Sister's Sacrifice : 'She did it for me'

    Sisters' living donor kidney transplant a success -- but not before a
day of nervous waiting

    By Alice Hohl[0]

    Staff writer


    Sister's Sacrifice : Occasional series chronicling a living organ
transplant



    Weeks and months of anxiety and hope turned to joy Tuesday when
doctors carefully sewed one of Suzanne Ruff's healthy kidneys into her
sister Jo Ann Villanueva's belly.

    The kidney began functioning immediately.

    "Suzanne would be so embarrassed," Jo Ann said, grinning, a few hours
after surgery. "Her kidney peed all over the doctor."

    To the doctors, a kidney that produces urine immediately after being
hooked up is the ultimate success in kidney transplants.

    The waiting began at 5 a.m. Tuesday when the two sisters, their
husbands and two daughters arrived at Northwestern Memorial Hospital.

    Jo Ann didn't need to be there for a few more hours but wanted to see
her sister before the surgery.

    Suzanne was scheduled to have her left kidney removed about 7:30
a.m., and Jo Ann would be wheeled into the same operating room to receive
the kidney four hours later. By 7 a.m., nurses were getting Suzanne ready
for surgery, and she lay on a rolling bed in her hospital gown with an
intravenous line already connected.

    "I'm very nervous," Suzanne said, clutching a rosary.

    She glanced at a nurse making marks in her chart.

    "You'll write me down as the most reluctant patient ever," she said.

    Suzanne has never had surgery of any kind. She's only been in the
hospital twice, to give birth to her two daughters. She admits telling her
husband, Bill, that she "changed her mind" after her water broke with her
first daughter.

    Suzanne said she is determined to donate her kidney to her sister to
spare Jo Ann the four or five years of dialysis she would have to endure
waiting for a kidney from a deceased organ donor.

    Still, she worries she or her daughters eventually could be diagnosed
with polycystic kidney disease, the hereditary disease that has spared her
so far but ravaged the kidneys of her mother, two sisters and other
relatives.

    This is the only spare kidney she has to give.

    Suzanne's daughters put on brave faces as their mother is wheeled to
surgery, joining Bill in assuring her everything will be all right.

    Colette, 26, a certified public accountant, and Rachel, 29, a medical
producer for CNN, both took time off from their jobs in Atlanta for the
transplant.

    As soon as Suzanne disappears, they dissolve into tears, clutching
each other for support.

    Four floors up, Jo Ann is all jokes and smiles as she sits in a chair
next to the window in the hospital room. She hasn't had a drop to drink in
about eight hours, and teases her daughters for drinking fruit juice in
front of her.

    "After my surgery they said I'd be on a liquid diet," Jo Ann said.

    "Yes! Liquids!"

    Jo Ann reflects on her final dialysis treatment, which caused a rare
bout of leg cramps, and the support from her students at Oak Forest High
School, where she is a teacher's aide in the English Language Learners
program.

    She said her students threw her a party with cake, cards and gifts,
and sent gifts for Suzanne, too. Their parents, to whom she teaches
English on the nights she doesn't have dialysis, prayed over her at their
last session.

    Jo Ann said she thinks the Fannie May candy stores opening up again
"is a sign," since she will hopefully be ending the restrictive diet she
had to follow while on dialysis. Chocolate, one of her favorite foods,
hasn't passed her lips in 10 long months.

    One down, one to go

    After Suzanne is wheeled away, her daughters and Janice Gill --
Suzanne and Jo Ann's other sister, who is already a kidney transplant
recipient -- head to the hospital chapel to pray.

    Family and friends with tense faces pass time in the seventh floor
waiting room, telling jokes to distract each other. They grab a quick
breakfast from the hospital cafeteria.

    "This is the part that hurts," said John Gill, the patriarch of the
family, "the waiting around."

    At 11:15 a.m., the phone in the waiting room rings with news that
Suzanne is doing well. Her left kidney has been removed.

    Bill and their daughters are relieved, but no one is ready to
celebrate until they know Suzanne's sacrifice is worthwhile.

    "We're one for two," someone mutters as family and friends settle
back into their chairs in the waiting room.

    Suzanne's kidney was removed laparoscopically, using a camera, a
light and a tool inserted through three small holes. Her abdominal cavity
was filled with air to give surgeons more room to work as they
disconnected the artery, vein and ureter in tight quarters.

    A slit of just a few inches was cut into her skin to give one surgeon
enough room to scoop out her disconnected kidney with his hand. Her
remaining kidney will increase in size over the next few months to
compensate.

