David Goldman remembers the day he received the call telling him his kidneys were failing. “I had gone to get my blood test for my marriage license,” he recalls. “My doctor called and said, ‘I have some bad news for you.’” Goldman was diagnosed with kidney disease. “I was 26 when I got that call. I thought I was indestructible, and here I was in end-stage renal failure facing dialysis.” Years later, Goldman took part in a 28-person paired-donation kidney exchange — the second longest in U.S. history.
Goldman first learned about kidney transplantation when he was doing research on kidney disease in an effort to better understand his condition. “I made a lot of calls to different associations, and somebody suggested that I speak to someone about kidney transplants,” says Goldman. His sister was his first kidney donor in 1986, and the transplant was successful for 25 years.
However, those 25 years weren’t without complications. “I had to take anti-rejection medications to stop my body from attacking and rejecting the kidney,” says Goldman. “Those medications made my blood sugars really unstable.” The result was irreversible damage to his pancreas — the organ responsible for producing sugar-stabilizing insulin. In 1997, 11 years after receiving a kidney from his sister, Goldman underwent a pancreas transplant at the University of Minnesota. “I had been a diabetic since I was 18 months old,” he says. “Suddenly, at age 41, I wasn’t a diabetic anymore because I had this fully functioning pancreas. It was life changing!”
In 2011, Goldman’s transplanted kidney failed, requiring him to go on dialysis to clinically purify his blood. “I was always an avid cyclist, but being tied to dialysis, you’re literally tied to the machine,” says Goldman. “Three days a week, you’re devoting three hours each time.”
Goldman tabled his active lifestyle in favor of crucial dialysis treatments for years while he searched for a donor. “You can’t ask someone, ‘Hey, will you donate your kidney to me?’” says Goldman. “All you can do is tell your story and hope that someone says that they’ll donate.” Friends and family came forward, but, because Goldman’s immune system was so sensitive, finding a match was proving difficult. “We tested almost 20 people who wanted to donate their kidney to me and none of them were a match,” he says.
Feeling like he had exhausted all opportunities, Goldman then heard about paired exchange donation programs, where two or more incompatible donor/recipient pairs team up. These programs examine compatibility on a larger scale. For example, if Donor A and Recipient A (incompatible) team up with Donor B and Recipient B (incompatible), Donor A will exchange with Recipient B (if compatible) and vice versa. Any number of pairs is possible.
Goldman and his donor pair connected with the University of Wisconsin Madison, where more than 65 hospitals were working together to match up paired-exchange donors and recipients. “Within a week, I was matched with 80 different donors,” says Goldman. “It was unbelievable.” Three days later, Goldman’s surgery was scheduled.
A Delicate Exchange
Goldman’s paired exchange was the result of a 28-person paired exchange that started weeks earlier by a donor in Memphis, Tennessee. “This man’s hospital was part of the exchange and his donation set off this chain,” says Goldman. All 28 surgeries took place over the course of just 5 weeks, and affected people all over the country. “It’s amazing because chains are reliant on people following through with the commitment,” says Goldman. “If someone drops out for any reason, the whole thing can fall apart.”
The most important message is that transplantation works, says Goldman. “I’ve been a transplant recipient since 1986,” he says. “I had a son and I have a great life. It wouldn’t have happened without organ donation and transplantation.”