our friend who volunteered to donate his kidney to Sander wrote this guest post.)
By Saul Kravitz
Since I heard Chaya Lipschutz’s story on This American Life, sometime around 2007, I had wanted to donate a kidney. My desire to donate a kidney never caused me to take action. After all, I had a family that depended on me as the primary breadwinner, and I feared being accused of being an irresponsible father. I always felt that if the opportunity presented itself to help someone that I knew, I would jump at the opportunity. I hadn’t given kidney donation much thought until I read an article in the Washington Post in January 2019 about a woman who donated a kidney to her ex-husband. Inspired by this act of kindness, I realized that I had the opportunity to help a friend who was trying to get cleared as a candidate to receive a kidney. I shared the Washington Post article with him and told him that although we’d never been married, I was interested in being screened to donate a kidney to him. What a great feeling to make that offer! Prior to making the offer I did my homework on the risks of kidney donation,and the recovery process, but I consulted no one. After I made the offer, I told my wife, and, as I hoped and expected, she fully supported my decision.
This started my almost year-long adventure to donate a kidney at the Toronto General Hospital (TGH) in Toronto, Ontario.
I wanted to share both my motivation to donate, and my experience, to encourage others to consider donating a kidney. For donors who are approved according to the KDIGO criteria, there is strong evidence that the risk is quite low. The major risk is that the remaining kidney gets damaged in a trauma such as a car accident. Kidney disease usually attacks both kidneys, so having a pair isn’t a huge advantage. Patients who have donated a kidney get a higher priority if they ever need a kidney.
Like most transplant centers, TGH likes to do all of their testing in-house, since this eliminates any uncertainty regarding the accuracy or quality of the diagnostic procedures. Traveling from Rockville, MD to Toronto, ON for testing meant that testing which typically would have been done in multiple stages had to be done in one or two intensive visits. My friend wasn’t medically cleared to receive a donated kidney until late October 2019, at which point the donor evaluation process could start. Since I was intent on giving a directed donation, the first step was to assess our compatibility. It was quickly determined that we were a match.
My evaluation required two 3-day trips to Toronto, the first in early December 2019 and the second in mid February 2020. I worked remotely part-time during these trips, so the impact on my vacation time was not significant. My costs were covered by the Ontario government. Once I had exhausted the reimbursement budget provided by the government, my expenses for the actual transplant would have been covered by a remarkable Jewish organization—Renewal—that recruits donors and is guided by the principle that the donors have volunteered to provide the kidney, and should bear no additional costs. I had the privilege to meet the volunteer head of Renewal Canada, and its local professional staff member—both kidney donors themselves—during my visits.
Anyone who would tell you that the kidney donation process is fun, is probably lying about the experience. The most annoying aspect is the waiting. If it were up to me, I would shorten the evaluation process dramatically. The testing itself is not painful or unpleasant, and you will probably learn something about the state of your health in the process. The “joy” of a 24-hour urine collection should not be underestimated.
TGH looks very much like a US hospital. The main difference is that everyone except the US visitors presents a provincial health insurance card when checking in for a test, whereas I presented a letter from the transplant office, instructing the staff to charge my tests to my potential recipient’s provincial health insurance account. The hospital is efficiently run—all my scheduled testing appointments took place with no waiting—modern and clean and the staff I interacted with were friendly and helpful. As a medical tourist of sorts, I was treated well.
The last stop on my second visit was the donor nephrologist who would make a recommendation for or against my donation. The nephrologist was the only appointment that didn’t start on time, and that was clearly because the doctor was focused on the patient, not the clock. When he finally arrived for my appointment, it was clear that he was determined to answer every question I asked about the data that had been acquired as part of the evaluation —and I had a lot of questions—with little concern for the time. In the end, I departed TGH for the airport 2 hours later than I had planned, and only by the grace of the travel deities and by running through the airport did I sit down, soaked in sweat, in my seat on the plane as the plane’s door was being closed. I’m proud to report that I made it from the front door of Pearson airport, through security and customs/immigration, and down the better part of a mile of terminal to the gate in 35 minutes.
My visits to Toronto weren’t all medical all the time. I managed to squeeze in a guided tour of the Ontario parliament and a visit to Fort York. I had the opportunity to visit with my friend, the intended recipient, including an eye-opening visit with him while he received dialysis. I stayed in AirBnbs in two different neighborhoods—Yorkville and the Financial district—and ate some excellent food.
In early March, as travel shut down for the Pandemic, the donor nephrologist called to inform me that my kidney donation adventure was over. The donor nephrology team determined that there was too much uncertainty about my kidney function, especially as I aged, so they could not approve me as a donor. I was extremely disappointed that I couldn’t donate a kidney to my friend, but I have no regrets that I made the attempt.
My friend, and many other people, still need kidneys in order to escape from the captivity of dialysis to the freedom of having a functioning kidney. Although my story does not have a happy ending, I hope it might inspire you to consider offering to donate a kidney to a friend or a stranger.
Saul has generously offered to answer any questions about the process from the donor’s perspective. You can contact him at firstname.lastname@example.org.
In Sander’s own account of Saul’s testing process, he wrote:
The medical team that was responsible for protecting his interests did its job. Given the lengths that Saul went to on my behalf, I could not put my own personal interests ahead of his safety. And that made me happy. I know that the health and wellbeing of any future potential donors will be paramount, just as Saul’s was.
It’s hard for me to be upset over how things turned out. And I can very honestly say that it’s hard to think of a time in my life when I was happier than when my friend gave me hope when he tried to give me his kidney.
Read the rest of Sander’s account in My (Failed) Kidney Reception Adventure in Toronto.