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When 27-year-old Nina Sanchez was 13 weeks pregnant, doctors gave her the devastating news that she had kidney failure. At a time when most mothers are eagerly awaiting the journey of pregnancy, Sanchez was grappling with a distressing diagnosis. Her new priority was now, not only her own health, but keeping her baby alive and healthy.
During her seventh month of pregnancy, she went on dialysis. Shortly thereafter, she delivered a healthy baby girl, thankfully, although six weeks early.
Now that her daughter had safely arrived, it opened the realm of therapeutic options for Sanchez. Her team of transplant specialists at Northwestern Medicine determined she would need a kidney transplant or face dialysis for the rest of her life. The search for a living-donor match began.
Sanchez’s brother, Sam Vega, was tested and found to be an incompatible donor. Just when it seemed she would never get the transplant she so desperately needed, Sanchez received a call from Northwestern’s transplant program with news that a match had been identified through what is known as a paired exchange transplant, which matches one incompatible donor-recipient pair to another, enabling an organ exchange.
“When my doctor told me he found a kidney for me, I was so relieved,” said Sanchez. “I was scared that I wasn’t going to be around to raise my daughter.”
“Patients are often able to find a willing donor,” explained Juan Carlos Caicedo, MD, director of the Hispanic transplant program at Northwestern Memorial Hospital and assistant professor of surgery in the Division of Organ Transplantation at Northwestern University Feinberg School of Medicine.
“But approximately one-third of the living donors are not a match for the loved ones they wish to donate to. Paired exchanges are becoming more common and give more patients the opportunity to find a compatible donor.” Unbeknownst to them at the time, Sanchez and her brother were matched to a father-daughter twosome.
Like Sanchez, Lino Martinez, a 69-year-old father of seven, suffered from kidney failure. His daughter, Maria Ortega, was his donor, but was not compatible. When doctors suggested they participate in a paired exchange, she said the choice was easy. “I would do anything for my father,” said Ortega. “It was a small thing I could do to give him a second chance at life.”
And like Ortega, when Vega was offered an opportunity to give his kidney to a complete stranger so his sister could receive a kidney, he said he did not think twice. “I was honored to give life to someone else so my sister could have a chance too.”
Martinez received Vega’s kidney and Ortega donated to Sanchez. Following their much-awaited transplants, the two families say they have forged a bond that will last forever.
With paired exchange transplants, recipients’ and donors’ identities are always concealed leading up to and after the transplants occur. The opportunity to meet is always offered. However, unless all parties agree, identities are never revealed. In the case with the Vega-Sanchez and Martinez-Ortega pairs, all parties wanted to meet and by coincidence, all participants were of Hispanic descent.
Northwestern’s transplant team performed its first paired exchange in 2006. Since then, more than 80 paired exchange transplants have occurred. Caicedo says the fact that Northwestern’s transplant program makes a special emphasis on the Hispanic community is a long-overdue and a unique offering in Chicago’s healthcare landscape.
High incidences of obesity, hepatitis B, and hepatitis C among our nation’s Hispanic populations put these communities at higher risk and greater occurrences of needing transplants. The National Kidney Foundation estimates that among the 90,000 people on the wait list for kidney transplant, approximately 16,000 are Hispanic. Furthermore, data provided by the United Network for Organ Sharing rank Hispanics as the second-highest ethnic representation among individuals awaiting liver transplant.
Northwestern’s transplant program caters to the unique cultural needs of all patients. For Hispanic patients, it features unique offerings including, but not limited to, educational sessions for patients and families that are conducted in Spanish and Spanish-language Web-based information about offerings at the Chicago campus and transplant’s satellite clinics.
“We know as healthcare providers that customized patient care is important for everyone,” said Caicedo. “Cultural differences influence how patients respond to care—it’s just as simple as that. For many Spanish-speaking families, family elders make most important decisions. So we know that by involving the family and by making it easy to communicate and easy for them to get information, we have a much better situation such that we achieve successful experiences for patients and their donors.”
Martinez and Sanchez agreed that after years of being sick and on dialysis, they have a new outlook on life. “It has changed everything for me,” said Sanchez. “I can now live a healthy and fulfilling life and be the mother my daughter deserves.”