Blood brothers: Kidney transplant gives a second chance at life

Thursday, 9 August 2018

Whangarei man Richard Langdon, 60, received a kidney in May.

Richard Langdon, left, and Damian Jackson. Langdon received a kidney from Jackson.

I had known for quite some time this day was going to come.

Polycystic Kidney Disease is a genetic disorder which runs in my family – my grandmother had it, my mother had it, my sister has it, and I have it.

Generally its about a 50/50 split - with my kids all of them could have it, or none of them could have it – it's a roll of the dice.

*Raising awareness in hospitals lifts New Zealand's organ donation rates

*How much do you know about kidney disease?

*Slow kidney donation rates leave patients facing years of waiting**

I first found out about 25 years ago.

At the time I was fit as hell (even) surfing overseas. When I had a medical the doctors picked up a bit of high blood pressure.

That was the giveaway, one of the traits of this thing. It increases your blood pressure because your kidneys are working harder.

For the past 10 years the doctors have been keeping an eye on things, knowing that it was going to kick in at some stage.

Five years ago I started losing kidney function, but it was a gradual decline - about one percentage point per month.

Because it's such a gradual decline you don't feel like you're going downhill too much, everything seems normal.

As your kidney function gets lower though, small things start popping up and you know your kidneys aren't working that well.

When I was down to 15 per cent, I'd notice days when I was really tired, feeling crook in the night, and just not being able drink as many beers as I used to.

Once you get down to 10 per cent, that's when the doctors start thinking about hooking you up to dialysis or finding a kidney donor.

I had two or three people come forward to donate, but they put you through a pretty stringent medical and in the end they got declined.

My 25-year-old daughter also put her name forward, but the doctors were worried she might turn out to be a carrier of the same gene in the future.

Well Damian, who's been like a member of the family for a long time, found out about the situation.

I'd known Damian for years, we played pool and darts together down at the Mt Manaia Club in Whangarei Heads, and his kids and my kids had been running around together since they were young.

He put his hand up to do it, instead of my daughter – which was bloody awesome of him.

By the end of the process I'd got down to five per cent kidney function. I'd have days off when I was really tired and had to sleep, but doctors were amazed I was still working and functioning reasonably well.

I was only a couple of weeks away from going on dialysis, so I was getting myself up mentally and physically for it, but I was quite lucky that Damian came through at the right time.

A space came up and we just put our hands up and said, lets get it done right now.

It was a pretty euphoric feeling.

It's a bit of a roller coaster journey - you go through that process with them as well.

Coming out of it was pretty horrendous though, with 10 days of pretty serious hospital care … there was all sorts of cords and bloody things going into me.

With the operation the new kidney was placed below the originals, almost in my stomach cavity, while the old kidneys are left to wither away.

I didn't feel well for at least two weeks, and was going in for check-ups with the doctors in Auckland every day.

Ten weeks later and I'm still going into hospital for blood tests twice a week, but it's becoming less often as time goes on.

My levels are all really good and the doctors are happy, but it looks like I won't be able to go surfing again for another four or five months.

Damian Jackson had never considered donating an organ, before he found out about Richard's condition.

On Wednesday 23 May 2018, I was wheeled to the operating room at Auckland Hospital, where the final stage of a six-month journey was about to begin.

I was there in the hope I could give my good friend Richard a second chance to live.

Richard's kidneys were on their last legs, with only six per cent of their functionality left.

He had been deteriorating for a while.

Usually witty and sarcastic, over the months he seemed to grow more and more tired.

As the process went on, I began to realise just how sick he was, and what a battle he had been fighting in the privacy of his own home.

Only near the end of the journey did I learn about the constant nausea and vomiting, low energy levels, and just how difficult normal day-to-day things had become.

Richard had inherited Polycystic Kidney Disease, a condition that leads to progressive cyst development and eventually kidney failure.

I knew he needed a new kidney, and I knew I had to help him however I could.

Fortunately my wife and kids were fully in support and helped me through every step of the journey, especially through the more frustrating parts of the process.

The most difficult part of the journey wasn't the blood tests, the heart scans, the CT scans, and cameras up in places no man would imagine – it was the months of waiting and double-ups of tests.

Richard's kidney function was decreasing week by week, and the need for a transplant was growing more urgent.

The long testing process was there to make sure I would be a suitable donor, and a match for Richard.

I couldn't figure out why things took so long … I mean, here I am to save my friend, to donate my kidney, so what is the hold-up?

