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The kidney transplantation took place March 28, 2000 at University Hospitals of Cleveland. Below, Karen and Charlie Tremont, about three weeks post-surgery.


Transplant transforms our lives

March 28 will mark another "kidney-versary" for the author and his friend. Charlie's kidney continues to function well and Mark has not had any kidney-related health issues. Here is a monkey's first-species story of what transpired, originally printed in the Lexington Herald-Leader, April 23, 2000.


Story by Mark Maloney                                                                                                Photos by Janet Worne
    It's 1 a.m. I'm kneeling in the stillness of a small chapel to pray. I do this every week. Parishioners at my Catholic church, St. Luke, pray in shifts in this Eucharistic Adoration Chapel 24 hours a days, seven days a week, breaking only for part of Holy Week.
    My shift is 1 a.m. to 2 a.m. every Friday, a time when the world outside my church is silent.
 
    Often, the time is deeply spiritual. But sometimes, in the silence, as I hear my prayers go out, I know that my mind is wandering. At those times, the whole thing feels routine.
    I begin with a few short prayers. 
    
Then I read the bulletin board filled with "sticky notes" that request specific prayers. Somebody has a relative who has been diagnosed with cancer. Someone else is having marital problems and needs help with rent money. 
    
Then I pray the rosary. 
    The silence is ideal for reflection. And on this night, last September, I had something to contemplate. This night was anything but routine. 
    
For the first time ever, I added my own sticky note to the prayer board. 
    
"Please pray that the recent blood test I took comes back positive so that I can donate my kidney to my friend Charlie." 
   Charlie Tremont is 47. He was diagnosed with kidney disease more than half a lifetime ago. 
    When I offered my prayer, Charlie had been on dialysis for 23 years. Three-and-a-half hours for each session, three times a week. In all, I figure, he had spent 11,200 hours tied to the machine that cleaned his blood. 
    That's 466 days.
    
But his time was running out. Without a new kidney, Charlie's quality of life--already deteriorating--would continue to slip. Death would follow. 
    Charlie had questions about his future, but doctors found it increasingly difficult to come up with answers because so few people had been on dialysis for so long. 
    "I decided I could write the final chapter of the book here and that could be the one that they keep referring to," he told me, "or I could get out of this business of dialysis and pursue a treatment with transplantation." 
    So in 1997, Charlie went on a waiting list for a cadaver kidney. 

    Charlie and I became friends by marriage. 
    He grew up near Pittsburgh, I near Chicago. We both met our wives during college days in northeastern Ohio. Charlie met Karen at Baldwin-Wallace College. I met Margie at the University of Akron. 
    Karen and Margie have been close friends since their freshman year at Riverside High School in Painesville, Ohio. Karen was a bridesmaid for Margie at our wedding in 1975. Margie sang at Karen and Charlie's wedding later that year.
    By that time, Charlie -- a quiet 22-year-old with a dry sense of humor -- had been dealing with kidney disease for three years.
    He was diagnosed over Christmas break during his sophomore year in college, in 1972. How did he become ill? His best guess is a virus, possibly from a severe bout of flu the year before.
    He took leave from school for one quarter. And as far as I can tell, that was the last time he let his disease slow him down.
    He returned to college, made up time in summer school and graduated on time in 1974.
    He continued to play recreational basketball and championship-level (3 handicap) golf.
    He and Karen had two sons, Christopher in 1983 and Andrew, or AJ, in 1985.
    He went to graduate school.
    Even as he waited for a donor kidney, he was working four days a week as business manager and finance director for St. Clare's Catholic parish in Lyndhurst, Ohio. He spent another day each week as consultant to a landscaping company.
    In 1997, when he was trying an entrepreneurial venture, a video-golf simulation business, Charlie worked as much as 16 hours a day.
    At that point, he had been on dialysis for 20 years.
    Chris and AJ had never known a time when their dad had not been on dialysis. It was a condition they tolerated. Charlie can't recall a time when either ever complained about restrictions on family lifestyle.
    Nor did Karen balk, even though Charlie admits that his personality suffered in the last year or two as his health worsened and goals were derailed.
    "It started to pull me down a little bit," Charlie told me. "I'm not ever much of a complainer. But I became a complainer. Short with my temper or short with my patience."
    He even told Karen, "Hey, that's the price you pay when you're that close to the line of fire. You're the closest person to me, so when I snap out and I want to get it off my chest, unfortunately you're the first one in the way.
    "But I think both of us, especially her, have been understanding and tolerant of my little snipsand stuff I get into. They come and go so quickly for me. It's not part of my personality. I lash out, but it goes away in 30 seconds."

    In 1977, the same year Charlie's dialysis began, Margie and I left Ohio and eventually made our way to Lexington. Charlie and Karen settled in Solon, Ohio, near Cleveland.  
    
