Transplant patients share physical, mental bonds

Stacy J. Willis

Sunday, April 23, 2000 | 9:21 a.m.

Madeline Lucero was being wheeled into an operating room when her surgeon held up a wet kidney and said, "Isn't it beautiful?"

The organ, a bit larger than a fist, had been cut out of her daughter and was about to be sewn into her own side.

"All I could think was 'Please put me under,' " Lucero said.

The kidney transplant didn't work. Within weeks, Dr. Scott Slavis was blinking away tears as he told her, "You've lost the kidney. I'm sorry. I did all I could."

Lucero and her family decided to try again. This time her son, David, then 29, went under the knife. To add levity to a grim situation the Luceros named the soon-to-be-donated kidney "Paco." Slavis sewed the kidney into a natural abdominal cavity in Madeline's right side and it began filtering waste from her blood almost immediately.

Four years later when David Lucero cusses in front of a guest in his mother's home, she squirms in her chair and chokes off a lifelong desire to scold him. He whips up his shirt to show what is indeed a "hell of a scar" -- stretching more than 12 inches from his back to his belly.

She shakes her head in embarrassment. But then a little smile sneaks out. And in seconds she looks up and says, "Every day I wonder how I got so lucky to have these kids, to have this kidney."

The world of transplantation is a strange mix of the macabre and heartwarming. It's the stuff of science fiction and urban legends -- ever heard the story about the guy who goes to a party and wakes up in a bathtub full of ice, his torso full of stitches and his kidney stolen? Ever heard about breeding pigs to harvest their organs for humans?

The science (the pigs) and the fiction (the stolen kidney) can each be a bit disturbing. But for more than 250 Las Vegas families in the last decade, transplantation has become the plot of their real lives, causing them to get savvy not only to science, but in many cases, to their will to live.

On Thursday Sunrise Hospital and Medical Center will host a reunion of kidney transplant recipients and donors. The fellowship among former transplant participants is steadfast -- just ask David Lucero, a porter at a local hotel-casino who whipped up that shirt just the other day at work when he heard a bartender talking about donating a kidney to her father.

"We compared scars," he says. "You become friendlier with people who have been through it." 'God and surgeons'

It's hard not to view Dr. Scott Slavis in dramatic light -- he is a man who tinkers with nature's distribution of major organs -- a man whose fingers dip inside bodies and fish out perfectly healthy kidneys and zip them into other people's abdomens, changing the duration and quality of lives.

His patients heap savior-like praise on him, calling him the "best surgeon ever," "a true hero" and "a wonderful man."

And devout Catholic Madeline Lucero freely offers this bit of advice to those who suffer from kidney ailments these days: "Put your faith in God and surgeons. God and surgeons."

Slavis is the only doctor at Sunrise who performs kidney transplants; he created the program a decade ago. His kidney transplant success rate is over 85 percent, he says.

Slavis is in the process of recruiting two new surgeons -- one to help him with kidneys, another to begin a pancreas transplant program. Today kidney transplants are the only type of organ transplant available in Clark County. In addition to Sunrise's program, kidney transplants have been performed at University Medical Center.

Sitting in his urology office on the fourth floor of an office building across from Sunrise hospital, Slavis, 45, is reserved and curious. He shifts the conversation away from himself at every opportunity. When he talks about the issue of transplantation, he chooses his words carefully. He says the most critical improvement in the science in the last decade is the enhancement of anti-rejection medication; but he thinks the future of transplantation includes breeding animals for their organs -- "but I don't want to get into that debate."

Biotech companies around the world are honing animal-to-human organ transplants -- a procedure called xenotransplantation. The industry expects to be ready to implant pig kidneys in humans within five years.

To Slavis, there is nothing controversial about the procedure: It's about saving human lives, making lives better. More than 160 people in the Las Vegas area, and more than 44,000 people in the nation, are currently awaiting transplants -- their lives burdened by long bouts with dialysis, special diets and increasing pain and fatigue.

Slavis performed more than 50 human-to-human kidney transplants last year -- averaging about one per week. Each one lasts nearly three hours in the operating room.

"It's just a great operation. It's very cool. The patients are extremely happy. You really change their lives significantly. These people are very sick and they need help," he says.

Slavis was raised in New York, educated at Emory University and the University of Miami, and moved to Las Vegas after working in Los Angeles.

"As far back as I remember, I wanted to be a doctor. I wanted to help people. It's hard work, but it's gratifying," he said.

The average cost of surgery is $75,000, usually covered by insurance plans. But the success of transplantation rests largely on the ability of the anti-rejection medicine to "fool your body into thinking the kidney belongs there," as Madeline Lucero put it.

Lucero keeps a day-of-the-week pill organizer piled high with her immunosuppressant medicine for each day.