The team at Auckland Hospital and Whangarei Hospital were leaving nothing to chance though, and we knew we could have complete confidence in the surgeons, medical team and nurses.

Somehow though, from the very beginning, something deep inside me knew that Richard and I were going to be a match.

And sure enough, after six long months of waiting, the final test results finally came back positive.

We were going to walk this journey together and have each other's back, just like we had done for the past 14 years.

Being a live donor is amazing, but it's something that I think most people would never think of doing in their lifetime.

I know I never did until Richard needed one – something clicked inside me, and I figured the least I could do was go through the tests to determine whether I was a match.

You get to see what the spectacular results of the medical brilliance of giving your organ to another person have.

Even if I wasn't a match with Richard, I could have been for someone else and changed their life for the better.

Richard is doing so well now, he's back to his usual witty and sarcastic self.

His partner is overjoyed; they finally get a chance at a real future together instead of what was surely a death sentence.

Their two young kids are blissfully unaware of what happened, and now they get the chance to grow up with their dad.

Ben Gordon donated his kidney to a stranger in 2016.

Sometimes organ donation doesn't always work and I suppose that's the way life is, but if you don't try then you'll never know.

For me the operation went as well as it could, I was a bit tender afterwards and had to avoid lifting for a while.

I work with cars, so I'm taking my time to build back up to full strength.

There haven't been any real side effects that I have noticed, apart from the big scar I don't really feel any different than before.

Richard's really lucky, it turns out I have really big kidneys, so he's got one which is 1.2 times the normal size.

When the decision comes to donate a kidney, more than 90 per cent of live donors are known to the recipient, either through family or friends who choose to give up a kidney.

Every year though, there are a small section of 'non-directed donors', who come forward to give a kidney to a stranger.

Clinical director for the National Renal Transplantation Service, Dr Nick Cross says historically, New Zealand has had unusually high levels of non-directed donations.

'It's an amazing thing they do.

'The reasons why [the numbers are high] are a bit unclear, but I'd like to think it's because Kiwis are people who are just keen to help out friends and strangers.'

A petition before Parliament calling on mandatory organ donation, launched by Jessica Manning who needs a double organ transplant, has amassed thousands of signatures.

Prime Minister Jacinda Ardern has said she doesn't think it should be mandatory.

In 2016 Ben Gordon donated a kidney to an anonymous recipient.

The 25-year-old Christchurch resident said he'd been wanting to do it since he was about 18.

'I thought I'm pretty lucky with my health, my family's pretty lucky … it was purely just in the interests of helping someone out.'

After expressing an interest in being a donor, Gordon went through 15 months of testing to make sure he was suitable.

'My friends were pretty good, although my old lady wasn't over the moon about it, she was thinking of the worst-case scenarios,' Gordon says.

'At the same time, once they'd accepted it they fully had my back on it.

'It's been made out to be a big deal, but to me it isn't really. I would hope that if I'd ever been in that position, there would be someone out there willing to do that for me.

'The more attention the topic gets, I think people will see this as the norm rather than an out-there kind of thing to do.'

Every year in New Zealand, about 500 people are on waiting lists to receive a kidney transplant.

Waiting times for those in need of a kidney can take years, with patients often going on dialysis during that time, and less than half will likely receive a transplant.

The majority of transplants were from deceased donors and a third from live donors.

Almost all live donations in New Zealand are for kidneys, although there is a very small number of liver grafts done as well.

Cross says live kidney donor levels are traditionally high in New Zealand, but there is still a push to increase the number of donors.

Since 2013, the number of deceased kidney donor transplants has risen from 55 to 118, while the number of living donors has grown from 58 to 69.

Cross says there is a small but significant gap in the benefits of live organ transplants over those from deceased donors.

Live organs were likely to last longer (17 years or more, compared to 15-16), and had a slightly lower rate of failure.

'Receiving a organ from someone in excellent health, which has come straight from them to the recipient in the same operating theatre, will last a bit longer than a kidney from a deceased donor,' Cross says.

While there are risks associated with any procedure, Cross says there is a lengthy testing process that potential donors went through to make sure they can handle the operation.

Damian Jackson and Richard Langdon catch up following the transplant.

'Donors are usually a very healthy subset of the population … so the risk for [their] health is very small.

'About three in every thousand donors will get kidney failure, which statistically is about the same as the general population.'

After a transplant it can take up to three months to fully recover, but there are no major side effects after the operation. .

'Having two kidneys is heaps of kidneys … Most people are born with a natural reserve so they can function with just one.'