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The Gift

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“Carlson thinks I was bitten by a shark. She wants me to show her my scar, like ‘That’s where a shark bit you!?’”

Paul Lee ’82 laughs as he talks about his 3-year-old granddaughter, who “runs wherever she goes.” Lee and his wife, Jan Arey Lee ’82, had just spent a few days at the beach with their son and daughter-in-law, Alex and Ansley, and their two granddaughters, Carlson and Bennett. At the end of the beach trip, Paul and Jan offered to take Carlson, the oldest, back to their home in Columbia, South Carolina, for a week — a special time known affectionately as “Jannie Camp.”

This year, Jannie Camp was a roaring success, full of all the activity and vivacity reserved for children in the single digits. “[Paul] would hop out of the bed when Carlson would call for us in the morning,” Jan Lee says. “We had the best time.”

Last year, Jannie Camp wasn’t possible. Last year, the global filtration rate of Paul Lee’s kidneys had dropped to just 6 percent. For someone his age, a healthy GFR would have been 60 percent or higher. Last year, Lee spent most of his days trying to sleep, wracked by insomnia and severe fatigue. He was on the verge of dialysis, a treatment he was avoiding for as long as possible.

Last year, Lee was one of more than 90,000 Americans on the waiting list for a kidney donor.

The Donor

Paul Lee grew up in Greenville and followed an older brother to nearby Clemson, where he graduated with a degree in administrative management in 1982. “Don’t look at my GPA,” Lee laughs. “I enjoyed my time there a little too much.”

Paul and Jan Lee actually dated in high school, but Lee says she broke up with him before they both attended Clemson. “Don’t let her say I broke up with her,” he says, lowering his voice.

“I’m listening!” Jan Lee interrupts, her voice echoing from another room.

The couple wouldn’t find each other again until years later, but in the meantime, Jan Lee was occupied by a large group of friends in her sorority, Kappa Delta. Among them was Ruthie Traylor, an English major from Macon, Georgia.

“I can name so many girls from Clemson that I have that sisterhood bond with,” Lee says. “Jane Robelot DeCarvalho, Deborah Walls McClure, Cindy Jones Foster, Jan Christian Yantz. I’m still in touch with these people. Ruthie is one of those.”

Ruthie Traylor Hite says Jan Lee was the first friend she met at Clemson: “It was one of the first days that I showed up for orientation that I met Jan. We’ve kept in touch all these years, and it’s been many.”

Lee met Hite for the first time when he and Jan began dating again their senior year at Clemson. Ever since the Lees graduated and got married, Jan has kept in touch with Hite and her other college friends through phone calls and occasional girls’ trips to the beach or the mountains; Hite was well aware of Lee’s deteriorating health. When she heard about his need for a kidney, she was moved, and the more she thought about it — the more she prayed about it — the more excited she got about the possibility of being a match for Lee. She asked herself what it would mean to be a live donor. It was never a question of her own sacrifice; it was a question of whether she would be able to help her friend.

“I’ll be 60 in a couple of months, and I’ve just always felt like I’ve had good health,” she says. “If there was any way that I could help my friend, I wanted to. It didn’t take me long to make the decision that if I could do this for Paul, I wanted to do it.”

Hite called Johns Hopkins.

The Transplant

Questionnaires, blood tests, urinalyses, tissue typing, visits to Johns Hopkins in Baltimore. Hite had to undergo an extensive process before she was named a match for Paul, which she kept under wraps in the beginning.

“I just didn’t want it to be about me,” she says. “The other thing, too, is I became pretty excited about it and invested in it. I knew that it would really be sad for me if I wasn’t a match for my friend.”

Hite wasn’t disappointed. At the end of fall 2020, at the same time, she and Lee were notified that she was a match. “That was a happy day,” Hite says.

Hite remembers getting questions from others, even those close to her, about why she would want to fly to Baltimore and donate a kidney in the middle of a pandemic. Hite, who had the steadfast support of her husband, Brian, had a simple answer: “The fact is, there are people who are still suffering from kidney failure and other issues, even during a pandemic. Those things didn’t stop. And my friend still needed it.”