I don't recall exactly when Margie told me Charlie had begun a quest for a transplant. I think my initial reaction was limited to a "Wow!" 
    Karen had told us that her family was praying about the matter. They were seeking the intercession of Padre Pio, the Italian monk who seems destined for sainthood. Pio, who died in 1968, was a stigmatist, one who bears the wounds of Christ. Catholics often invoke his name in prayers seeking miraculous cures. 
    
One night--it was 1998, I think--Margie hung up the phone after another update from Karen. No luck on a kidney yet. 
    And then I said something. I didn't think about it. I still don't fully know why I said it. 
    I said it matter-of-factly. Even quietly. I said, "I could donate a kidney to Charlie." 
    And my wife looked at me as if I were nuts.

    More phone updates, "I could donates," and wild looks followed over the months. 
    But Margie's puzzled glances began to show a little less disbelief. She agreed to ask Karen what I needed to do to be tested. 
    "Well, first he has to have O-positive blood," Karen said. 
    End of story, Margie thought. 
    
"O-positive," I said the next day, when I pulled out my blood-type card. 
    More phone calls. 
    A lab kit was shipped from Cleveland. Twelve test-tube-size vials of my blood were drawn, then air-expressed to Cleveland.
    Days passed. A week. Two weeks. Three. 
    That's when I posted my prayer request on the chapel bulletin board. 

    I'm an ordinary man, OK?
    If I'm driving in traffic and somebody cuts me off, I'm liable to cuss.
    I go to church, yes. I say my prayers. I try to do my duty as a human being and as a person of faith. 
    If you had asked me a year ago whether the prayers of an ordinary man like me are answered, I probably would have told you yes. But there was always a small part of me looking for tangible proof. 
    Today, I will tell you yes. Definitely. 

    At 2 a.m., my prayer shift was over, and I went home to bed.
    Shortly after 9 a.m. that morning, a nurse from Cleveland was on the phone. 
    "Exactly how are you related to Charlie?" she asked. 
    The blood test matched well enough that we might have been brothers. 
    In tests of six antigens -- proteins that might stimulate the immune system to reject a donor organ -- Charlie's brother Terrence was a zero match. His sister Helen matched in three, but could not be considered because of other health concerns. Karen and I both matched in three.
    But if Karen were the donor, who would care for Charlie and Karen during recovery? And why put their sons in harm's way by having two parents with one kidney?
    I knew what should be done.

    
In the days after learning I might be "the match," my nerves were a bit frayed. I felt a strange mixture of anticipation and fear about the thought of giving up a body part. 
    I headed to church. But this time I went during the middle of the week, seeking help, at St. Peter's in Lexington.
    And I swear Rev. Dan Noll's reading of the gospel that day was meant for me. 
    "Do not be afraid of those who kill the body but cannot kill the soul," Jesus tells his apostles in Matthew 10:28. "Rather, be afraid of the one who can destroy both soul and body in Gehenna." 
    A great calm fell over me. 

    It was January before everyone agreed. Charlie told me the "positive energy" I was feeling helped convince him and Karen. I would be the one.
    Time for me to get nervous again. Not about losing a body part, but about telling my mother.
    The youngest of eight children, I would never do anything to cause Mom distress if I could avoid it. I just didn't know how she would react to this news.
    I did know I had to do it in person.
    As I neared the interstate, a traffic light turned red. A van with a lone bumper sticker pulled up in the next lane. 
    The bumper sticker said: "Hope. Padre Pio."
    Nerves were calmed.
    And my mother was totally supportive.
    Later, at the hospital, she would wear a silver choker, adorned by a peacock. "I'm proud as a peacock," she would tell Karen.

    The transplant was to take place at University Hospitals of Cleveland -- but first I'd have to pass several tests.
    In February, it was a psychological evaluation, lab work, chest X-ray and an electrocardiogram.
    Two weeks later came an IVP -- intravenous pyelogram -- an anatomical study of the kidneys.
    A week later, March 21, came an arteriogram, a study of the veins and arteries of the kidneys. Some people have more than one artery to the kidneys, making transplantation impractical.
    I had one artery to each.
    As Charlie drove me to his home that night, Karen called on the car phone. "We have a kidney," he told her. "Thumbs up!"
    On March 23, a Thursday, Charlie, Karen and I met with Dr. James A. Shulak, head of the transplant team.
    I asked him how unusual it was for me to be the match Charlie had been waiting for.
    "It's very unlikely when it happens to be a friend," he said.