Most patients will take the drugs for the rest of their lives, costing them between $10,000 and $18,000 per year, according to Claudia Swift, who coordinates the renal transplant program at Sunrise. Most commonly, insurance plans cover only a portion of that -- sometimes as much as 80 percent.

"Once my dad's company went on strike, and he had to take another job at a different place to keep paying for my mom's pills," David Lucero said.

New appreciation

Humans are born with two kidneys, located in the back just below the rib cage. Every day, the kidneys filter about 200 quarts of fluid; about two of which are discharged as urine. Kidneys also release hormones that regulate blood pressure, control the production of red blood cells, and produce vitamins that control growth.

But many transplant recipients report that in addition to the physical relief of having a functioning kidney, transplantation resulted in a renewed appreciation for their lives -- a spiritual overhaul of sorts.

Joel Parker, 38, underwent a company insurance physical in 1993 that revealed his kidneys were failing.

Parker was a construction worker and a racquetball player who had shown no symptoms except occasional fatigue, which he attributed to being in his 30s.

"I was totally surprised. I thought it might be a mistake. I felt fine," he said. Doctors were not able to definitively diagnose the cause of his kidney failure -- the need for a transplant can be caused by a range of problems, most commonly from diabetes or hypertension -- diseases Parker did not have.

"So I lived with the condition for a while. And I denied it. In fact, I think I lived in denial about actually needing a transplant all the way up until they wheeled me into the hospital," Parker, the owner of Extreme Concrete, said.

Parker looked into other ways to curtail his worsening symptoms -- acupuncture, meditation, Deepak Chopra tapes.

Meanwhile, his family members got tested to see if their blood cells would match his and make them eligible to donate.

His mother was a half-match and she wanted to donate.

"I didn't want her to do it," Parker said. "I had a really hard time thinking of endangering her life. I felt it was my problem. Finally, one day she told me not to take this away from her, not to take away her ability to help."

His mother, Sue Borgstrom, is his office manager. At the time, she was 59 -- doctors generally don't consider anyone over 60 a good donor candidate.

"I can't even talk about it without getting choked up," said Borgstrom. "We tried natural remedies, we tried everything else. But he's my son, and I really wanted to do this. What else can I say. To me, it was an honor to do it.

"But I'd be lying if I said I wasn't scared. I had had a different kind of surgery once before, and I hated it. I hated the pain. But how could I not do this?" she said.

In January 1998 Slavis performed the successful transplant. Borgstrom was out of the hospital in three days; Parker in four. Within six months, Parker was playing racquetball in the Transplant Games -- a nationwide competition for transplant recipients of all types.

Parker says the relationship between he and his mother has improved greatly -- both in their personal lives and at work.

"I don't care if she burned the office down, I don't think I could yell at her," Parker said.

"I had a relatively easy go of it, compared to some people. But I'll tell you something. It's changed my life. More than just my physical health. It's changed my attitude," he said.

"It's opened up my awareness of my precious time here. It's caused an attitude change -- you want to keep a smile on your face. You realize how blessed you are to have a roof and food and transportation and family. You realize how good God has been to you."

Recently Parker was headed into an athletic club to play racquetball when he saw an old, familiar face.

"It was Dr. Slavis. I didn't really know him that well, you know, it was all professional. But I stopped him and I showed him my wallet pictures of my new 10-month old son -- my first child. He was very nice, and very happy to see that I had started my family. And even though he was just going in there to work out just like me, I couldn't stop calling him 'Sir,' " Parker said. Union of bodies

In the end, transplantation is about one body needing something from another body in order to continue living.

Ryan Smith met his future wife, Shayndel, at a church gathering. The couple fell for each other quickly. They wed within four months. Shortly thereafter, Ryan found out he would need a kidney transplant. Shayndel gave him her kidney last month -- just before their first wedding anniversary.

The two haven't even had time to enjoy the microcosm of the first year of marriage -- there has been little focus on setting up house, exploring their new family roles. Instead, there have been time-consuming preparations for major surgery.

The couple waited five hours in pre-op, cleaned and prepped for surgery. There was a lot of time in which either of them could have backed out, they said.

"But we just played tough for each other," Ryan said. "We just joked around. But we were nervous."

Shayndel was taken in first. Midway through her surgery, Slavis called Ryan on a telephone from inside the operating room.

"He told me she was going to be fine," he said. "That was such a relief.

Both surgeries went smoothly. When the newlyweds awoke, Slavis stood by their beds.

"He told me that when he folded her kidney and put it in me, it just blossomed like a flower," Ryan said.

"I am so reminded about how precious our time together is, how precious our lives are, and for some reason, we were blessed," Shayndel said. "We have to make the most of it."

Stacy J. Willis is reporter for the Sun. She can be reached at (702) 259-4011 or by e-mail at willis@lasvegassun.com.

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