On April 13, 2020, Ruthie Hite and Paul Lee walked into the hospital together, hand in hand.

Hite was up first. Her kidney had to be removed and prepared before it could be given to Lee. After she went through pre-op and was being taken into surgery, she passed Lee in his hospital stall. “I remember them rolling me by Paul, and I just told him that I loved him,” Hite says. “And I gave him a ‘Go Tigers!’”

Hite’s kidney was removed through a minimally invasive laparoscopic surgery, and then the kidney was flushed and put on ice. Dr. Desai would be performing the transplant. But first, he had to prepare Hite’s kidney for Lee, which was slightly more complicated than usual.

“The donor kidney had two renal arteries,” Desai says. “That happens about 10 percent of the time. In this situation, we did a back-table reconstruction of the two arteries so that we could install them as a single artery.”

Desai used what’s called a fish-mouth technique to join the side walls of the two arteries to make one common orifice at the end of them. One of the arteries was particularly small, only 3 mm in diameter.

“We brought the kidney to the recipient in the operating room and opened up the recipient to expose the vessels we were going to sew the kidney onto, the external iliac artery and external vein.”

Desai says after the kidney was sewn onto these vessels, he waited to let the blood flow and re-profuse the kidney. Once the bleeding dried up, he and his team connected the ureter from the donor, which comes with the kidney, to Lee’s bladder. “And then we closed him up,” he says.

Lee no longer sees Desai. His post-transplant care has been transferred to a nephrologist. But Lee will never forget the doctor who he says, “sat down patiently with me, would explain to me whatever dumb questions I had.” Lee remembers that the nurses who came to check on him post-surgery knew Desai had performed his transplant because his scar was so perfect.

“It’s humbling to realize that the process of transplantation lets a person live, on average, twice as long as they would have lived on dialysis,” Desai says. “In your day-to-day process, you kind of check the boxes and get your work done, but when you step back and take a 10,000-foot view of it, you realize what an honor and privilege it is to be a part of that — to be able to have that degree of impact on someone’s life.”

The Gift

Paul Lee is looking forward to playing golf again. He’s looking forward to eating potatoes, which “used to be the devil, you know,” he chuckles. Decreased kidney function causes heavy mineral buildup in the body, including elements like potassium and calcium. Before the transplant, Lee was on a low-potassium diet: “You could basically eat lettuce.”

But most of all, Lee is looking forward to more Jannie Camps.

“I get to see my grandkids grow up,” Lee says. “I’m far more committed to living a healthier lifestyle, not just for myself but just to honor the gift that Ruthie has given me. I just can’t say how grateful I am for what she did.”

Lee is still on a mixture of medications, including antiviral, antibacterial and antifungal prescriptions. And he’s dealt with some common complications, including a couple of infections related to the surgery. Eventually, he will be down to three pills, which he’ll take for the rest of his life: two immune suppressants and one prednisone. It’s a small price to pay, he says.

Hite calls the Lees often to catch up on the week and compare GFR rates with Paul. They’ve become as close as family, evidenced by the mutual warmth and affection that pours out when asked about each other.

“Everybody has the opportunity to say they want to be an organ donor when they complete their driver’s license, so I did that,” Hite says. “But never did I dream that I would be a live donor to someone and for it to be somebody I knew from my Clemson days. Somebody that I have a friendship with. I would not have imagined that happening, but I sure am glad that it did.”

Jan Lee calls her college friend a hero.

“She doesn’t want to hear it,” she says through tears. “She does not want that. She wants us all to take from this experience to grow closer to God. And we all have. You just can’t help but hold her up.”

Paul Lee echoes his wife.

“There’s nothing in it for her!” he exclaims. “There really isn’t. She never wavered. I just wonder how many people would do that.”

Last year, Lee was one of more than 90,000 Americans on the waiting list for a kidney donor. This year, he has the chance to start again — thanks to a scar that looks like a shark bite and an old friend from Clemson.

“She has given me the gift of life,” Lee says. “She really has.”