South Memphis sisters can't share kidney, but exchange link in chain of life

[Karol]

South Memphis sisters can't share kidney, but exchange link in chain of life
By Tom Charlier

Sunday, July 3, 2011

Once the pain pills took hold, Vernita Jarmon eased herself to the edge of the bed and signaled she was ready. Across the hall, Linda Richmond, squeezing a pillow to quell her own soreness, was ready too.

With her brother-in-law's help, Jarmon slowly stood up and took some halting steps, steadying herself as she crossed the hall on the 10th floor of Methodist University Hospital. Soon, she was at Richmond's bedside, leaning over to embrace her.

For just a moment, the sisters held each other, faces inches apart, neither saying a word. Each wiped away tears.

"You look good," Jarmon finally said.

"You look good too," Richmond answered.

The two women from a close-knit South Memphis family hadn't seen each other since before their diametrically opposite surgeries on the previous day. Jarmon, 39, had a kidney taken out; Richmond, 44, had one put in.

But it wasn't her sister's kidney that Richmond received, although at one time that was their intention.

Instead, Jarmon, whose different blood type made her an incompatible match with Richmond, made an arguably bigger sacrifice. She agreed to donate a kidney to a stranger thousands of miles away so her sister, in turn, could get a compatible organ from another faraway donor.

Jarmon and Richmond were part of a chain of giving and receiving known as the National Kidney Registry, a program Methodist recently signed onto that gives patients a way to receive a transplant in about one-fifth the normal waiting time for the organs.

Their "paired donation" kidney operations last Tuesday were the first in Tennessee.

The registry program sprang from a national shortage of kidneys that is expected to only get worse as a result of rising obesity and diabetes rates and an aging population.

Nearly 90,000 Americans currently are in need of a kidney. Those who don't have a live donor are placed on a federally supervised list to receive an organ from a deceased donor, which takes an average of more than four years. Many die waiting.

"There is a dearth of kidneys, and this is particularly pronounced in Memphis," said Dr. Vinaya Rao, medical director of the kidney-transplant program at Methodist, one of the nation's leading transplant centers.

Of those kidney patients who do have a live donor, about one-third are incompatible with him or her. That's where the registry program fits in.

It is a sort of swap market for kidneys. When a prospective donor isn't compatible with the intended recipient, the registry finds other matches so the donor can give to someone else, while the intended recipient gets a kidney from another donor.

A further benefit is that kidneys from live donors last twice as long, on average, as those from deceased ones.

"It's a good deal for everyone," said Dr. Luis Campos, surgical director of the Methodist kidney-transplant program.

By enabling more donors, the registry program also reduces the number of people on the list to receive organs from deceased donors.

"The gift of life is multiplied because of this program," Rao said.

Although there are other registry programs, Methodist officials say they chose the New York-based NKR because of its elaborate processes for finding matches. To offer the best chances a kidney won't be rejected and will last the longest, the registry uses sophisticated software -- the kind employed by the New York Stock Exchange -- to cross-match donors based on a number of factors, including blood type, antigens and antibodies.

As a result, it finds matches for donors and recipients so quickly that the average wait in the program is only 11 months. For Richmond, it was just a matter of weeks.

Richmond landed in the program after taking a route to kidney disease that's frighteningly common among African-Americans. Hypertension and diabetes, the conditions that led to the death of her mother, caused her kidneys to fail less than a year and a half ago.

Richmond attributes some of it to her family's "lack of education" about diabetes when she was growing up.

But if her upbringing led to problems for her original kidneys, it also instilled a family closeness that would play a part in getting her a new one.

Richmond and Jarmon and a third sister grew up in a South Memphis duplex and were governed by rules set by their very strict parents, especially their father, a feed-mill worker who previously had picked cotton.

Willie Motley's main rule for his three daughters was to stick together.

"We were raised that one can't be without the other," Jarmon recalls.

That meant when one girl went to play, another had to be with her. When one went into a store, she couldn't be alone.

