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.
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.
“I felt extremely safe during all my visits and surgery. Disinfecting, thorough cleanings, physical distancing and disposable masks were some measures I remember from my experience,” says Jesus.
Following surgery, Jesus recalled feeling minor pain around the area of incision and significant gratitude. Both Jesus and Teresa were discharged from Mass General a few days after their surgeries.
“Many patients, both the donors and the recipients, ask about restrictions following surgery,” says Leigh Anne Dageforde, MD, MPH, Teresa’s donor surgeon. “There are not too many restrictions on their long-term activities. I generally recommend six to eight weeks of no heavy lifting. For donors, recovery is easier. For instance, they are usually able to drive about a week after they donate.” Other recovery recommendations include staying hydrated and giving your body time to recover from the operation. Both the donors and the recipients are encouraged to walk even the night of surgery.
While many recipients of donated organs, particularly kidneys, generally outlive their new organ, Dr. Elias says that Jesus and Teresa’s case represents the ideal treatment option for renal disease. “Living donation has a better outcome overall. There are fewer complications and the results last longer,” says Dr. Elias.
Since the surgery, Jesus has never felt better, his energy levels are back to normal and he has returned to his normal life. Some of his postoperative follow ups include weekly blood work and virtual visits with his Mass General care team. Teresa reports a similar recovery, with return to normal life shortly after discharge.
“When I look back at my journey, it was truly one of the best medical experiences I have ever had. I am grateful for my wife and my entire care team at Mass General,” says Jesus. For Teresa, she says the experience of being able to donate her kidney to her husband as well as help another person in need through the paired kidney-exchange program, has been nothing short of rewarding.
Following their operations, Teresa and Jesus have returned to normal life.
Our kidney transplant programs at Massachusetts General Hospital and Brigham and Women’s Hospital provide nationally recognized, personalized care for kidney failure. We lead innovative clinical trials and Mass General Brigham’s pioneering research allows some patients to live drug-free after transplant. Our clinical teams offer advanced treatment options for highly sensitized patients, patients with incompatible living donors, and patients with complex medical or surgical issues.