Wife's kidney donation a true gift of love for Frederick man

By Katie E. Leslie, News-Post Staff

January 26, 2006

Photo by Travis Pratt The Laffer family are, from left, Sarge the dog, Tess Laffer, Brad Newman, Melanie Laffer, Gene Laffer, Andrew Laffer and Hope the dog. By giving her husband a kidney, Melanie Laffer saved his life and taught her children the meaning of love

FREDERICK -- Gene and Melanie Laffer had known for years that Mr. Laffer would one day need a kidney transplant. Believing the surgery was decades away, the Laffers said they assumed the kidney would come from a deceased donor.

Then in February 2005, doctors informed him that due to his advanced renal failure, he would need a transplant as soon as possible.

"It was the end of the road for me," said Mr. Laffer, a 56-year-old accountant who moved with his family to Frederick five years ago from Long Island, N.Y.

Though the average wait time for a kidney in the U.S. is three to five years, Ms. Laffer took matters in her own hands, and joined the growing number of people who have become living organ donors.

"When it's a reality and you have a loved one that needs an organ, that changes your perspective," Ms. Laffer said.

Before she could donate a kidney to her husband of 19 years, Ms. Laffer underwent a long series of physical and psychological examinations to determine her compatibility.

"I never expected to go the distance ... It was one (test) after another and another and another and I kept passing," Ms. Laffer, 48, said. "I never got knocked out of the running."

On Dec. 30, 2005, she and her husband underwent the lifesaving surgery at Georgetown University Hospital in Washington. Though she was well enough to leave on Dec. 31, she opted to stay an extra day to spend New Year's Eve with her husband.

Mr. Laffer's recovery was not as smooth.

Discharged one week later, he was rehospitalized with complications, finally returning home Jan. 12.

Ms. Laffer said she never anticipated giving one of her own organs, until the need arose.

"It wasn't a question," said Ms. Laffer, a teacher at New Market Middle School. "If I end up as a match and I don't do it, I'll feel like I'm messing up some master plan, and who is going to mess with that?"

Support system

Intrafamily kidney donations are not uncommon ----they totaled 34 percent of all Maryland kidney transplants performed between Jan. 1, 1988, and Oct. 31, 2005, according to the Organ Procurement and Transplantation Network.

OPTN is a federally funded, nonprofit organization created by Congress that facilitates organ matching and placement.

Of the 1,815 intrafamily kidney transplants in Maryland, 268 came from spouses such as Ms. Laffer.

Any organ transplant surgery carries with it physical and emotional implications, but for intrafamily live donors, those implications are heightened due to emotional ties.

"If you're the donor, you feel responsible," Ms. Laffer said.

As in transplants where the organ is donated by a stranger, intrafamily donors and recipients undergo separate pre-surgery preparation.

The Laffers each had their own team of specialists guiding them through the pre-surgery process.

"Even though we'd go to the same place, they'd treat us each as individual patients," she said.

With such individualized treatment medical staff can ascertain whether the donor feels in any way coerced into the surgery or has financial incentives, according to Nina Schroder, a social worker for the University of Maryland living kidney donor program. Receiving money for an organ is illegal in the U.S.

"(My counselor) must have asked me 10 different times in 10 different ways if I was doing this because I wanted to," said Ms. Laffer.

She and her husband also have experienced vastly different post-surgery treatments, she said. While Mr. Laffer must undergo regular medical checks to evaluate his health and transplant success, Ms. Laffer had one post-surgery follow-up and isn't scheduled to see her doctors until six months have passed.

"I do all the work ----he gets the support," she joked.

Few U.S. hospitals require a post-surgery psychological examination of donors, largely because there is no way to be reimbursed for that cost, said Brigitte Reeb, administrative director for the Johns Hopkins Comprehensive Transplant Center.

"You can't bill for those appointments," explained Ms. Reeb. "That's a national problem right now. There's a push to do that more effectively."

Though the Johns Hopkins Comprehensive Transplant Center does not have a requirement that donors have a post-surgery visit with a psychologist, it is conducting a study funded by a National Institutes of Health grant to assess pre- and post-surgery attitudes toward donation, and overall quality of life, Ms. Reeb said.

The Johns Hopkins transplant program includes such services as a mentor program for donors and recipients in which they are paired with peers who have been through a transplant. The center also offers educational support groups for families and friends, Ms. Reeb said.

She pointed out that organ transplants from living donors have such an extremely high success rate -- roughly 97 percent, according to the National Kidney Foundation -- that many donors might not have a great need to see a counselor after surgery. Transplant center professionals are also confident in the donor's ability to handle post-surgery outcomes, because potential donors are rigorously evaluated for physical and mental health before surgery.

"We would never do a transplant if a person seems emotionally unstable," Ms. Reeb said.

But having an emotional support system in place is important, whether it comes in the form of family, therapist or support group, advised Ms. Laffer.

A combined family, the Laffers have two children together, Mr. Laffer has two from a previous marriage, and Ms. Laffer one child from a previous marriage. She relied on her family and friends to help her through the roughest period of the transplant process: Within days of his first release from the hospital, Mr. Laffer began showing early signs of organ rejection and was rehospitalized.

"Emotionally, I'm feeling a little bit, like, I don't want to say responsible, but yes, I'm really invested in this," said Ms. Laffer on Jan. 9, when Mr. Laffer was back in the hospital. "I did this for him. I want this to work much more than a stranger."

Ms. Schroder said she advises donors to be prepared for the possibility the surgery won't work.

"It's really important to at least consider the possibility that it can happen, but not focus on that," she said. "They've made a beautiful choice, a beautiful decision, and it is no longer in their hands."

The University of Maryland Transplant Center aims to eventually conduct a more thorough analysis of post-surgery attitudes toward donations, she said.

"Our hope is to do more thorough long-term follow-up with regards to a donor's medical and psychological status," she said.

No regrets

The Laffers and their children said they have no regrets about their decision, and have seen positive changes since the surgery that go beyond the improvements in Mr. Laffer, whom they have nicknamed "Trifecta," for his three kidneys.

"There's definitely a lot more serenity in the house, it seems. For a long time we saw Dad slowly fading," said Brad Newman, 20, who is Ms. Laffer's son from a previous marriage. "Things are better now. There's more to hope for."

Andrew Laffer, 15, agrees.

"Through this operation, it just fixed everything, not just organ-wise, but relationship-wise. You really love each other," he said to his parents.

But the surgery did pose a major problem for this fun-loving family, 9-year-old daughter, Tess, pointed out.

Until Mr. and Ms. Laffer's bodies, particularly their sides, are fully healed, "We can't make them laugh, which is really hard!"

Copyright © 1997-2006 Randall Family, LLC.

This article posted February 19, 2006.