    
On the eve of surgery, Karen, a third-grade teacher at St. Rita's Catholic school in Solon, received a "spiritual bouquet" from her students. It was addressed to "Mr. Tremont and Mark." Each student listed prayer intentions such as "one Our Father, one Hail Mary, and one Glory Be." We got a kick out of one that offered "one Mass, two Our Fathers, and three Hope You Feel Betters." 
    I had expected that neither a gospel nor even a spiritual bouquet would sustain me in the dark hours of March 28, the day of surgery. I expected terror. 
    I was wrong. 
    I arose at 4:15 a.m., calm as ever, and took what would be my last shower for several days.
    After checking in at 6 a.m., Charlie and I were in "pre-op" by 7, dressed in goofy-but-practical gowns.
    By 7:15, anesthesia was making its way through my body from an intravenous drip in my hand. I hung on to my senses long enough to flash "thumbs up" to Margie and Karen.
    Then I was unconscious. 
    My left side was cut open, just below the ribs. The incision was not quite eight inches long. 
    Dr. David Seaman, assisted by Shulak, removed my left kidney, about the size of a fist, during an operation that lasted more than three hours. 
    Shulak took my kidney to an adjoining operating room and prepared it for implantation into Charlie's left front side. His diseased kidneys would remain in place. 
    Before Charlie's surgery began, though, Shulak was called back to the first operating room. 
    A clamp had slipped off an artery. I was losing blood. Shulak remembers such a thing happening only once in the last six or seven years. 
    Now, my surgery was inching closer to four hours than three. But the problem was soon fixed, and Shulak began to work his magic on Charlie. 
    No complications. 
    Doctors told our wives that everyone was fine and the kidney was ... working
    
Tears of joy. 
    
Words of praise. 
    
Hugs and kisses. 
    
A visit to a nearby chapel. 
    
Wish I could have seen it all. 

    
Because of the slipped clamp, I needed a CT scan and blood transfusion the next day. Then I developed a fever. Nurses checked my "vitals" every 15 minutes for several hours. 
    I found it difficult to sleep while lying flat because of nasal congestion. And when I did sleep, I awoke with splitting headaches. 
    But I caught an unexpected break because the surgery di not require removal of a rib, as is the norm. 
I was sitting in a chair by Thursday, on my feet by Friday, slowly roaming halls by Saturday, and discharged from the hospital Sunday. 
    Charlie was placed on an anti-rejection drug "cocktail" immediately after surgery. 
    The initial cocktail recipe made him feel awful for several days. A new formula had him back on track by Sunday. 
    On Monday, the sixth day after surgery, he experienced initial signs of rejection. And there was a suspected leak, we learned, between his bladder and his new kidney. 
    Steroids helped to fight off rejection, and the suspected leak turned out to be a false alarm. 
    By Tuesday, Charlie was much improved. By Thursday, he was released from the hospital. 

    
You'll never feel alone if you take part in a transplant. 
    Charlie and Karen were flooded with support, but Margie and I were, too. Family, friends, and neighbors too numerous to single out offered visits, cards, phone calls, gifts, and prayers. And lots of e-mail. 
    The NBC television affiliate in Cleveland devoted 2 1/2 minutes of an 11 p.m. newscast to tell our story.
    On the day before our return to Kentucky, as I sat with Margie in the hospital atrium, a woman paced past our lunch table five, maybe six times. Finally, she worked up the courage to approach.
    "I saw you on TV," she said. "You did a wonderful thing."
    We talked a bit and asked what brought her to the hospital. Tears welled. She said she had breast cancer, and the cancer had spread to her bones.
    But she had put that aside to tell us what she was thinking.
    "You have a room in heaven."
    Overwhelmed.

    Kathy Decker, a friend of the Tremonts, recalls meeting me in the hospital. I had just been moved from recovery to my single-patient room
    I was still woozy and do not recall the conversation, but Kathy swears it's true.
    "Too bad you guys couldn't get a double room," she said. "Then you could ask Charlie how your kidney's doing."
    I replied, "It's not my kidney anymore. It's Charlie's."

    
His first night home from the hospital, Charlie tasted orange juice, a dialysis no-no, for the first time in 20 years. So far, so good. 
    "Charlie's prognosis is that he has a 90 percent chance of this kidney working a year," Shulak said, "probably a 70 to 80 percent chance for five years, and probably close to 70 percent chance for a 10-year survival of the kidney. 
    "At that point onward, nobody knows for sure. But if he gets out to 10 years, it's probably not going to fail." 
    One symptom of his kidney disease is already improved. An overactive parathyroid had produced unwanted phosphorous that collected in his fingers and left them crooked. 
    Within days of his surgery, the phosphorous had dissipated. He could extend his fingers straight. 
    The red has left his eyes and returned to his skin color. 
    His appetite is back, his energy on full throttle, his weight up 5 pounds. 
    In a way, he is born again. 
    In a way, I am too. 

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