Article written and published in June 2008 on non-directed donation in the medical journal, "Progress In Transplantation" Transplantation".

1. Brief Communication
Living donors: personal perspective of a
nontraditional living donor
I
Christina Bryant, RN, PTC
n January 2007, after fighting for nearly a year for nephrectomy patients and transplant recipients. I under-
the opportunity, I became a nontraditional living kid- stood the risks involved, had waited 17 years to pursue
ney donor through an intimate tribute to my aunt who my goal, and was determined not to be told “no” again.
died of renal failure at the untimely age of 31. I was 14 The solution seemed obvious . . . I would have to “estab-
years old when she became ill and was dismissed as a lish a relationship” with someone on the transplant list.
candidate for donation because of my age. Following In an effort to make a difference on behalf of those
the funeral, 18 years ago, I defied my mother with the waiting for a lifesaving transplant, I initiated the Share
statement, “I won’t always be fourteen” and set it in my Life Foundation and used the media to raise awareness
mind that one day I would make a difference to some- about the need for nontraditional donor programs and
one. On January 15th, 2007, at the age of 31, for obvi- my desire to be a living donor. The media attention gen-
ous reasons, I donated a kidney in memory of my aunt. erated an outpouring of support for the cause and numer-
My mother set her fears aside and joined me as she offered ous e-mails flooded the foundation. In an effort to be
her support and cared for me throughout my recovery. an equal-opportunity donor, I decided to “establish a
Last month, my recipient and I celebrated the 1- relationship” with the first person on the transplant list
year anniversary of our transplant. God willing, he will who e-mailed the foundation with a compatible blood
walk his daughter down the aisle, attend his son’s high type. The first e-mail that I received came from the wife
school graduation, live to know his grandchildren, and of a dialysis patient who had been on the waiting list
grow old with his beautiful wife. for 2 years. She graciously offered her support and
As amazing as this journey has been, few people volunteered her services to the foundation. I became
understand the obstacles that I faced as I pushed for- acquainted with the family through a series of e-mails
ward in my resolve to make a difference. The transplant and telephone calls. After we had “established a rela-
community is leery of nontraditional organ donors and tionship,” I contacted the transplant center, this time
few transplant programs nationwide support nontradi- with the intent of donating to a specific individual. Once
tional/altruistic gifts or have protocols that allow for again, I was told that I would not be allowed to donate.
this approach to donation. The protocols were not only limited to those donors
I have been blessed with a unique perspective and and recipients who had an established relationship; the
felt pressed to share my experience with the hope of relationship had to be “preestablished.” In short, I was
encouraging change. told that I could not donate to someone who I had got-
In February 2006, I approached my local trans- ten to know for the sole purpose of donating a kidney.
plant center with the intention to donate anonymously At this point, the process seemed ridiculous. I was
to someone on the transplant waiting list. I was shocked frustrated, angry, and determined in my resolve to
when I was refused the opportunity. I was a perfectly become a living donor. I threatened to use the media in
healthy middle-aged woman, offering somebody a sec- a follow-up story that would illustrate the hospital’s
ond chance at life, and I was being turned away. In an policy and my subsequent fight for the right to donate.
effort to find an alternative means to accomplish my With a combination of time, patience, and a great
goal, I began to do some research. It didn’t take long to deal of persistence, the screening process was initiated
discover that very few nontraditional donor programs by the local transplant center. My blood was drawn for
exist nationwide that would allow what I was trying to tissue typing, and within a few weeks I was contacted
accomplish. Additionally, I was not prepared for the with the results. We were a suitable match, and I would
attitude and reaction of various clinicians who managed be allowed to move forward with the psychosocial and
our case. Rather than embrace my desire to share life, I physical components of the evaluation.
was treated as though I was trying to bypass the system Our celebration was short lived, however. As soon
and disregard hospital protocols. These protocols only as the screening was initiated, the years of dialysis took
provided the means for donors to donate to someone a toll on my recipient’s health. He had developed a heart
with whom he or she had an “established relationship.” condition that required placement of a stent and pace-
As a registered nurse, I had experience in urology maker. He was informed that it would be 6 months
and surgical intensive care, taking care of both post- before he would be medically suitable for transplant.
1 Progress in Transplantation, Vol 18, No. 2, June 2008

2. He called me with the news, devastated and concerned I will never quit hoping that time will bring a fresh
that I would choose to donate to someone else. I perspective and a season for change. I look forward to
responded without reservation, “This kidney is getting the day when nontraditional organ donation will not
perfect preservation . . . I’ll be ready when you are.” only be allowed but will be welcomed.
Some changes took place during the 6 months that As a procurement transplant coordinator, I have
followed. The transplant center established the neces- been blessed to witness the best that humanity has to
sary protocols that would allow nontraditional donors, offer through the lives of those who have loved and
and my recipient and I were contacted about the oppor- tragically lost. Our donor families exemplify great-
tunity to participate in the program. On January 15, ness, heroism, and strength when they embrace life,
2007, I became a nontraditional living donor. despite death. I strongly believe that those same altru-
In March of last year, after the surgery, a position istic attributes manifest in the lives of the living every
opened for a procurement transplant coordinator with day without regard to tragedy.
our local organ procurement organization. I applied, With nearly 100 000 people on an ever-growing
and shortly thereafter, joined the clinical team. Because transplant list and nearly 75% of those individuals wait-
of this opportunity, I am able to incorporate my pas- ing for a kidney, I think we need to ask ourselves if we
sion for organ donation into my clinical ambitions. are doing all that can be done. Deceased donors alone
Ironically, my professional roles and responsibilities cannot fill the void. It is time to pursue change, open our
have afforded me the opportunity to establish rela- minds to new possibilities, adopt a new perspective, and
tionships with the surgeons that I had adamantly dis- embrace the benefits of nontraditional organ donation.
agreed with in the past. I have the utmost respect for If we’re ever really going to make a difference,
them and I value the remarkable work that they do, but we’ve got to change the way we think.
2 Progress in Transplantation, Vol 18, No. 2, June 2008