What's the best present your best friend ever gave you?
Few can match what Rachel Duff of Geneva gave Mandi Davis in November: A kidney. In a roundabout way.
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Duff took a chance on giving a kidney to a stranger, trusting that a kidney transplant chain would work out and her friend would wake up from surgery with a new lease on life from somebody's else's kidney.
The story of the Nov. 21 operations at Northwestern Memorial Hospital in Chicago, in which Davis and two other people received new kidneys, started almost 20 years ago, when Duff and Davis, now 25, met at Harrison Street Elementary School in Geneva.
"Were we in Daisies (Scouts) together," Davis said.
Duff's mom was the troop leader. The girls and their mothers became friends, and even closer a few years later when the families ended up living on the same street. Davis recalled crashing her bicycle at Duff's house, and exploits such as eating cat food to see what it was like. "So we had a really funny friendship," she said.
Davis was being tested annually, as she had since her kindergarten physical, for kidney function. Doctors thought she had a benign condition, basement membrane glomerulonephritis. She took medication but didn't worry.
But then her lab work changed in 2010. A subsequent biopsy showed she had something else: Alport syndrome, a progressive genetic condition.
"So I'm a mutant," Davis said, laughing.
Nobody else in her family had the disorder or the genetic markers. She changed medication and knew that she might need a transplant one day.
"Maybe when I'm 50 or 60," she thought.
Davis left in August 2011 to study in Ecuador. But her condition worsened rapidly. Doctors told her she would need a transplant by age 35 at the latest, and that she should start arranging for one immediately, as it can take years to get a kidney from a deceased person.
By fall 2012, her condition was bad enough she had to start dialysis to remove toxins from her blood.
Transplant-wise, she ran into obstacles. Her only sibling, a brother, didn't share her blood type, and her parents weren't eligible. Lots of friends were tested but didn't match. Duff's mom matched but was deemed too old to give a kidney to the younger woman.
Duff was the only one to agree to a swap.
"Obviously, it was meant to happen," she said.
"It's like a running joke between our families that we were cousins ... so we are basically related. You've got to love your family," Duff said. She passed a physical and "annoying" psychological examinations, and it was then a matter of waiting.
A swap is also called a transplant chain. They have recently increased in popularity in the United States. A donor agrees to give a kidney to another person, and a friend or relative of the recipient then gives one of his or her kidneys. It can involve as few as four people. In 2012, there was a 60-person swap in the U.S. that took four months and started with what's called a "Good Samaritan" donor: someone who donates just because he or she thinks it is the right thing to do.
But the Duff-Davis effort happened on one day, at one hospital. All went well, and the women were up and walking around later that day. "You made me look bad," Duff told Davis, because Davis was the first one up, walking to Duff's room.
Back to normal
Duff recovered quickly from surgery and returned to work at a veterinary practice and as a theater technician. She has to avoid certain medications and be sure to tell any medical practitioners she has a single kidney.
Davis, who teaches high school Spanish, has returned to her home in Milwaukee and will resume working after the holidays. She's glad to be off the restrictive diet she was on with the dialysis, and to not have to plan her life around dialysis appointments. Her old, nonfunctioning kidneys are still with her. Doctors don't bother to remove them, she said, because they shrivel up.
And both agree more people should think about doing a kidney swap.
"I really wish people knew how low-risk it really is to donate. Rachel saved my life, and I'm so grateful," Davis said.