Lisa Yario thought she'd just pulled a muscle in her lower back while trying to move around some furniture in a Florida condo. She didn't know at the time the pain would be her body's first message to her that the countdown to a potentially fatal outcome had begun.
Yario, from Lombard, had a severe kidney infection. It was the kind of infection she'd feared for the past 10 years.
Vicki Wieland also knew that day was coming. She'd spent the last decade going to hospital visits with Lisa for regular tests of her sister's kidney function. The St. Charles resident also watched her youngest sister trudge down a slow path where her body betrayed her more and more. Breast cancer treatment in Yario's youth pummeled her kidneys, making it almost certain they would fail her one day.
Yario and Wieland had always had that type of bond where they knew they'd give up their lives for each other if necessary. And when Wieland learned her little sister was laid up in a Florida hospital for five days just to get stable enough to come home, the time had come.
Wieland wouldn't have to give up her life for Yario. But by donating a kidney, she did have the ability to keep her living.
The kidneys are a major part of the body's filtration system. The more poorly Yario's kidneys functioned, the worse she would feel. Some days Yario would feel so drained of life she couldn't get out of bed.
"It's constant fatigue," Yario said. "It just feels like somebody pulled your batteries out. It's a long slide downhill. And it's been this way for so long that people say I don't even realize how much it's changed me."
Yario's chemotherapy and radiation treatment for bilateral breast cancer came at age 24. That was 10 years ago.
For patients with kidneys functioning even more poorly than Yario's, it's a life of having a machine filter your blood in a process called dialysis three times a week for four hours or more at a time. Yario never reached that point.
But she still had some bad days, and even on her worst she knew she could count on Vicki.
'Almost a twin'
Wieland's bond penetrates so deeply with Yario it goes to a rare chemical level. In the world of kidney transplants, antibodies and matching blood and tissue types are key to finding a donor with a compatible kidney. The more compatible a donor is, the better the chance of a kidney withstanding the recipient's natural rejection of a foreign invader. Most siblings will match up well in half of the six general categories on the compatibility checklist. Yario and Wieland matched in every category.
"She's almost like a twin," said Anita Pakiasi, renal transplant coordinator at Loyola University Medical Center, where the surgeries took place on March 11. "This is the ideal situation."
There are about 4,000 people in Illinois right now looking for their own ideal kidney transplant situation, according to the National Kidney Foundation of Illinois. Many of them will fail in that search, said Diane Hollingsworth, director of medical education for the branch. People are living longer, but taxing their kidneys more through rampant increases in diabetes and hypertension thanks to poor eating and exercise habits.
"Those two are kinds of silent killers," Hollingsworth said. "Before they realize they have an issue, their kidneys are gone. Now the wait list for a new kidney is getting so long that people will die while they're waiting."
At Loyola, the average waiting time for a new kidney can be as long as six years. But trends show that wait is getting longer and longer across the nation. In 1999, there were about 42,000 people in the United States waiting for a kidney transplant, according to a study in the American Journal of Transplantation. By 2008, the wait list nearly doubled to about 80,000 people.
That's why some transplant hospitals like Loyola are trying to encourage more donations from people who are still alive, like Wieland, rather than waiting to share the gift of life until the donor's is already over. The recipients of kidneys from living donors tend to experience less rejection of the new organ and longer organ survival rates.
Because of that, Loyola is looking to create chains of willing donors. The chains would amount to a network of living donors with recipients who are the best matches on the checklist of organ donation compatibility.
For someone like Yario with an ideal match, her new kidney from her living sister may last 40 years as long as she takes her anti-rejection medication and goes to her regular checkups faithfully. Pakiasi said living donors go on to live fully functional lives and receive a dual reward. Not only do they save a life, but living donors receive priority if one day they need a new organ themselves. Most donors are back to normal activity in four weeks.
Just a few days after receiving her kidney, Yario was still taking it all in. She's not thrilled about the 25 to 30 pills she's taking to make sure her new kidney likes its new home. But she is happy to be feeling more energetic than she has in maybe 10 years.
"The whole thing just seems unreal," Yario said. "We've talked about this happening for so long that it still doesn't feel like it happened. It doesn't register that I've had a new organ put into my body. Vicki has made this tremendous sacrifice for me, and I really don't know how to say thank you."
Wieland already has her thank you.
"When they came into my hospital room and told me Lisa's kidney function levels were already closing in on normal I just started sobbing," Wieland said.
"It was so worth it."