"One can't be without the other" also meant that when walking to school at Dunn Avenue Elementary, the girls stuck together while crossing the scary railroad overpass on Cincinnati Road.

And while other kids roamed the neighborhood at all hours, the sisters couldn't even go into the street to pick up an errant ball. They also learned that if their father told them to do something, they'd better not make him repeat it.

"We were raised strict," Jarmon says. "When we got older, we appreciated how we were raised."

In addition to keeping them safe and out of trouble, the rules forged the closest of bonds between the sisters.

Those bonds remained strong as the girls grew up. Richmond, who is married with three sons and two grandchildren, became a warehouse worker and lives in Whitehaven. Jarmon, who doesn't have any children, works as an armed guard and lives in South Memphis.

The two are close enough that Jarmon noticed with distress the toll that kidney disease was taking on Richmond as she began dialysis.

"She's a high-spirited person," Jarmon said. "She just wasn't herself."

One of Richmond's sons offered to donate an organ, but doctors, citing indications of early hypertension, said he likely would need both of his kidneys.

After offering to donate a kidney to her sister, Jarmon was disappointed to find out she wasn't a match. But when told of the registry program, she was happy to learn she could help more than just one person by being part of a chain of donation.

"Why not share my good health?" she said.

Jarmon was told she could change her mind at any time and drop out. She wouldn't consider not helping her sister.

"She's got children and grandchildren to be here to look after," Jarmon said.

One day, as Jarmon picked her up after dialysis, Richmond thanked her for her decision to "give me a second chance at life," Jarmon recalls.

"I said, 'God gave you a second chance because he gave me the strength.'"

Richmond acknowledges feeling reservations about her little sister -- who had never even been hospitalized -- undergoing an operation on her behalf.

When they last met before Jarmon's operation, the feelings were particularly intense.

"It was hard for me to let her leave," Richmond recalls. "She was like, 'Don't cry, don't cry.' But she was crying herself."

If the lead-up to the surgery was difficult for the sisters, it was taxing on the medical teams too.

Paired donor operations can be complicated, logistically. There are flights and courier services to be verified, complex billing arrangements to be made, and the various surgical duties assigned.

This one was to be a four-kidney swap beginning in Maryland. A donor there was to provide a kidney to be shipped to Memphis to be implanted in Richmond. Jarmon's kidney would be flown to California and implanted in a patient at UCLA. An organ from UCLA was to be transported to Chicago for yet another patient.

Eventually, a kidney will be sent back to Maryland, completing the chain.

Jarmon's surgery occurred Tuesday morning, after which her kidney was flown to California.

Unlike livers and lungs, kidneys can last outside a body for at least 22 hours before they must be implanted.

But the larger swap was barely under way before the first glitch occurred:

A kidney missed its flight.

The surgery in Maryland apparently ran long, resulting in a courier service not getting the organ to Baltimore-Washington International Airport in time for the flight to Memphis. As a result, Richmond's transplant operation was pushed back a few hours to allow for a later flight.

When the kidney did make it to Methodist later Tuesday -- packed in a foam-plastic cooler inside a cardboard shipping box -- Campos spent time scraping away fatty tissue and examining it for tumors or any other problems.

The nearly three-hour surgery went without a hitch.

And by the following afternoon, the two sisters, still aching and woozy, were reunited in Richmond's room.

There, they reminisced and marveled at each other's resilience.

"I'm glad to see you up," Richmond told Jarmon.

Though sore from the experience, Jarmon says she's glad she went through with the operation so her sister could improve. And she would like to someday meet the person who got her kidney.

As for Richmond, she doesn't feel as if her new kidney came from a stranger. "It's hers," she said, nodding toward Jarmon.

On Friday, the two had lunch together in Richmond's room a few hours before being discharged.

Once they've recovered, the sisters will have more time to spend together before returning to work.

They'll still check in with their ever-watchful father. To this day, he always wants to know where they are.

Because one can't be without the other.

-- Tom Charlier: (901) 529-2572


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