Two-time kidney transplant recipient, Mark Fairey with wife Erika, opens up about what it means to receive two lifesaving organ transplants.
In late November 2018, my wife Erika and I made our way up to the sixth floor post-transplant clinic at St. Paul’s Hospital. After locating a pair of seats together, I noticed the assemblage of patients giving me knowing looks, having recognized the calculated, slow gait of a new transplant recipient. If they assumed that at age 32, this was a new experience for me, they would be wrong. I was just coming off my second kidney transplant.
Even prior to my original transplant in 2006, it had been explained to me that as a young, otherwise healthy patient afflicted with Alport syndrome and type 1 diabetes, I would likely need multiple transplants in my lifetime. Although graft longevity has continued to increase with greater scientific understanding and improved immunosuppressive therapies, chronic rejection continues to be an unavoidable long-term consequence of organ transplantation and the driving reason behind re-transplant.
When the medical team at St. Paul’s recognized a slow, persistent decline in my kidney function, and all treatment options to extend the life cycle of my kidney had been exhausted, we began the process of looking into re-transplant. Not only was this my second time, but my youngest brother has also already received a kidney transplant. As such, we thought we knew what lay ahead. We set out to spread the word about my search for a living donor, gradually expanding the circulation of emails and eventually creating a website.
An additional consideration for re-transplant is that patients often develop antibodies related to their first transplant, which can make it more difficult to find immunologically compatible donors and significantly limits the chance of receiving a transplant. Finding a suitable match is critical as a high antibody count leads to issues with rejection and graft failure. Fortunately, I had not developed a high antibody load.
Unfortunately, during the search for a living donor, my transplanted kidney failed to the point where renal dialysis became necessary. This was a new experience for me – prior to my first transplant I had continued to exercise and play hockey, but this time I was incredibly fatigued, nauseous, and not doing well. I spent five months visiting the St. Paul’s dialysis unit, where I underwent hemodialysis three days a week. Dialysis is far from a cure to kidney failure, but it is a way to keep your body running, although there are numerous complications associated with relying on it long term. Sadly, this is a reality for many patients with kidney failure, some of whom wait for years in the hopes of a deceased donor transplant. I have a great deal of admiration and empathy for dialysis patients, looking back at my five months attending St. Paul’s 6B ward. Transplantation, let alone re-transplantation, is simply not an option for everyone.
Now, more than two years since my re-transplant, I’m glad to report that I’m feeling well, and my monthly numbers are stable. I consider myself incredibly lucky on many fronts – being relatively young and healthy, having a low antibody load, and having followed medical advice through the first transplant, I was given the opportunity to explore re-transplant. I have also been especially blessed to have found two living donors, whose generosity can never be repaid.
For many of us lucky enough to undergo transplant, re-transplant is a future possibility that needs to be considered. It’s never an easy thing to plan for, and as I learned, each situation can be very different and have unexpected obstacles. I continue to advocate for and support transplant research as I know it is through scientific advances that we will find better ways to preserve transplants so that they last a recipient’s entire lifetime. One transplant for life is the ultimate goal.