    Suzanne's family is told they will have to wait at least an hour
before she is out of the recovery room and ready to have visitors in her
hospital room.

    A chance encounter

    The families turn their energy to seeing Jo Ann off for her surgery.

    They are happy they can tell Jo Ann the good news about Suzanne
before she loses consciousness from the anesthetic.

    As everyone gathers in the hall to take turns seeing Jo Ann, they are
startled to see nurses roll Suzanne past them to the recovery room. Her
eyes flutter open, dazed.

    She asks whether she has already had the surgery, and a nurse tells
her the kidney was removed.

    "It's gone?" she asks incredulously.

    And then she disappears into the elevator.

    Jo Ann waits behind a hospital curtain as they clean the room after
Suzanne's surgery.

    "I can't believe she did it for me," she says. "The only reason I'm
here is because of the support from Sue and from Bill and Sue's family."

    She says she is not yet fantasizing about spending her three dialysis
nights at home again, or eating chocolate and pizza, or drinking water
until her thirst is quenched.

    "I'm being pessimistic. If anything happens, it will be too hard."

    Jo Ann has repeatedly said she wishes she didn't need to accept her
sister's gift, but there are not enough organ donors. Without healthy
organs from people who die, living donors must make up the difference.

    Just after noon, Jo Ann is taken into surgery.

    The waiting room is filled with anxious people, most of whom have
been up since 3 or 4 a.m. Their energy is flagging despite cup after cup
of coffee.

    Cheers of relief

    At 1:45 p.m., the waiting room phone rings again.

    Relatives look at each other, concerned. It seems too early for the
surgery to be complete.

    Jo Ann's husband, Dave, is out of the room, pacing the hospital
halls, so Kristina, 25, takes the call.

    "She's doing good," Kristina announces. "They said it's working."

    Relatives breathe a sigh of relief, but most are holding out for more
information.

    A family plagued by kidney disease needs specifics. Did the kidney
produce urine right away? How much?

    Fifteen minutes later, Dr. Alan Koffron appears in the waiting room.
He steps back as more than a dozen people rise from their seats, eyeing
him expectantly.

    "It's great to see so much family here," he says. "The kidney is
working immediately."

    He has measured a liter of urine already.

    "It's working like gangbusters. She didn't have one problem."

    Cheers go up, and family and friends break into wide smiles.

    Jo Ann's husband and daughters hug Suzanne's husband and daughters,
whispering words of gratitude.

    "I just can't get over it," Dave says.

    "Because of them, I got my mom back," Kristina says, motioning to her
cousins. Her sister Katie, 21, nodded in agreement, saying she was looking
forward to seeing her mom in the evenings again, when Jo Ann would no
longer be hostage to the dialysis center for four hours at a stretch.

    Colette and Rachel say they are proud of their mom, Suzanne, who was
very frightened and worried about the procedure.

    "One of the gifts Mom gave -- as well as the kidney -- is the lesson
of life and love and courage to our family," Rachel said.

    About an hour later, Suzanne is situated in her hospital room, and
her family delivered the good news that her kidney was working fine inside
her sister.

    "That's the point of it," Suzanne mumbled, still sleepy from the
anesthesia.

    Tears, nausea and gratefulness

    On Wednesday morning, the pain, soreness and nausea have set in for
both Suzanne and Jo Ann.

    In separate rooms at separate times, both sisters are made physically
ill by the Jell-O.

    "The doctor asked if I felt like I was hit by a truck," Jo Ann said.
"I said no, more like a small Volkswagen."

    Both sisters want to see each other for longer than the few seconds
they spent together Tuesday night when Suzanne was slowly walking the
hallway.

    But it is hard.

    "It hurts when I see Sue, because I start crying. You get all choked
up and you tighten up," Jo Ann said, motioning toward the long incision in
her recently sliced belly.

    As if on cue, Sue makes her way into the doorway, a pillow pressed
against her belly. Sue says she has to walk to work out the air that was
pumped into her body for the surgery, but she prefers not to.

    "I get worse when I stand up," she says.

    Jo Ann begins to get teary-eyed, looking at her sister who is in
obvious pain.

    Suzanne shakes her head.

    "Stop that. It hurts when you cry," she says.

    "I know you're grateful."

    Jo Ann tells her sister she asked the nurse to save Tuesday's
newspaper for her, the same way she saved the newspapers from the days her
two daughters were born.

    "Yesterday was the day I was reborn."

    Part 4