A beautiful gift — donated kidney
By Alice Keesing
Advertiser Health Writer
Lorena Diego has always been a giver. But today the Maui resident went under the knife to fulfill a most rare offer: To donate a kidney to someone, anyone, who needs one.
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The recipient, Edsel "Eddie" Ralar, met Diego only a month ago but calls her his angel. Her healthy kidney will free him of the draining, five-hour bouts of dialysis that he endures three times a week.
Lorena Diego waits her turn to get her blood drawn as a sample is taken from Edsel Ralar by assistant lab supervisor Donna Anderson at St. Francis Medical Center. Diego is undergoing surgery today to donate a kidney to Ralar.
Those who work with kidney transplants, meanwhile, say Diego's gift is astounding. The number of living donors is slowly increasing, but still rare. But even more rare are "nondesignated" donors — those who offer their kidney to whoever may need it. Most donors are relatives or friends of the recipient.
"It is extremely unusual for someone to donate their kidney without knowing who they're giving it to," said Julie Schweitzer, chief operating officer for the National Kidney Foundation of Hawai'i. Only a handful of people in the country have done so, she said, and Diego is the first Hawai'i resident to take the step.
She and Ralar — coincidentally also from Maui — underwent surgery this morning at St. Francis Medical Center in Honolulu.
What Schweitzer describes as Diego's "immeasurable act of humanitarianism" began in July. That's when Diego received a clean bill of health at her annual physical.
"I thought, 'I'm so healthy, what can I do, what can I give?' " said Diego, 44, a Wailuku resident who works as an administrative assistant for a company involved in the cleanup of Kaho'olawe.
A magazine article about a living donor on the Mainland started her thinking.
She e-mailed the kidney foundation, telling them she wanted to donate. Even for those at the foundation, it was an unusual request. But after talking with Diego, Schweitzer realized she was sincere.
Diego's only condition was that her kidney go to someone in Hawai'i. She has seen family and friends go through dialysis and knows the staggering impact of the disease.
Of the 330 people in Hawai'i waiting for an organ transplant, more than 300 need a kidney.
Diego said that as she was growing up on the Kunia pineapple plantation, she learned the spirit of giving at an early age.
For more information on kidney disease and care, call the National Kidney Foundation of Hawai'i at 593-1515
"We led a simple life; big family; poor family; but we gave a lot," she said. In recent years she has volunteered her time and energy for Alzheimer's and cancer causes in Hawai'i. As mother to three children, she also said, "When I was a single mom on Maui, I tapped the resources, and now it's time to give back."
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In donating her kidney, Diego is thinking of the many times when she felt unable to help others.
"I watched my sister going through breast cancer; my mom is (also) a cancer survivor. I couldn't do anything. This time I can."
As with any potential donor, Diego was put through a battery of tests to ensure she would not be harmed by the surgery or the loss of a kidney.
"Donors go through a very rigorous and hard process just to become a candidate," said Catherine Bailey, the transplant coordinator at St. Francis. "She went through plenty of hoops to get here."
She has had blood and urine tests, an EKG, a CT scan and X-rays. A psychiatrist evaluated her to ensure she could deal with the emotional issues of the surgery.
The medical profession is mindful of the ethical issues of organ transplants, said Dr. Whitney Limm, the surgeon assigned to remove Diego's kidney this morning.
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He said some potential donors have been rejected because they were doing it for money, or out of guilt or pressure.
Edsel Ralar waits with wife Kathy, left, and his kidney donor, Lorena Diego in the radiology department of St. Francis Medical Center in Honolulu for an X-ray session for Maui's kidney donor and recipient.
The doctors also weigh the physical risks to the donor, said Limm, head of the Renal Transplant Program at St. Francis. While kidney donors have a more than 99 percent survival rate, there are small risks associated with the surgery, such as bleeding or infection.
Doctors accept only donors whose kidneys are working at the highest level to be sure they can manage for the rest of their lives with only one.
"They're not going to take somebody where they're going to save one but hurt the other," Schweitzer said. "That's why it's so hard to pass the test to become a donor."
Diego passed all the tests with flying colors. But at every step along the way, the experts told her she was free to change her mind.
She calmly told them no.
"When I get involved in something, I see it through," said the soft-spoken Diego with a smile.
In December, Diego's blood samples were sent to the United Network for Organ Sharing in Virginia to see if she was a match for someone on the list.
She was.
The match was perfect — a 1-in-10,000 chance. Even more remarkable, the match was someone whose home is just a 45-minute drive away from Diego: Eddie Ralar in Kahana.
Ralar, 44, a breakfast chef at the Ritz Carlton, has been undergoing dialysis for eight months. His kidneys failed after a surgery to remove cancer in 1987. He and his family couldn't believe their luck.
"It's a wonderful second chance," said Ralar's wife, Kathy. "We had the cancer first to get through and now this — someone is definitely watching over us."
A month ago, Diego arranged to meet Ralar and his family at one of their hula shows at the Napili Kai Beach Club. They connected, and as the pair went through a last battery of tests yesterday, there was a quiet bond between them.
"She's beautiful outside as well as inside," he said.
Today, Diego was wheeled in for a five-hour surgery to remove her left kidney. Within minutes of its leaving her body, it was to be placed in Ralar's.
Diego should be able to go home to Maui in a few days. With one kidney, she can expect to live her life as she would with two, Limm said.
Ralar will stay at least seven days in the hospital and three weeks on O'ahu as doctors watch for signs that his body is rejecting the transplant.
There's about a 25 percent chance of that happening, but Ralar yesterday was looking forward to beginning his life again.
"It's going to be getting back to be free again," he said. "I can go back and do things that I want to do like fishing and spending more time with my family."
And there's no question that "family" now includes Lorena Diego.
Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014.
