Thirty years after he was diagnosed with kidney disease, Chris Sadler realized that the day had finally come to either begin dialysis or somehow, miraculously find a matching kidney donor in short order.
But what the Waco resident didn’t realize was that such a donor lived under his own roof — or that his successful procedure would end the suffering of a family he’d never met.
Chris and his wife, Susan, met during their freshman year at Baylor in the early 1980s. After dating off and on during college, they married in 1985.
During his years at Baylor, a urine sample taken during a routine physical raised the red flag that Chris might have the same kidney disease that had forced his father to go on dialysis.
“They found that I had excess protein in my urine, which can be a symptom of kidney disease, and because of my family history it obviously got my doctor’s attention,” Chris, 52, said. “They couldn’t diagnose it yet because it hadn’t advanced enough at that point to where it would show up in my blood. So for the longest time I thought, ‘Well, maybe not ...’ ”
Although the possibility of having the life-altering disease was never far from Chris’ mind, he didn’t let it rule his life.
“I did go through the mental process of where if I did have it, that it’s extremely slow and medical advancement is so fast that who knew what would happen in the next 10, 20 or 30 years?” he said. “I don’t think I ever really worried about it. … I honestly felt that God was in control anyway, so I’ve always been at peace about it.”
Chris and Susan went on to raise two children and together own Green Life Interiors, which Susan runs. The couple also has part ownership in other local businesses, including Facelogic Spa, American Guaranty Title Company and more recently, an LED-light manufacturing company, Pruf LED.
Nevertheless, Chris was all too familiar with the damage the disease could do. His father was diagnosed with kidney disease in his late 40s. The disease was so slow-moving that the elder Sadler didn’t know he had it until he started having symptoms
“By the time they knew he had the disease, he was really close to having to go on dialysis,” Chris said. “My dad had to go on dialysis, which is a big reason why I wanted to try to be proactive and not have to do that. Back then, live kidney donors were not as common as they are now.
“Typically, a person would go on a donor list and wait for a deceased donor. My dad was on dialysis and then it ended up that a young man was in a fatal motorcycle accident and it happened to be that my father was a match.”
Chris said his father did “fantastic” after his transplant and lived another 23 years with his donated kidney before dying of a heart attack in 2008.
Chris’ uncle, the twin brother of his father, was also diagnosed with the disease. Twenty-five years after a transplant, his uncle is doing well.
Chris saw the toll dialysis took on his dad and for a long time thought he was destined to go on the kidney machine as well until a match was found — something that isn’t guaranteed.
The National Kidney Foundation reports that as of June, nearly 97,000 patients were awaiting kidney transplants in the United States. Last year, 16,812 kidney transplants were performed; of that the majority — 11,043 — came from deceased donors. The rest were from living donors.
Last year, 4,903 patients died while waiting for a kidney transplant.
Life marched on for the Sadlers. The children grew up and moved out. Susan continued to run Facelogic. Chris, known by his family and friends as a multi-tasker, continued to grow his business, play the drums for his church’s praise band and enjoyed various sports, as well as hunting and fishing.
“As years went by the decline in function in my kidneys began to increase a little,” Chris said.
Chris’ visits to his nephrologist became more frequent.
“We really stayed on top of it,” he said. “I got down to about 17 percent function a little over a year ago and my doctor began to talk to me about getting a port in my arm for dialysis. He had us go to a seminar at the kidney center that talked about the different options for dialysis.
“For the first time I felt the anxiety of all of this and remembered my father going through all of this. I said, ‘I don’t want to do dialysis. I want to see if there’s any possible way that I can get a live donor transplant and get it done before I get bad enough for dialysis.’ ”
Chris’ doctor was supportive of the idea and sent him to the most experienced live-donor program in the United States — Texas Transplant Institute in San Antonio.
Susan had hoped that although she and Chris weren’t biologically related, she would somehow be a match and be able to give him her kidney.
