Former patient reflects on
transplant operation, 35 years with mom's kidney
BY KRISTIN WEIDENBACH
Inga Goodnight's kidney was working
just fine when she checked into Stanford Medical Center
to have it removed. Carrying it carefully into the next
room, a team of surgeons stitched it into her 27-year-old
son and hoped that it would save his life. Thirty-five
years later, Gary Goodnight and his 84-year-old mother
rarely think of the kidneys that they share, but Gary's
Christmas visit from his home in London gave mother and
son occasion to reflect on their place in medical
history.
Gary's 1965 operation was the third
human kidney transplant done at Stanford, which was the
first hospital on the West Coast where surgeons performed
the procedure. Last year, 127 people received a new
kidney at the Medical Center.
The late Roy Cohn, MD, who was a
Stanford professor of surgery, and his team had first
transplanted a kidney between identical twins in 1960 and
followed up with a mother-to-daughter transplant in 1964.
The world's first successful human kidney transplant
between identical twins was performed at the Peter Bent
Brigham Hospital in Boston in 1954.
The development of immunosuppressive
drugs first allowed transplants to be successfully
attempted between family members who were not identical
twins. Later, advances in immunosuppressive therapy
allowed transplants even between unrelated people, and
immunuosuppressive drugs like cyclosporin are still the
mainstay of transplant recipients today. Gary Goodnight
has been taking an immunuosuppressive drug called Imuran
since he received his new kidney.
In 1965, kidney transplantation was
considered a risky and experimental procedure. It was
approved only for "terminal" patients who were
believed to have no other means for survival. "It
was a last resort operation," said Gary. "[The
doctors] didn't tell me, but they did tell my family that
it might buy me an extra year," he said.
Gary's kidneys had been damaged by
glomerulonephritis. His kidneys stopped filtering waste
from his blood and failed to excrete fluid from his body
in the form of urine. At eight years old, Gary was
admitted to an Indianapolis hospital where he stayed for
a year. "Essentially they put me in there to die. I
was like a big water balloon all flat on one side from
lying in bed," he recalled.
A move to Arizona's hot, dry climate
resulted in a dramatic improvement in Gary's health. His
kidneys functioned normally for the next 15 years but
then began to fail, adhering to his doctors' predictions.
It was 1964.
"I started to deteriorate. I was
turning green because I was so toxic. [The doctor] said,
go check yourself into Stanford, we've got to do a
transplant," Gary said.
Unbeknown to him, members of his family
had already been tested to see if any would be a
compatible kidney donor. His mother, Inga, was found to
be a good match and preparations for the transplant
proceeded. Gary's kidneys were removed and he underwent
dialysis for two weeks to cleanse him of the toxins that
had accumulated in his body.
The day of the transplant, both Gary
and his mother were prepared for surgery. General
anesthetic was still considered quite dangerous at the
time, and Gary's doctors did not want to risk it so he
was given a spinal block and remained awake throughout
the operation. When the kidney was removed from his
mother in the adjoining operating room, Gary asked to see
it before it was inserted. "Cohn said, 'For God's
sake knock him out. He's driving me crazy!' " Gary
said with a laugh. "I was asking too many
questions."
The operation was a success and Gary's
doctors were thrilled that his new kidney began producing
urine right away. He experienced no episodes of
rejection, and his mother's kidney has served him well
for the past 35 years. Likewise, Inga has had no
deleterious effects from the transplant operation.
"I just had a physical and they said the kidney was
fine," she said.
Compared to the seven days that today's
kidney transplant recipients typically spend in the
hospital, Gary's two- month-long inpatient recovery time
was lengthy, but he believes that he was probably kept in
the hospital so long because it was a learning experience
for the doctors and nurses.
"I was up and around and fine, but
it was a big deal for them and I became kind of the pet
of the hospital," he recalled. "I didn't like
hospital gowns, didn't want to wear pajamas and they
wouldn't give me street clothes, so the interns would
sneak in surgical gowns and I'd put a stethoscope around
my neck and go on clinical rounds with them," Gary
said with a laugh. "I'm sure every one of them would
deny it to this day," he quickly added.
Gary also remembers that a kidney was
transplanted between two dogs at the same time that his
operation was conducted to serve as a control. "At
the time, there was a lot of guesswork involved," he
explained. "Based on the body weight, they were
medicating the dog as a control on me. So I'd go down and
visit 'my dog,'" Gary said. These visits continued
until one day he went to the animal house and was told
that his dog had died.
Fortunately for the Goodnights, Gary
escaped such a morbid fate. "Before the transplant I
was so sick that I was at the point I didn't care. I was
thinking, 'just let me sleep or die,'" he recalled.
"After the operation, I felt fine for the first time
in years." SR
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