Kelly White’s kidney was a perfect match for her first cousin, Dana Brumfield, whose polycystic kidney disease (PKD) had worsened to the point she required a transplant. Their blood types, tissues and antibodies were compatible. As Kelly recalls, “I remember telling Dana I’m in good health, I almost never get sick or ill. It seemed like me being a donor for her was meant to be.”
Late on a Thursday afternoon, after spending the first of two days undergoing tests to confirm her kidney was a match for Dana, Kelly got a call from a Cleveland Clinic caregiver. They were canceling the second day of her tests, and instead she would meet with Alvin Wee, MD, director of the Kidney Transplant Program at Cleveland Clinic’s main campus. A CT scan revealed the presence of a growth on Kelly’s right kidney with abnormalities that appeared it could be cancerous.
Kelly was shocked about the discovery and concerned she may no longer be a viable donor for Dana.
As Kelly recalls, “Dr. Wee told us even though there are few reported cases, the team felt confident that with their expertise they could remove the small tumor from my kidney and transplant the organ into Dana.”
Kelly and Dana were comfortable with Dr. Wee’s plan. As Dana, who has seen Cleveland Clinic nephrologist Saul Nurko, MD, for years throughout her journey with PKD remarks, “I’ve always had exceptional care at Cleveland Clinic. I put my trust in Dr. Wee and God. They were going to have to take out a part of Kelly’s kidney anyway, so why shouldn’t I use this completely compatible kidney?”
Because a transplant with a kidney that has been resected of a small tumor is uncommon in the United States and mostly performed on a deceased donor where there are incidental findings, Dr. Wee held meetings with a multidisciplinary team of Cleveland Clinic specialists including urologic oncologists to discuss details of the case and best steps moving forward. After several meetings, the team and both patients decided to proceed.
Dana (left) and Kelly (center) during a follow-up appointment with Dr. Wee at Cleveland Clinic. (Courtesy: Cleveland Clinic)
“My colleagues and I knew we could safely remove the kidney, excise the tumor ex vivo and transplant the kidney,” says. Dr. Wee. “Because Kelly originally wanted to donate her kidney, the team felt comfortable suggesting this approach.”
A few months after doctors detected Kelly’s tumor, the surgical team moved forward. First, Dr. Wee removed Kelly’s right kidney, which was immediately placed on ice to temporarily halt its metabolism. Then, he and his colleague, Mohamed Eltemamy, MD, removed the tumor with a safe margin.
After the repair and vascular reconstruction, and with more than 95% of the kidney remaining, Dr. Eltemamy transplanted it into Dana, who was prepped and ready in an adjoining operating room.
The cousins recovered from their surgeries quickly, with Kelly driving back home to Kentucky two days later. They had minor pain and minimal postoperative complications.
Five days after the operation, doctors were surprised to learn the pathology lab results: the tumor was benign. This discovery brought additional relief to Kelly and Dana.
“I have an overwhelming sense of gratitude and thankfulness for the opportunity I’ve been given” says Dana. “Some of my family members have died from PKD, and now I have the opportunity to see my three adult sons marry, maybe have children, grow their careers and live their lives. Those are things I might not have been able to look forward to before.” Dana, with a perfectly functioning kidney, plans to return to her job as a school cook in the spring of 2024.
Kelly, who is a nurse practitioner, feels blessed to have been able to help her cousin and fortunate her decision to be a donor ultimately identified a serious health issue.
“I believe we are put on this earth to help others, and I am very much an advocate for being an organ donor,” she states. “Now that we’ve been able to successfully treat and transplant my kidney, I hope fewer kidneys will go unused because of a growth on them.”
Dr. Wee shares a similar hope. “If Kelly had solely undergone the operation to remove her tumor, she would have missed the opportunity to donate at the same time. Dana may have had to continue waiting to receive a kidney.” In a field where there is an ongoing shortage of kidney donors, “We want to push the envelope and safely get more usable kidneys. This case, with Dana and Kelly, is a catalyst for doing that.”
Glickman Urological & Kidney Institute