By Kristin Ellis and Russell ZillApril 27, 2009
WASHINGTON (Army News Service, April 27, 2009) -- Eleven days before Sgt. 1st Class Tanya Colomathi was to receive a kidney transplant, the doctors at a civilian hospital in Georgia told her the donor was not the best match and canceled the operation.
"I took that really hard," she recalled. "[It was] a pretty hard fall."
Eleven months later, Colomathi came to Walter Reed from Fort Gordon, Ga., for a kidney transplant from a better match, friend and fellow Soldier, Spc. Rebecca Brown. The day before the April 16 surgery, Colomathi described herself as, "elated, relieved." The two Soldiers met about 15 months ago at Fort Gordon, where Colomathi works as an investigator for the Criminal Investigation Division and Brown is a military police Soldier.
"We got close and she told me her story, what she went through with other [donors]," Brown said. "I felt that if I can help someone, then I should...if she needed one, more than I did, then I was going to do what I could to help her."
"It's not something she has to do, she voluntarily is doing it." Colomathi said. "She stepped up and did this when I didn't have family members that would do it. It puts her in a class all by herself. I couldn't ask for a better person to do it, I really couldn't."
About two years ago Colomathi was diagnosed with lupus nephritis after a routine physical fitness test left her with high blood pressure and dizziness, followed by weeks of fatigue and swelling in the face. Her kidneys were failing, and she began dialysis three times a week.
"I have never dealt with illness before, at least not at this level. I was really worried," Colomathi said. "I'm the health nut. I'm the one who gets sick."
End-stage kidney disease is when the kidney is no longer able to do the job that it needs to do to support the person, said Maj. Stephen Olson, medical director of the dialysis unit. The kidney regulates electrolytes and fluids and clears toxins from the body, he said.
"It's not painful at all," Olsen said. "There are no warning signs until the vast majority of the kidney function is gone."
Eight or nine people came forward to be tested as potential donors for the 32-year-old, but none were the best candidate until Brown came forward.
"This is a little bit unique because we do a little less of those that are military-to-military living donor," Olson said. "A person with one kidney can go on to have relatively normal kidney function. We will follow them over the course of their lifetime, but we expect them to have a full and healthy life. They can have a full career in the military."
Walter Reed is the only transplant specialty center within the Department of Defense. About one-third are Army, the other two-thirds come from the Navy, Air Force, Coast Guard and Marine Corps. It's also one of the oldest programs, with the first transplant in 1969, according to Lt. Col. Edward Falta, chief of Organ Transplant Service.
"Our patients that we're transplanting are different from our civilian community. Your patient is going to be the same person you see when you deploy. They're going to be delivering your mail, they're going to be guarding the front gate, they're going to be making sure your paycheck arrives on time, they're going to be cooking meals," Falta said. "It's your own community you're helping with. You're not going to say goodbye when they get discharged, you're going to see them all again."
During the surgery, the donor is brought to the operating room ahead of the recipient to prepare the kidney. The surgical team doesn't do anything irreversible to the donor until the recipient is brought down and prepared. Brown's procedure was laproscopic, so the kidney was brought out through an incision on the bikini line.
The two operating rooms sit adjacent from each other. Once the kidney is moved from one to the other, the team can re-implant the blood vessel supply right away. The recipient will stay in the hospital for four or five days, and the donor stays for about three.
"They take their time and make sure everything is accurate," Brown said of the Walter Reed doctors and nurses. "They want to make sure you have the best care and the best doctors. They're very thorough."
Colomathi agreed, "They keep us informed. They don't keep us in the dark about anything. No surprises."
Olson explained that Colomathi will be on anti-rejection medications for the rest of her life. Education and communication is key between the doctor and patient.
"Part of the challenge is, after a kidney transplant, to keep their kidneys healthy," he said. "They are on drugs that suppress their immune system so it does not identify and attack the kidney. We keep track of them to ensure that precious resource, the kidney, is utilized for as long a period as possible. Especially in the circumstance of a living donor where someone has made a lifetime sacrifice."
"I couldn't go to sleep last night," Colomathi said the day before the surgery. "It's real. Before it was just a date, now we're here."
(Kristin Ellis and Russell Zill writes for the Stripe and WRAMC-TV)