Jesus Maradiaga and Teresa Barahona, husband and wife, are both originally from El Salvador and now live in Massachusetts, USA. Back home, Jesus was in the agriculture business and Teresa in the restaurant business.
In 2018, Jesus started to feel pain in his right knee. As the pain continued, Jesus decided to seek a medical opinion in El Salvador. During his doctor visit, Jesus remembered being prepared to undergo knee surgery but instead received a diagnosis he did not expect: kidney disease.
Following the diagnosis, Jesus and Teresa first sought to understand his condition. They then researched treatment options in El Salvador and abroad. Following their research, they decided that the best option for him was Massachusetts General Hospital in Boston, USA.
Start of kidney disease
An avid soccer player in his home country of El Salvador, it was during a recreational game when Jesus Maradiaga felt an unusual pain in his knee. As the pain persisted, he decided to book a consultation with his primary care provider. When his doctor observed other markers of potential disease — including changes in his eyes and skin — Jesus was sent for an immediate blood test.
Upon reviewing his results, the doctor informed Jesus that he would need to undergo urgent dialysis treatment. He was soon diagnosed with renal insufficiency, or kidney disease.
“I was in utter shock about my diagnosis. It did not seem real, as I did not have any other symptoms,” Jesus says. Other symptoms of kidney disease can include fatigue, shortness of breath and nausea.
Faced with an unexpected diagnosis, Jesus and his family took some time to understand his condition and the treatments available in El Salvador. Following their research, they decided that the best option for him was to seek care at Mass General.
Soon after his first appointment, the Mass General nephrology team confirmed he had renal insufficiency and recommended long-term dialysis treatment. Jesus recalls it was very hard to hear the news, but he was committed to his dialysis treatment for the foreseeable future.
As a native Spanish-speaker, Mass General ensured a medical interpreter from the Mass General Medical Interpreter Services was available and present during all visits and procedures.
Hope of a transplant
Jesus underwent dialysis treatment for approximately two years, during which he remembers feeling weak and lethargic. It was the thought of a potential transplant that kept him motivated and hopeful for the future. He learned from his Mass General transplant care team that living donation would be the best way to receive a new organ. While numerous friends and family members volunteered to be screened to be potential living donors, none were successful.
“The biggest hurdle is to find a person who can donate,” says Nahel Elias, MD, surgical director of kidney transplantation at Mass General and Jesus’ transplant surgeon. “Finding the perfect match is not the problem; it is finding a person who is healthy enough to donate.” For all patients like Jesus managing kidney disease, Dr. Elias says that living donation is the preferred treatment option over dialysis and deceased donation, as the organ is more sustainable.
In the beginning, the family did not consider Teresa, as she had a different blood type. However, her determination to help her husband led them to pursue her as a potential donor.
“Since the beginning of Jesus’ diagnosis, I was fully committed to donating my kidney to him. Seeing him go through dialysis just reinforced my decision and how impactful my kidney donation would be. I did not even think twice about it,” says Teresa.
To participate in a kidney exchange, Teresa first had to confirm that she was eligible to become a donor, which involved a few rounds of comprehensive testing, blood work and meeting with a social worker living donor advocate. She was ultimately deemed to be healthy and approved to donate; however, she was an incompatible match for Jesus. The Mass General kidney transplant team recommended that they participate in a paired kidney-exchange.
“The biggest misconception about living donation is that you have to be a perfect match with the recipient,” says Dr. Elias. “In reality, you do not have to be a perfect match — just a healthy one.”
Mass General entered them on the UNOS Paired Kidney Exchange Program waiting list, which works to expedite transplants in patients with blood group antibodies or other incompatibilities to their potential living donors. Through this program, Teresa donated her kidney to an unknown recipient while Jesus received a kidney from an unknown donor as part of a swap.
As for Jesus, the hope that had fueled him for two years was becoming a reality.
