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By Sara Ann Hutto \u201917<\/b> Paul Lee \u201982 needed a kidney. When Ruthie Traylor Hite \u201983 found out she was a match, she didn\u2019t hesitate<\/strong><\/p>\n<\/div><\/section><\/div> WATCH THE VIDEO:<\/b> \n The Gift<\/a> from Clemson University<\/a> on Vimeo<\/a>.<\/p>\n<\/div><\/section><\/div> \u201cCarlson thinks I was bitten by a shark. <\/span>She wants me to show her my scar, like \u2018That\u2019s where a shark bit you!?\u2019\u201d<\/span><\/p>\n Paul Lee \u201982 laughs as he talks about his 3-year-old granddaughter, who \u201cruns wherever she goes.\u201d Lee and his wife, Jan Arey Lee \u201982, 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 \u2014 a special time known affectionately as \u201cJannie Camp.\u201d<\/span><\/p>\n This year, Jannie Camp was a roaring success, full of all the activity and vivacity reserved for children in the single digits. \u201c[Paul] would hop out of the bed when Carlson would call for us in the morning,\u201d Jan Lee says. \u201cWe had the best time.\u201d<\/span><\/p>\n Last year, Jannie Camp wasn\u2019t possible. Last year, the global filtration rate of Paul Lee\u2019s 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.<\/span><\/p>\n Last year, Lee was one of more than 90,000 Americans on the waiting list for a kidney donor. <\/span><\/p>\n<\/div><\/section><\/div> The Roadblock<\/b><\/span><\/p>\n \u201cI\u2019m sorry. You\u2019re not a candidate.\u201d<\/span><\/p>\n Paul and Jan Lee were getting used to disappointment. It was 2020, and they were in the thick of applying to as many hospitals in the Southeast as they could, hoping to be accepted to one of their transplant programs. Unfortunately, Lee\u2019s medical history was the reason for the constant rejection.<\/span><\/p>\n Lee spent most of his career in the U.S. Secret Service, mainly investigating financial fraud cases. He spent five years in Plains, Georgia, as part of former President Jimmy Carter\u2019s protective detail. In 1999, during a routine physical required by the Secret Service, his urine showed microscopic blood and protein. It wasn\u2019t until the early 2000s, when Lee was 40 years old, that he underwent a biopsy with a nephrologist. He was diagnosed with IgA nephropathy, an autoimmune disease that attacks the kidneys.<\/span><\/p>\n For many years, Lee\u2019s condition was more or less asymptomatic. That changed with a diagnosis of kidney cancer in 2018.<\/span><\/p>\n \u201cThey had to take about two-thirds of one of my kidneys,\u201d Lee says. \u201cThat left me with really decreased kidney function.\u201d<\/span><\/p>\n Many hospitals won\u2019t accept transplant candidates unless they have been cancer-free for three years or more \u2014 a major roadblock for Lee at the beginning of his transplant journey. He couldn\u2019t wait for that time frame. If he was going to avoid dialysis, he needed a new kidney fast.<\/span><\/p>\n \u201cOne of my supervisors at the Secret Service was from Maryland,\u201d he continues. \u201cAbout three years ago, he had a kidney transplant at Johns Hopkins, and he gave me all of the contact information.\u201d<\/span><\/p>\n Despite Lee\u2019s cancer history and the growing concerns surrounding COVID-19, Johns Hopkins Hospital accepted his application.<\/span><\/p>\n \u201cFor Johns Hopkins to be so confident and say, \u2018We can do this\u2019\u201d \u2014 Jan Lee pauses for a moment, emotion thick in the silence \u2014 \u201cThe precautions were there. Honestly, the kidney overrode the virus in our mind. If they were ready to go, we were doubly ready.\u201d<\/span><\/p>\n<\/div><\/section><\/div> The Match<\/b><\/span><\/p>\n Finding a match for an organ transplant<\/span> is no easy thing. It\u2019s one of the main reasons why so many people are still waiting for life-changing operations. Factors like blood type and antibodies must be tested, and characteristics, such as age, weight and donor health, must be carefully considered before doctors can give patients (and living donors) the green light for a transplant.<\/p>\n Dr. Niraj Desai, director of the kidney and pancreas transplant program at Johns Hopkins Hospital, says matching organs to patients is one of the greatest challenges doctors face in transplant programs across the nation.<\/p>\n \u201cThe [waiting] list is so long,\u201d Desai says. \u201cHow do we innovate in a way to use more organs? How do we deal with all the patients to maximize the organs we can use? We\u2019ve done a lot to look at ways to use more organs from both deceased donors and living donors, pushing age boundaries, pushing infectious risk boundaries, things like that.\u201d<\/p>\n Paul Lee had finally made it onto the list at Johns Hopkins, but now, like so many others, he had no choice but to wait.<\/p>\n When the Lees told their family and friends they were looking for a kidney donor, they weren\u2019t asking or expecting anyone to volunteer. Of course, Jan filled out the questionnaire, hoping she would be a match for her husband. So did Lee\u2019s brother and one of Lee\u2019s co-workers.<\/p>\n But there was someone else who was interested, someone Paul and Jan Lee had never anticipated. Little did they know they would find a match sooner than they\u2019d hoped.<\/p>\n<\/div><\/section><\/div> The Donor<\/b><\/span><\/p>\n Paul Lee grew up in Greenville<\/span> and followed an older brother to nearby Clemson, where he graduated with a degree in administrative management in 1982. \u201cDon\u2019t look at my GPA,\u201d Lee laughs. \u201cI enjoyed my time there a little too much.