“He never asked me (to be a donor) and I had no hesitation,” Susan said. “I had always hoped in the deep recesses of my soul that I could be a donor, but we also knew the complexity of the process it took for his father to get one.
“So I knew that for me to be a match was way out there. I knew, realistically, that medically speaking, that was probably not going to be the case.”
When Chris and Susan went to the Texas Transplant Institute to see if Chris would be a viable candidate, Susan was asked if she would like to go ahead and be screened as a possible donor
“I said ‘OK,’ and as I began to pass the stages of screening, it was kind of building and getting more exciting because I knew I might actually realize the opportunity,” she said.
Chris was told he was a good candidate for a transplant. Then Susan received the news she’d been hoping for.
“I was sitting in the H-E-B parking lot getting ready to do my shopping when my phone rang,” she recalled. “The lady called me and told me that I was a match. I just couldn’t believe it. It was overwhelming.”
“I think we weren’t surprised, because God can do whatever he wants,” Chris said. “It was very surreal. I mean, really, we’ve been waiting all these years and my match was my spouse. We just both looked at each other and said, ‘Oh my gosh! This is amazing!’ ”
Despite their match, they volunteered for the Incompatible Living Kidney Donor Exchange Program through the Texas Transplant Institute.
“We realized that if she was going to give up a kidney and I was going to get one, we might as well, hopefully, allow another person to get one,” Chris said. “Sure enough, a month out from our surgery day, they called and said they had a father/daughter pair and the daughter was willing to donate to her dad, but they were not a match. He was on dialysis and had no other options.”
What made this kidney exchange unusual is that the 24-year-old daughter, who was not a match for her father, was a match for Chris, while Susan was a match for the father.
But how did Susan feel about Chris not receiving her kidney?
“I was excited for them,” she said. “We knew the father would get to come off dialysis. We had the perspective of seeing Chris’ dad go through dialysis, so we had an appreciation for getting to come off of that. It was a very fulfilling, very rewarding experience.”
Chris admitted to having mixed emotions.
“There was a selfish part of me that wanted my wife’s (kidney). There’s just something about that bond and we’re married and that was going to be another bond,” he said. “But I would say the feeling was extremely minimized when we realized what it was doing for somebody else. Knowing what dialysis can do and knowing that this was going to allow this man to get off dialysis and have energy back and have his life back — my initial feelings were quickly insignificant.”
As the day for his surgery grew near, the effects of Chris’ diminishing kidney function were taking their toll. The multi-tasking, high-energy businessman was fatigued. His body ached as if he had the flu and he had no appetite.
“I got to the point that I was eating because I knew I needed to eat. I wasn’t even hungry,” he said.
But he’s quick to point out that he is one of the lucky ones. “I didn’t have the bad swelling, vomiting or the constant nausea. I was very fortunate in that way.”
Even with those symptoms, Chris worked right up until the day they left town for San Antonio.
By the time the July 24 surgery date arrived, Chris was down to only 11 percent kidney function. The surgeon told him that he had used his kidneys to the point that they would have been forced to put him on dialysis if he wasn’t having the surgery.
Privacy laws prevented Chris and Susan from meeting or even seeing the father and daughter with whom they traded kidneys until at least six weeks after the surgeries.
“They had us even come to a different location in the hospital to check in so that we never crossed paths,” Chris said. “We never saw the other people at all.”
Chris and Susan said they hope to meet the father and daughter at a future date.
The donor goes to surgery before the recipient so the surgeons to make sure that the kidney is healthy and that there are no complications that would prevent them from removing it. They don’t start surgery on the recipient until they confirm that the donor’s kidney is usable.
There is a definite advantage to having the donor and recipient in the same hospital at the same time, Chris said.
“They told us that one of the reasons that the average life of a live donor liver is longer is because it never gets put on ice,” he said. “They literally take it from the donor, and they say it’s still warm when they put it in the recipient.”
Surgeons and medical staff manned four operating rooms at once while the kidneys were removed from the two donors and then placed into the recipients. Susan’s surgery lasted two hours. Chris was in surgery for about 3½ hours.
