It’s hard enough for most people to imagine what it takes for a living donor to give an organ to a friend, family member or stranger. What about those who have done that good deed twice? Only 47 people in the U.S. have donated more than one organ to two different people over the past 25 years, according to the United Network for Organ Sharing (UNOS), the non-profit that runs the nation’s transplant system. (Another 17 people have donated two different organs to the same recipient on different dates.) Of those who donated to two different people, 43 out of 47 donated a kidney and part of their liver. A New Jersey rabbi, a California football coach and a director of a Maryland consulting firm are among those 47. Here are their stories:
A Rabbi Gives Life
Ephraim Simon, a 51-year-old rabbi in Teaneck, N.J., says he had difficulty finding a hospital willing to let him donate a second organ. He first donated a kidney in 2009 at New York’s Weill Cornell Medical Center to a father of 10 children. The two met before the surgery and now are close friends. “I go to all of his children’s weddings and he comes to mine,” says Rabbi Simon, who has nine children of his own. “That was just such an incredible experience. I thought I really want to do this again, but I only have one kidney. What can I do?” He heard about living liver donors and started looking for someone in need. But every time he heard of a case, hospitals turned him away because he was a prior donor. Then he learned that the Cleveland Clinic would accept him. He donated part of his liver to a Long Island father of three in December. This recovery was much more intense because it followed open surgery with a large incision, not a laparoscopic procedure like the kidney operation. It took Rabbi Simon three to four months to fully recover. He says it was worth the physical pain. “The reward of bringing a father back to his children, of a husband back to his wife, that reward is infinitely greater than any risk that I took,” he says. “If I could do this again I would do it tomorrow morning,” he adds. “But I think I’m done. There are many more different ways for me to continue to give.”
Two Gifts to Strangers
Nathan Hauser, a 39-year-old director at a consulting firm in Germantown, Md., is unusual in that he donated organs twice to strangers and chose not to meet them. After seeing a commercial about the lack of living kidney donors, he found a website that paired donors and recipients. He tested for a young woman in Long Island but they didn’t have compatible tissue types. A nurse at the hospital told him about kidney donor chains, in which a healthy person donates a kidney without a designated recipient and sets off a chain of transplants. He set off a chain in August 2008. “I ultimately decided not to meet the recipient,” Mr Hauser says. “I thought it would be more powerful to be anonymous.” In 2013 he started thinking about donating part of his liver. The first two hospitals he reached out to were against allowing him when he mentioned his kidney donation. He gave up on the idea, but last year he saw a commercial from the University of Pittsburgh Medical Center seeking living liver donors. “Medicine advances quickly, and I thought maybe in these five years it’s become more acceptable,” Mr Hauser says. On March 7 he donated part of his liver to a woman. Again, he chose not to meet her. A couple of weeks ago she sent him a card through UPMC thanking him and telling him she was doing well. Mr Hauser regularly donates blood and platelets. He’s on the bone marrow registry. He’s a volunteer firefighter and EMT, a Habitat for Humanity volunteer, and helps low-income people prepare their taxes. He attributes his service to a strong personal belief that people should look out for each other. He also has the time as a single man. “It’s a fulfilling way to keep myself busy,” he says.
A Major Step for Family
Sean Gomes’s organ donations both went to family members. The 54-year-old (header photo above) is an information technology manager for Monterey County, Calif., and head football coach at North Monterey County High School. In 2003, he donated a kidney to his father-in-law, who was suffering from renal failure. “We had a good relationship before that, but after that, we had an even stronger bond,” he says. His father-in-law died in 2010 of a heart condition but also had kidney failure. At his mother’s funeral in October 2017, Mr Gomes’s cousin told him about his need for a liver transplant. Mr Gomes broached the topic of becoming a living liver donor. They reached out to the University of California, San Francisco and began the process 10 months later. He was almost too old to donate, but he was healthy and in good shape. He ran regularly before the surgery to help with his recovery. In January he had the surgery. He was in the hospital for five days and took off two months paid leave from work. His cousin had some complications and recently had his bile ducts reconstructed. “I felt blessed that I could help him see his grandson grow up,” Mr Gomes says. Mr Gomes and his wife donate blood and platelets regularly and his wife, Maria Gomes, was a bone marrow donor. “That would be the next thing that maybe I could do if I match someone,” Mr Gomes says. They are devout Catholics. He says religion definitely plays a role in his decision to donate two organs. “My thought was if it didn’t go right and I passed, that it was God’s will and that was my fate,” Mr Gomes says. “But I felt comfortable that he would take care of me and guide me through and everything would turn out OK, and it did.”
The Psychology of Live Organ Donors
Mary Amanda Dew, a psychiatry professor at the University of Pittsburgh School of Medicine, studies the mental health of organ recipients and donors, as well as their quality of life. She says first- and second-time donors are always evaluated by a social worker and sometimes a psychologist or psychiatrist. “When somebody wants to donate again, there is very careful consideration about why they specifically want to do it,” Dr Dew says. She says evaluations make sure that potential second-time donors understand that the outcomes for the recipient might not be the same as the first time and the surgery may be riskier, with a longer recovery. Usually, organ donors have a history of donating blood or platelets or performing community service. If there is no such history, Dr Dew says doctors will wonder why the donor has chosen such a drastic way to give, and whether the person understands the dangers involved.
UNOS Living Donor Committee chair Randolph Schaffer says there is no national policy prohibiting people from donating more than one organ. When the second donation is going to someone the donor doesn’t know, there may be a more thorough exploration of reasons behind the decision. Doctors are more apt to accept organ donations going to strangers now, as the risks of kidney transplants, in particular, have decreased and the success of transplants has improved over the past few decades. “We realize that people can have a psychological benefit by doing something good anonymously that can justify the acceptable degree of personal physical risk by undergoing the surgical procedure,” he says.
Credit: Sumathi Reddy for The Wall Street Journal, 30 September 2019.