Tuesday, February 18, 2003

By ANGELA RUCKER
Courier-Post Staff

They meet by chance. Fall in love. Get married. Then one gives a kidney to the other just in time for Valentine' s Day.

"In my heart, I knew I was the one to give him my kidney," said Rita Weber, who met her husband, Cherry Hill lawyer Andy Weber, in Washington seven years ago at a birthday party for former D.C. Mayor Marion Barry.

Rita, who grew up in Stratford, and Andy, who grew up in Glassboro, made a love match. But, as far as kidneys go, they were completely incompatible.

That's is where Dr. Lloyd Ratner, a pioneer of incompatible transplants in the United States, stepped in - providing a medical assist to the adage that love conquers all.

Kidney transplants between donors with incompatible blood types or antibodies was considered impossible decades ago. But that is not the case today, said Ratner, who performed such a surgery on the Webers last Tuesday. Both are recovering.

"The chances are that we may be able to increase live kidney donations by about 35 percent, which would make a big impact on the number of organs available," said Ratner, director of transplantation at Thomas Jefferson University Hospital in Philadelphia. "There are a lot of people who are out there waiting for donors."

The procedure has been done successfully in Japan for more than a decade and is slowly picking up steam in the United States. Right now, though, there are just three places where people can find a trained physician: Jefferson, The Johns Hopkins Hospital and the Mayo Clinic.

Just ask Weber, who became a lay expert on the subject when he learned three years ago that the kidney disease he had inherited from his father had progressed to the point that he would need a transplant.

No relative was compatible and neither was his wife, Rita, a director of marketing and sales for a Trenton software company.

"I have a list of every single (donor) list in the country," Weber said before beginning the most intensive of the presurgical procedures necessary for this kind of transplant. "There really was no easy answer to this thing. The thing I learned is you have to be very proactive in this transplant business."

So that is what he did. So much so that he became a volunteer with the National Kidney Foundation.

When he learned that Ratner was performing incompatible transplants but working in Baltimore at the time, Weber tried to get an appointment. There was a months-long wait.

Then Ratner came to Jefferson. The Webers, who live in Mount Laurel, got an appointment in two weeks, and were deemed good candidates for the procedure.

"In extraordinary circumstances it really creates some options for people," said Dr. Lawrence Weisberg, a board member of the National Kidney Foundation of the Delaware Valley.

While kidney transplants are commonplace these days and have a high success rate (most patients are in the hospital less than a week), transplants between incompatible donors require additional steps to ward against the recipient rejecting the new organ.

Antibodies that would irreversibly reject the new organ are removed in a preoperation procedure called plasmapheresis, which is similar in concept to dialysis. Once those antibodies are gone, the patient gets a medication that includes antibodies needed for proper functioning. The recipient's spleen, the primary manufacturer of antibodies, must be removed as well.

And, like other transplant recipients, these patients must also take anti-rejection medications after the surgery.

Twenty million people have chronic kidney disease, said Weisberg, who heads the division of nephrology at Cooper Health System and is a professor of medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.

"The large majority of them don't even know it," he said. "People have no symptoms until they have advanced kidney failure, which is one of the biggest problems with kidney disease."

The disease isn't reversible. Doctors can treat the the underlying causes, but that only slows down inevitable kidney failure.

Somewhere around 50,000 people are waiting for a new kidney, and about 300,000 are on dialysis.

"It's a huge problem and the dialysis population is growing tremendously," Weisberg said. "It's growing because diabetes is epidemic and hypertension is epidemic."

Because there are too few donors, researchers are investigating other options, including bio-artificial kidneys and transplanting nonhuman organs. But those options aren't yet available, and may never be. Ratner suspects more transplant programs throughout the country will try incompatible transplants in the next three to five years.

That means more access to more kidneys, which has been one of Andy Weber's goals - in addition to getting a new kidney for himself.

Before the surgery, he said he was confident of success and even ventured that he would be getting an especially high-quality kidney from Rita, who is 19 years his junior and a former collegiate athlete. He's 55; she's 36.

Rita jokingly suggested the transplant would also transfer some of her good habits on to her husband.

"I knew that I was in his life for a reason," she said. " He already has my heart; now he's getting my kidney."

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Reach Angela Rucker at (856) 486-2459 or arucker@courierpostonline.com