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Chad Ryan | The Journal Gazette
Mikki Linton, left, received a kidney from her mother, Tracy Parker, in November. The two women are now celebrating their first Mother’s Day since the transplant.

Mother's gift brings family closer

Seizes opportunity to save her daughter’s life

Today is a day that honors the depth of a mother's love.

All Mikki Linton and Tracy Parker, both from Warsaw, have to do to understand that bond is look at each other.

Linton, 22, is alive today because her mother, Parker, 50, was willing to donate a kidney her daughter desperately needed. It was a donation that changed the course of Linton's sudden struggle with a rare condition that, left untreated, could have caused her kidneys to shut down and claim her life.

Linton says the medical trouble started, ironically enough, after she had a miscarriage in July 2012.

A few weeks later, she noticed swelling in her legs and feet – a not-uncommon symptom in pregnancy – but, she thought, a bit odd after the end of one.

The swelling didn't go away. “It was getting harder and harder to walk,” she says, adding she finally gave in and went to an emergency care center.

After some blood work, she was sent to a hospital, and that trip led to an ambulance ride to Lutheran Hospital in Fort Wayne, because doctors were alarmed her blood pressure had spiked to a dangerous level.

Linton spent a week in Lutheran for tests. Doctors discovered her kidneys were working at only 50 percent and diagnosed her with lupus, an autoimmune disease that often strikes young women.

When diagnosed with lupus, the body mistakenly begins attacking its own tissue.

Linton was prescribed medications and sent home. She was told to return for weekly blood tests in the hope her kidneys would rebound.

But, she says, she didn't get better. When the first week's test results came in, she got a phone call she'll never forget.

“They said, ‘You need to come back to the hospital – like now,' ” she says.

Her kidneys were functioning at only 35 percent, and her whole body was swelling up with excess fluid the organs couldn't eliminate.

“It got bad just that quick,” her mother says.

At that point, doctors realized Linton also had Wegener's granulomatosis, another autoimmune condition, where inflamed blood vessels restrict blood flow to certain organs. In her case, the kidneys were the target.

It's not known what triggers the condition, but Wegener's makes the body produce tiny clumps of tissue called granulomas that destroy normal kidney function.

Linton suddenly found herself facing imminent kidney failure and starting dialysis, a procedure in which a machine cleans the body of waste. Without continuing dialysis indefinitely, toxins would build up and she would die.

“I was just scared because I didn't know what dialysis entailed. I just knew it drained all my blood from my body and cleaned it. Other than that, I just didn't know anything,” she says.

Even worse, Linton says, her mom wasn't with her. But, she says, she didn't want to worry her before she had more information.

A chance to give life

Parker was in Colorado that week in 2012, working as she had for several years during the month of September as a cook at a hunting camp during elk season.

When she found out about her daughter's hospitalization, Parker says, she felt “very helpless.”

“At that point, they didn't know what was the matter with her. I was just shocked because of how healthy she always was,” Parker says.

But she came home, and the two started working together to get information about Linton's only other option, a kidney transplant. In May 2013, the two got a confirmatory opinion from experts at the Mayo Clinic in Rochester, Minnesota, and by July, Linton had started the testing necessary to find a matching donor, so her body wouldn't reject the new organ.

“I remember she went in for some testing, and they said it was time. She had to start looking for a donor,” Parker says. “I was like” – she raises her right hand – “right away.”

Despite her age and the need for major surgery, she says she felt no hesitation. “None,” she says. “None at all.”

John Ducker, transplant nephrologist and medical director of Lutheran's transplant center, says family members are always the first place to look for potential matches.

Mothers and children, he says, automatically share 50 percent of their genetic make-up. So, transplants between them are “not uncommon” and even more likely since advances in anti-rejection drugs mean fewer aspects of the two have to match, he says.

But such transplants also are not an everyday occurrence. Sometimes the donor might have health issues, or the kidney disease might be hereditary, making donation unsuitable.

Often, patients must undergo a widespread search to find a donor or turn to donation from a person who has died and given permission for organ donation.

Ducker says he's seen only a couple of mother-to-daughter transplants in his 17 years of practice.

But mothers and daughters have a better chance than other unrelated living donors of sharing even more than 50 percent of the important anti-rejection characteristics, he says.

And, he adds, there's an emotional bond there that often increases willingness to donate and face the prospect of living out life with only one kidney.

Parker was a match. Her stepfather, Tom Parker, of Warsaw, also turned out to be a match.

“I kind of hesitated, though, because she's my mom,” Linton says. She added that she had several surgeries during her year after diagnosis because of other conditions and aspects of dialysis and understood donation had risks.

“Knowing what I had been through, I didn't want her to go through it (surgery) because of me.”

But Parker didn't look at it that way.

“Every mother gives life to her child once,” she says. “I looked at it as now, with my daughter, I get the chance to do it twice.”

A mother’s love

Before their surgeries on the morning of Nov. 19, the two were in separate hospital rooms next to each other. Both recall crying.

Parker was wheeled into a dark operating room where Fort Wayne urologist and nephrectomy surgeon Dr. Mark Dabagia made three small incisions in her abdomen, and using Lutheran's laparoscopic da Vinci Surgical System, freed her kidney and removed it through a thin tube.

The robotic system is controlled at a console at which the surgeon sits operating instruments according to guidance provided by a tiny video camera, which sends images of the inside of the body to video screens.

The kidney, which Parker says “looks like a nice chicken breast,” was then put on ice and walked across a sterile walkway to a brightly lit operating room where Linton was waiting.

After the organ was examined and cleaned, it was surgically attached, the surgical team waiting until the kidney produced urine – a matter of minutes – before closing the incision.

Linton did not have her two nonfunctioning kidneys removed.

“They shrivel up when they're not being used,” she says.

Both operations were over by lunchtime. Parker says she felt fatigued after the surgery, but that went away in a few weeks.

“After that, I felt I didn't even miss it,” she says of her kidney.

What was most gratifying to her, she says, was the change in Linton. “She was a lot more bright-eyed, right away, … even right after surgery,” she says.

Since getting the kidney, Linton says, her life has changed. She no longer needs to make sure she gets a certain amount of fluid each day or avoid certain fruits and vegetables, including bananas and potatoes, because of their high potassium content.

“It was terrible. … My favorite food is mashed potatoes,” she says, laughing.

Ducker says his patient will have to take three anti-rejection drugs that will also help treat her lupus, plus blood pressure medicine for the rest of her life.

She may need another transplant because she is young, but there's a good chance the kidney will last at least 10 years, he says.

“The longest time for a kidney I know of out there is 35 years, and that was done before the new (anti-rejection) medications,” he says.

Ducker says one reason a transplant is considered a better option than dialysis for a young woman is that dialysis precludes pregnancy and childbirth. A transplanted kidney means that, if there are no complications, a woman can go on to have a baby, he says.

“We have to change medications (during pregnancy) and wait a year after the transplant,” he says. “We want everything perfect for a year, and then we can consider it.”

Linton says she's not sure becoming a mother is something she'll want to do soon.

But, from her mom, she adds, she's learned what a mother's love means and “so thankful” for it.

And she's ready to pass that on.

“I have a little nephew,” she says, adding that her sister Haley Linton, from Warsaw, has a 1-year-old son, Hunter, whom she adores.

“I spoil him like crazy,” she says.

rsalter@jg.net

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