August 24, 2019
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Pemaquid man’s altruism sparks kidney transplant chain that unites 6 Mainers

Eric Zelz | BDN
Eric Zelz | BDN

When Stanley Galvin of Pemaquid decided to donate a kidney to a stranger, he hoped to help another Mainer live a long, healthy life. He ended up helping three.

Galvin is part of the largest kidney transplant chain ever to occur within Maine’s borders, triggering a succession of surgeries that involved two more donors who provided organs to three ailing recipients. The six individuals, all of them Maine residents, met for the first time Monday morning in Portland.

Surgeons at Maine Medical Center performed the half dozen surgeries in a single day, scrubbing in at 6 a.m. Nov. 4 and staying in the operating room until 9 p.m.

The hospital convened the six participants on Monday both to introduce them to one another and to highlight a troubling shortage of donor kidneys nationally. About 7,000 patients die each year waiting for a suitable transplant, according to Dr. Juan Palma, one of the two Maine Medical Center surgeons who operated on the patients.

In the growing field of “paired donation,” willing donors found incompatible with their intended recipient — often a friend or family member — are matched with a suitable patient in need.

Galvin, who retired and moved to the village in Bristol from Washington state nearly five years ago, said he decided to donate a kidney after seeing news coverage of other transplants. He researched the process and connected with the Portland hospital’s transplant program, undergoing a battery of tests and finally learning in October that a recipient had been identified.

“I just wanted to give somebody a kidney,” he said. “I had no idea what potential was there.”

Rather than participate in a national kidney donation registry, Galvin wanted his organ to benefit a fellow Maine resident. He became the first link in the transplant chain.

“Maine people are so caring and giving and just great people,” he said. “I just thought, I want to help somebody here in Maine.”

On Monday, Galvin met James McLaughlin, a retired engineer from Scarborough who now has his kidney.

“It was almost like there was an immediate friendship there,” Galvin said. “I asked him how my kidney was doing, and he said it was just pumping like crazy.”

McLaughlin’s kidneys had declined slowly over the last four decades. He learned two years ago that he’d need a transplant, and he faced the daunting prospect of dialysis, a blood-cleansing procedure that requires frequent, lengthy treatments and restores only a fraction of kidney function.

“I feel great,” McLaughlin said Monday. “I walked just under two miles yesterday.”

Both his wife, Mary Ann McLaughlin, and his daughter offered to donate a kidney to him, but neither proved a match.

To be considered suitable, donors must first be deemed healthy enough to give up an organ and undergo surgery. Then doctors test their blood type and makeup of antibodies to ensure both are compatible with the intended recipient. Otherwise, the recipient’s immune system can reject the new organ.

The transplant program staff discovered that James McLaughlin’s wife was a suitable donor for another man in need of a kidney, Jan Bohlin of Harpswell. She agreed to give her kidney to him instead, forming the second link in the transplant chain, the first of its kind in Maine.

“I think it would have been great if he had gotten mine,” Mary Ann McLaughlin said of her husband. “But actually, this is even better, because in this scenario three people benefitted.”

Bohlin started experiencing health problems in 2004, learning that overgrowth of fibrous connective tissue in his abdomen had closed off the tubes that carry urine from the kidneys to the bladder, causing his left kidney to atrophy.

“It was pretty exciting to think that after 10 years of having kidney issues — and having to live a life with severe anemia and all the other associated little issues that go along with it — there was light at the end of the tunnel,” Bohlin said Monday, still visibly weak from the surgery and a subsequent procedure to remove a hematoma he developed.

Like James McLaughlin, Bohlin also had a loved one willing but unable to donate a kidney to him. George Shepard, a friend and the cousin of Bohlin’s wife, wasn’t compatible, but he, too, agreed to continue the chain. Bohlin expressed gratitude for Mary Ann McLaughlin’s donated kidney, but he also viewed Shepard as his donor, because his friend’s generosity made the transplant possible.

Shepard of Pittston donated a kidney to Richard Cook, a retired University of Maine nutrition and food science professor.

While donating a kidney requires fairly extensive tests before the procedure — including X-rays, CT scans and blood work to rule out any concerning health conditions — Shepard said his life will return to normal. The procedure entails the typical risks associated with any major surgery, including the potential for bleeding and infection, but donors typically experience no lasting effects from living with one kidney. Transplant surgeons often discourage donors from using certain pain relievers, including ibuprofen and aspirin, which can reduce blood flow to the kidneys.

“Other than that, nothing’s going to change,” Shepard said. “I’ll go a few weeks without lifting or tugging so I don’t tear the stitches out, and then I’m back to normal.”

Cook of Hermon was on dialysis for more than two years, visiting the clinic three times per week after experiencing years of declining kidney function because of problematic growth of scar tissue. He also underwent heart surgery earlier this year, developing complications that led to his temporary removal from the transplant waiting list. Then he learned Maine Medical Center had found a donor.

“I went from the lowest of lows to the highest of highs,” Cook said. “It was just an incredible feeling. It was almost like I could hardly believe actually what was going on. It’s been a really fantastic trip.”

Now, none of the members of the transplant chain has a standard-issue set of two kidneys. The donors each have just one of the bean-shaped organs, while James McLaughlin, Bohlin and Cook all have three.

Surgeons remove the diseased kidney only in cases of infection or bleeding, Palma explained. Cutting it out can lead to higher risk of complications.

Instead, surgeons transplant the donated organ to a different spot lower in the abdomen, he said, rather than its natural placement on either side of the spine and behind the stomach and liver. That allows surgeons to more easily connect the donated kidney’s artery and vein to those already existing in the pelvis and attach the tube that carries urine from the kidney to the bladder, Palma said.

Palma operated on the three donors, while Maine Medical Center transplant surgeon Dr. James Whiting tended to the three recipients.

“It was kind of like being part of a celebration,” Palma said of the 15-hour succession of surgeries. “You get energized by your patients.”

Palma also was involved in a paired kidney donation chain earlier this year that included two Maine residents and four others.

In Maine, 80 to 90 people remain on the waiting list for a kidney transplant, among about 100,000 across the country, Palma said. But just 17,000 transplants are performed each year, leading to a distressing gap between supply and demand, said Dr. John Vella, director of the Maine Medical Center transplant program. Diabetes, high blood pressure and other conditions can lead to kidney failure.

The average patient lingers on the list for two to five years. While more than half of all kidneys are donated after death — such as in cases of car accidents or other trauma — organs from living donors promise better survival and fewer complications for recipients, Vella said.

Galvin, who commiserated with Shepard over some lingering post-op nausea after Monday’s event, said he was overwhelmed by meeting the other Mainers in the transplant chain that his decision sparked.

“I knew that on the day I had surgery, there were five other people going through either donating or receiving a kidney,” he said. “But you come together and you see that they’re real people. It was just an amazing feeling.”

 



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