New UAB program helps woman improve her life with third kidney transplant
by Laura Gaddy
lbgaddy@annistonstar.com
Jan 12, 2014 | 4262 views |  0 comments | 61 61 recommendations | email to a friend | print
Ann Marie Reynolds, Vicky Junior (Anniston Star photo by Trent Penny)
Ann Marie Reynolds, Vicky Junior (Anniston Star photo by Trent Penny)
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When Ann Marie Reynolds was diagnosed with kidney disease at age 15, she was a sophomore at White Plains High School and an otherwise healthy girl.

She has since become a high school graduate, a sorority sister, a college student, a dialysis patient, and a three-time kidney transplant recipient. After receiving her last kidney in July, Reynolds said she was again freed from the restraints of time-consuming dialysis treatments.

"You do get so much freedom, not being attached to a machine," Reynolds said. "With a transplant you do get that time back."

Reynolds, now 32, was on a kidney transplant list for a third time and had less than a 1 percent chance of finding a match when she learned of UAB Hospital’s Paired Donation Program. Doctors at UAB used the organ exchange program to match Reynolds with a compatible donor in a three-way organ exchange that also paired two other hard-to-match kidney patients with compatible donors.

“Ann Marie is one of the many examples of folks we are able to get transplanted at UAB,” said Reynolds’ surgeon Dr. Jayme Locke, Reynolds' surgeon.

Locke said without the program, Reynolds would have likely spent the rest of her life on a list waiting for a kidney from a deceased donor.

The UAB program uses a computer system to match living donors with potential recipients. The list is comprised of donor-recipient pairs in which the donor and recipient are incompatible.

For example, donor-recipient pair A may be incompatible, and donor-recipient pair B may be incompatible. But, the donor from pair A may be a match for the recipient in pair B, and the donor from pair B may be able to give a kidney to the recipient in pair A.

In Reynolds' case a third donor-recipient pair was identified, allowing a three-way organ exchange.

Vicky Junior, an area nurse, mom and wife, decided in fall 2012 to be Reynolds’ donor. A longtime family friend, Junior said she had watched Reynolds struggle with her illness for years.

“I would be a bad person if I didn’t even consider it,” Junior said.

Within weeks of learning of her diagnosis as a teenager, Reynolds received her first dialysis treatments. By the time of her high school graduation, she had received her first kidney transplant. But, while she was in college, the organ failed, and Reynolds was forced to resume dialysis treatments. She was placed back on a waiting list for a kidney. A decade passed before she received a second transplant, but that organ failed, too.

Reynolds had been back on the donor list for about a year when Junior decided to help her, but after a medical exam they learned they were not compatible. That would have been the end of the idea if not for the Paired Donation Program.

“I said I would give a kidney in honor of Ann Marie, which bumped her up to the top of the list,” Junior said.

Programs like UAB’s are extremely rare and new. Locke said paired kidney exchange programs like the one that benefited Reynolds have been developed since the early 2000’s at three leading medical institutions: the Mayo Clinic, Cedars-Sinai Medical Center and Johns Hopkins University.

UAB began work to establish its own organ exchange program in 2006, but it did not become fully operational until 2013.

Now the number of top-tier medical institutions developing paired kidney exchange programs is expanding, but UAB’s program is unique. UAB’s program is special because doctors there have the ability to perform transplants between pairs who do not have compatible blood types or who have incompatible antibody levels.

“That’s part of what makes us unique here at UAB,” said Locke, who came to the UAB from Johns Hopkins University’s Comprehensive Transplant Center where she had worked in surgery and research through 2012.

Locke said UAB’s antibody compatibility program can be especially helpful for patients such as Reynolds who have built-up antibodies as a side effect of having multiple transplants.

“She had become highly sensitized and the more sensitized a patient, the more difficult it is for them to find a donor,” Locke said.

Dr. David Leeser is chief of the kidney and pancreas transplant program at the University of Maryland Medical Center, one of the nation’s largest transplant programs, which also includes a paired kidney exchange program.

“UAB is one of the big programs nationally that are really pushing this field forward,” Leeser said.

Leeser identified three main scientific and technological gains that have enabled doctors to develop paired kidney exchange programs in recent years. First, he said doctors developed the ability to identify patients’ antibody types, which enabled them to determine on paper which donors and recipients are likely to match.

Equipped with that information, people began listing donor and recipient information in databases that are used make compatible matches.

“On paper that would take a lot of time, but a computer can do it quickly,” Lesser said.

Lastly, Leeser said, doctors began employing less invasive laparoscopic surgical techniques to extract organs from donors. Patients can recover from a laparoscopic surgery in as little as two weeks, but it takes between six and eight weeks to recover from a traditional surgery.

Junior, a registered nurse, said she weighed the effect the medical procedure would have on her before deciding to move forward with the surgery. In addition, Junior said physicians talked to her extensively about the potential effects of the procedure and gave her the option to back out of the procedure.

But, Junior said she felt comfortable moving forward.

"I just felt like it was something I should have done, or that I was supposed to do. I just knew it in my heart and I prayed about it,” Junior said.

In July an extensive team of doctors and medical professionals performed the three-way surgical exchange that helped Reynolds and two other people. During the 14-hour surgical procedure, surgeons extracted kidneys from three donors and inserted them into the three recipients.

Reynolds and Junior were paired with two other sets of incompatible matches, a husband and wife team from Rockwood, Tenn., and a two sisters from Hayneville, Ala. In the end, Reynolds received a kidney from the husband and wife team, one of the sisters received Junior's kidney, and the husband received the donating sister's kidney.

The day after the procedure all six patients met in a waiting room. Reynolds said she instinctively knew which one of them donated to her.

"Something just stood out when I saw her," she said. "I kind of had tears in my eyes."

Almost five months have passed since Reynolds received her new kidney, she is no longer linked to dialysis machines. She is no longer bound to plan her days around treatments, and, for the first time since she was 15, Reynolds said she can plan a trip, a career, a life. Although she’s lived in several other locations since her days at White Plains, Reynolds now calls Atlanta home. She’s pursuing a degree in radiation therapy.

"I feel like this one is mine. I feel like this one was sent by God for me," Reynolds said. "It makes me very thankful."

Staff Writer Laura Gaddy: 256-235-3544. On Twitter @LGaddy_Star.

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