Once Chris was out of surgery, he was sent to an intensive care unit to be monitored closely for the next 24 to 48 hours to look for signs that the body might be rejecting the kidney. Once doctors believe the patient is over the initial hump, they are moved to a regular room.
Susan was released in two days, while Chris stayed five days — the minimum time for a kidney recipient. After monitoring and adjusting his anti-rejection medicine dosages, Chris was deemed “stabilized” and sent home to recover with Susan.
Even though he was feeling the post-surgical pain of his incision, Chris says he immediately could tell the difference in his energy level.
“The overall fatigue and malaise was gone,” he said. “My appetite was back. I was able to stay up late, which was something I hadn’t done in a long time, but the incision left such an impact that I also didn’t feel like doing anything for a while.”
His new kidney flushed out 10 pounds of fluid that Chris hadn’t even realized he had been retaining.
While Chris was starting to feel better, Susan, was affected by the surgery.
“I went from a totally healthy standpoint to having come through surgery and having an incision and waiting for things to get back to normal again on me and that took three to four weeks,” she said.
One lifelong reminder of his transplant is the anti-rejection medicine Chris will take every 12 hours for the rest of his life. Not taking his medicine properly can cost him his new kidney.
However, the doctor said Chris has been “very meticulous” about his care, a habit that will be important in the years ahead.
Chris, who is by nature a “go-getter,” was proactive in his treatment — a move that kept him off dialysis and gave him back his active life. He encourages patients with kidney disease to explore the option of a pre-emptive transplant.
“People need to know that the live-donor approach is a very successful approach and if they would be proactive and go to the nephrologist regularly for monitoring and stay on top of where their kidney function is, they can begin that process of trying to find a live donor,” he said. “What’s cool about this exchange is that you may have a friend who is willing to donate a kidney, but is not a match. If they’ll go to the exchange program, there’s a very good chance that they’ll match somebody else which will give you the credit to get a kidney from somewhere else in the database. The database increases your odds (of finding a kidney) significantly.”
In addition to congenital kidney disease, other conditions can trigger kidney failure. The more common cause of kidney failure is either diabetes or high blood pressure, which are systemic diseases. In recent years, as Type 2 diabetes has increased in the United States, more diabetic patients have developed kidney disease.
Their incisions have healed and the Sadlers have returned to their jobs and activities. Chris is playing drums with a renewed gusto. Their journey has given them a deeper appreciation for God, modern medicine and each other.
“There was a peace in me that I think God gave me over the years,” Chris said. “I didn’t know what was going to happen. I didn’t know if I was going on dialysis, whether I was ever going to get a kidney, or whether I was going to die at 50-something years old. I didn’t know, but I was confident in knowing that God was going to be there to give me the strength whatever the outcome.”
“For years we didn’t have the answer and we had to rely on faith and we had to rely on God holding us up and that He was going to be there for us no matter what,” she said. “It’s just at the end, when we got to this point, this was the answer.”
Chris said he wasn’t surprised that Susan offered to donate her kidney to him.
“Knowing her and having her as my mate all of these years — it’s another example in our relationship of the long journey we’ve been on together of where we’re truly committed,” he said. “But I really questioned her heart about this. I told her more than once that I didn’t know if I was comfortable with her doing this.”
Susan’s reply: “I told him, ‘Too bad.’ ”
Texas Transplant Institute
Background: A department of Methodist Hospital, Texas Transplant Institute has performed more than 3,600 kidney transplants to date. In 2012, it performed 229 transplants — 175 from live donors and 54 from deceased donors. Texas Transplant Institute has performed more live donor transplants (nearly 1,900) than any other program in the U.S. in the last four years and is the national leader in paired kidney donation, in which incompatible donor and recipients pairs are matched with other incompatible pairs
Success: The program received a 97.91 percent one-year survival rating for patients receiving their first kidney transplant from January 2009 to June 2011. The rating is above the national average for all transplant centers in the United States. (source: www.srtr.org)