Edward Richmond

It's not uncommon to find Edward "Skip" Richmond playing golf, taking his dog for a daily walk, or out working in his yard. Skip, a 77-year-old resident of Rockland, Wis., enjoys being busy; it's part of the way he lives. But, in 2003, when he suffered kidney failure, it looked like Skip's active life was a thing of the past.

Help arrived, though, from an unexpected place. After his doctor convinced Skip to consider having a kidney transplant, his granddaughter, 22-year-old Elizabeth Kinsey, was determined to help — so determined, she traveled halfway around the world to donate one of her kidneys to her grandfather.

A chance to get his life back

Skip had experienced difficulties with his kidneys prior to 2003. His physician Venkateshwaran Iyer, M.D., was monitoring him closely at Franciscan Skemp Healthcare in LaCrosse, Wis. — part of Mayo Health System. The situation didn't appear to be critical until Skip had a bad case of the flu and, without warning, his kidneys shut down. He was placed on dialysis right away, first in the hospital and then on an outpatient basis.

"We kept expecting things to turn around," recalls Marcy Richmond, Skip's wife. "It just didn't seem possible that his kidneys wouldn't come back at all. But, after two months, nothing had changed. So, we figured that would be our life from there on in."

Dr. Iyer urged them to consider the alternative to dialysis, a kidney transplant. He explained that if Skip had a transplant, it was quite likely he would be able to resume his old life. Skip was hesitant. "I didn't want to do that to my kids, to have them give me a kidney when I'm old, and they're young," he says.

"At first, we didn't think it was an option," says Marcy. "We thought he was probably too old for a transplant. Then, Dr. Iyer told us he was not too old. He explained the procedure and answered our questions. He also talked about the negative long-term effects dialysis could have. After that, we decided a transplant was the way to go."

According to Michael Ishitani, M.D., the Mayo Clinic surgeon who performed Skip's kidney transplant, having a transplant past the age of 65 is much more common now than in the past. Advanced age and other medical factors that used to be barriers to transplants are no longer insurmountable due to the success of living-donor transplantation.

"At Mayo Clinic, we perform more transplants on patients who are older than many other centers do. We do it because the quality of life, the patient survival rate and the overall patient benefit is much better with a kidney transplant than with dialysis," says Dr. Ishitani.

He continues, "We do transplants on these individuals almost exclusively using live-donor transplantation because the cadaver transplant list is so long that most patients have a four-to-seven-year wait. For those over the age of 65 on dialysis, that's too long."

A donor from around the globe

After Skip decided to follow Dr. Iyer's recommendation and have a transplant, he faced the next big hurdle: finding someone willing to donate whose blood type matched his own. Each of the Richmonds' five daughters were tested as possible donors. None of them matched. It was then that Elizabeth stepped forward. "She said, 'Grandpa, do you need a kidney? I'll give you one,'" Marcy recalls. "She made up her mind that she wanted to do it and felt strongly about it."

Although she was steadfast in her decision, it seemed Elizabeth's generous offer might get bogged down in logistics. As a senior airman in the U.S. Air Force, she was stationed overseas in South Korea. There was some doubt as to whether she could get a six-week medical leave for the transplant surgery and recovery.

The details fell into place beautifully, though. In October 2003, Mayo sent Elizabeth a kidney donor test kit. When the results came back, they showed she was a good match for her grandfather. Elizabeth also learned that as a transplant donor, she was allowed to take medical leave from the Air Force. She arrived in the U.S. on Feb. 21, 2004, and Skip had his kidney transplant surgery at Mayo Clinic in Rochester, Minn., on Feb. 27.

Skip remained in the hospital for a week, and then stayed at the Gift of Life Transplant House in Rochester for an two additional weeks so Mayo doctors could monitor his condition. Elizabeth got out of the hospital after only two days. She returned to South Korea at the end of March.

The speedy recovery Elizabeth enjoyed is due in large measure to the minimally invasive laparoscopic procedure Mayo Clinic uses to remove a living-donor's kidney. Surgeons remove the kidney through a small incision in the lower belly. In addition to a shorter hospital stay, donors also experience less pain than they do with other transplant procedures.

"In the old days, the open techniques required a five-to-seven day hospitalization and an eight-to-twelve week recovery time," says Dr. Ishitani. "With the surgical technique we use, most donors are in the hospital two days and usually are getting back to normal within two weeks."

A bright outlook

Since the surgery, Dr. Iyer's prediction has proven accurate: Skip is back to enjoying his favorite activities.

"He takes the dog for a mile-and-a-half walk every night," says Marcy. "Before the transplant, there were times when he didn't know if he could make it up the steps when he got back. Now, he takes his walks, comes back, goes up the steps and doesn't even notice it. Yesterday, he played 18 holes of golf. There's quite a difference."

As for Elizabeth, she's back to her Air Force duties in South Korea. Her grandparents report she's feeling well and is working out to get her muscles back after the time off for surgery. She recently decided to re-enlist for another three years. Her new assignment will take her overseas again, this time to Germany.

Elizabeth, and other living donors, are unlikely to experience problems connected to having only one kidney, according to Dr. Ishitani. "These are healthy people, and studies have shown that they have no higher risk for developing kidney failure than anyone else," he says.

Looking back on the experience, Skip and Marcy know the decision to have a transplant was the right one. "Skip went through dialysis for eleven months. The appointments were three times a week, three and a half hours each, with a half-hour drive one way to get there. That was all we did those days, and it really wore him out," says Marcy. "Things are so different now. We can do what we want to again. We couldn't have asked for anything better."