stanford medicine



Chain reactionOne act of altruism continues to change kidney transplant patients’ lives

Josie Soriano’s recovery from surgery has been so smooth that she often forgets all about it, until she sees the small scar on her abdomen.

Twelve weeks after she donated one of her healthy kidneys, she completed a 10K run in her community. Josie’s husband, Allan, has had an equally smooth transition. Twelve weeks after he received a new kidney, he finished a 5K walk, and he continues to play golf and ride his mountain bike.

Norbert von der Groeben
Allan and Josie Soriano
Allan and Josie Soriano after Allan received a kidney and Josie donated one of hers to an unknown person in need.

Last fall, the Sorianos were key players in a “daisy chain” of transplants orchestrated by the National Kidney Registry ( Josie, 40, would have donated a kidney to Allan, but their blood types didn’t match. So through the registry she donated a kidney to a stranger in New York, which meant that Allan, 45, could receive a kidney from an unknown donor in Southern California. Each chain begins with an altruistic donor willing to donate a kidney without knowing anything about the recipient, and ends with a leftover donor waiting to make an anonymous gift.

The chain was the idea of New York software developer Garet Hill, whose daughter lost kidney function when she was 10. He wanted to donate a kidney to her, but they had incompatible blood types, and in the end, a cousin donated a kidney. Hill wanted to help other families, though, so last year he founded the registry to match kidney donors and recipients. That’s what led to a carefully scheduled set of surgeries started on the morning of Nov. 19, 2008, for the Sorianos, two other recipients and two other donors. “All the donors were under anesthesia at the same time,” says Marc Melcher, MD, assistant professor of surgery, who was the primary surgeon on Allan’s three-hour surgery and first assistant on Josie’s four-hour surgery. “Otherwise, with the [transcontinental] time differences, you can imagine that a donor could back out after others in the chain had already donated their kidneys.”

The kidney transplant chains have provided life-saving organs to 31 kidney recipients nationwide since the registry was launched in February 2008. They are a response to the growing list of sick patients who have to wait years for transplants. The United Network for Organ Sharing reports that more than 82,000 patients nationwide are waiting for kidneys. At Stanford, there are about 950 such patients.

When the Sorianos had their surgeries in the fall, they didn’t know who their respective recipients or donors were, in keeping with the registry’s insistence on anonymity. “I was very curious, but Allan didn’t want to know,” Josie recalls. One day after being discharged from Stanford Hospital in November, she got on the Internet and identified Allan’s donor. “Steve [Shaevel] was easy to find since he and his wife, Gail, a kidney recipient, are advocates for kidney-related issues.”

In late January, Josie finally “introduced” Allan and Steve by e-mail. And in May, the Sorianos and the Shaevels met for lunch in Santa Clarita. “We were really excited,” Allan says.

He adds that he’s put on 20 pounds, thanks to the side effects of medications. And the day he returned to his engineering job from a medical leave of absence, he was unexpectedly laid off.

So how’s he holding up, overall? “I’m feeling very well, even quite energetic, and I’m looking for employment — considering graduate school full time. We’ll see what the future holds.”

The Sorianos took a camping trip with family members to Yosemite in May to celebrate their fourth wedding anniversary, and these days they’re only looking ahead. “I still have no regrets about the donation,” Josie says. “The doctors and nurses at Stanford really took time to educate us and to make the process as painless as possible.”

Diane Rogers






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