Patient Story: Lisa Munro
Kidney patient’s life transformed thanks to an only-at-St.-Michael’s transplant procedure
By the time she was diagnosed with the interstitial tubular kidney disease that had already taken its toll on several of her family members, Lisa Munro was struggling just to get out of bed in the morning. After working 60 hours a week, the litigation lawyer didn’t have much energy left to do anything else.
“I thought I was doing fairly well, and my lack of energy just a part of my life to which I had adapted. I now realize that I’d probably been ill for years, but because the disease progressed so gradually, I didn’t appreciate just how ill I was,” she says. “It shows how your body and mind adjust to illness.”
Her family doctor had referred her to Dr. Jeffrey Perl, a nephrologist at St. Michael’s, whom she lauds as having managed her care expertly. About this time, she realized her kidney function had declined significantly because she developed anemia. In addition to the chronic fatigue, she was cold all the time. “I have a telling photo of my husband and me at the cottage in summer: he’s in shorts and a t-shirt and I’m in a down vest, booties and long pants.”
In May 2019, a bout of food poisoning escalated the severity of her condition. Her creatinine levels spiked, indicating severe kidney impairment. She felt nauseous all the time. Dr. Perl told her it was time for dialysis. He also suggested she ask around for a donor. While she waited for a transplant, she went on home peritoneal dialysis, which allowed her more autonomy than dialysis administered in the clinic.
After her first dialysis treatment, Lisa felt fantastic. But she desperately needed a new kidney. Because of her blood type, O, she thought she could only receive an organ from someone with the same blood type. She faced the prospect of years on daily dialysis that she feared would mean giving up the job she loved, while waiting for a kidney from a donor, deceased or living. And because her family members were at high risk or already battling the disease, they couldn’t be donors.
She was not comfortable about asking for a kidney; however, she confided in a long-time work colleague and friend about her fears for the future. Without being asked, he offered to give her one of his kidneys. Unfortunately, his blood type wasn’t compatible. But, at St. Michael’s, blood type incompatibility is no barrier.
In fact, St. Michael’s is the only centre in North America to do a procedure that makes organ donation from one person to another of a different blood type possible, as long as their immune systems are compatible. It’s called ‘immunoadsorption therapy for blood type incompatible transplant in living directed organ donation.’ Once donor and recipient are deemed otherwise compatible and prior to the transplant, the patient goes through a desensitization process, similar to plasmapheresis, to lower the patient’s level of antibodies to the donor’s blood and reduce the risk of rejection of the donor kidney. The immunoadsorption treatment at St. Michael’s is unique because the device used, Glycosorb ABO column, removes only very specific antibodies during treatment, which is safer and has fewer side effects. In Lisa’s case, the treatment was so successful she didn’t require a repeat treatment after the transplant, which took place in November 2019.
“There are people who are genuinely selfless in this world, and who want to do something meaningful for another person. To give an organ to someone you’re not related to – what kind of person does that? It is unfathomable and I get emotional talking about it. Although,” she jokes, “my friend did apologize in advance if I were to suddenly develop cravings for Doritos and KFC.”
The transplant changed her life, she says. “I have energy; I started an exercise routine for the first time in ages. I love food again – do you know how good a carrot tastes? My husband made my first meal after I left the hospital, lentil stew. After having food restrictions, it was the best meal I’d ever eaten.”
Lisa is grateful for the treatment she received at St. Michael’s. “At every stage, I had empathetic, committed, driven professionals – like Dr. Perl and Dr. Jeffrey Zaltzman, the head of Nephrology – who cared about my care and were relentless in finding ways to improve my quality of life. I’m a litigator. I ask a lot of questions. And every single member of the dialysis, living donor, apheresis and post-transplant nursing and physician teams answered them,” she says.
“I never thought about people having a calling until I came to St. Michael’s.”
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