\u201d<\/span><\/p>\n Paul and Jan Lee actually dated in high school, but Lee says she broke up with him before they both attended Clemson. \u201cDon\u2019t let her say I broke up with her,\u201d he says, lowering his voice.<\/p>\n \u201cI\u2019m listening!\u201d Jan Lee interrupts, her voice echoing from another room.<\/p>\n The couple wouldn\u2019t 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.<\/p>\n \u201cI can name so many girls from Clemson that I have that sisterhood bond with,\u201d Lee says. \u201cJane Robelot DeCarvalho, Deborah Walls McClure, Cindy Jones Foster, Jan Christian Yantz. I\u2019m still in touch with these people. Ruthie is one of those.\u201d<\/p>\n Ruthie Traylor Hite says Jan Lee was the first friend she met at Clemson: \u201cIt was one of the first days that I showed up for orientation that I met Jan. We\u2019ve kept in touch all these years, and it\u2019s been many.\u201d<\/span><\/p>\n 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\u2019 trips to the beach or the mountains; Hite was well aware of Lee\u2019s deteriorating health. When she heard about his need for a kidney, she was moved, and the more she thought about it \u2014 the more she prayed about it \u2014 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.<\/span><\/p>\n \u201cI\u2019ll be 60 in a couple of months, and I\u2019ve just always felt like I\u2019ve had good health,\u201d she says. \u201cIf there was any way that I could help my friend, I wanted to. It didn\u2019t take me long to make the decision that if I could do this for Paul, I wanted to do it.\u201d<\/span><\/p>\n Hite called Johns Hopkins.<\/span><\/p>\n<\/div><\/section><\/div> The Transplant<\/b><\/span><\/p>\n Questionnaires, blood tests, urinalyses,<\/span> 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.<\/span><\/p>\n \u201cI just didn\u2019t want it to be about me,\u201d she says. \u201cThe 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\u2019t a match for my friend.\u201d<\/span><\/p>\n Hite wasn\u2019t disappointed. At the end of fall 2020, at the same time, she and Lee were notified that she was a match. \u201cThat was a happy day,\u201d Hite says.<\/span><\/p>\n 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: \u201cThe fact is, there are people who are still suffering from kidney failure and other issues, even during a pandemic. Those things didn\u2019t stop. And my friend still needed it.\u201d<\/span><\/p>\n On April 13, 2020, Ruthie Hite and Paul Lee walked into the hospital together, hand in hand.<\/span><\/p>\n 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. \u201cI remember them rolling me by Paul, and I just told him that I loved him,\u201d Hite says. \u201cAnd I gave him a \u2018Go Tigers!\u2019\u201d<\/span><\/p>\n Hite\u2019s 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\u2019s kidney for Lee, which was slightly more complicated than usual.<\/span><\/p>\n \u201cThe donor kidney had two renal arteries,\u201d Desai says. \u201cThat 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.\u201d<\/span><\/p>\n Desai used what\u2019s 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.<\/span><\/p>\n \u201cWe 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.\u201d<\/span><\/p>\n 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\u2019s bladder. \u201cAnd then we closed him up,\u201d he says.<\/span><\/p>\n 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, \u201csat down patiently with me, would explain to me whatever dumb questions I had.\u201d 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.<\/span><\/p>\n \u201cIt\u2019s humbling to realize that the process of transplantation lets a person live, on average, twice as long as they would have lived on dialysis,\u201d Desai says. \u201cIn 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 \u2014 to be able to have that degree of impact on someone\u2019s life.\u201d<\/span><\/p>\n<\/div><\/section><\/div> The Gift<\/b><\/span><\/p>\n Paul Lee is looking forward <\/span>to playing golf again. He\u2019s looking forward to eating potatoes, which \u201cused to be the devil, you know,\u201d 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: \u201cYou could basically eat lettuce.\u201d<\/span><\/p>\n But most of all, Lee is looking forward to more Jannie Camps.<\/span><\/p>\n \u201cI get to see my grandkids grow up,\u201d Lee says. \u201cI\u2019m 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\u2019t say how grateful I am for what she did.\u201d<\/span><\/p>\n Lee is still on a mixture of medications, including antiviral, antibacterial and antifungal prescriptions. And he\u2019s dealt with some common complications, including a couple of infections related to the surgery. Eventually, he will be down to three pills, which he\u2019ll take for the rest of his life: two immune suppressants and one prednisone. It\u2019s a small price to pay, he says.<\/span><\/p>\n Hite calls the Lees often to catch up on the week and compare GFR rates with Paul. They\u2019ve become as close as family, evidenced by the mutual warmth and affection that pours out when asked about each other.<\/span><\/p>\n \u201cEverybody has the opportunity to say they want to be an organ donor when they complete their driver\u2019s license, so I did that,\u201d Hite says. \u201cBut 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.\u201d<\/span><\/p>\n Jan Lee calls her college friend a hero.<\/span><\/p>\n \u201cShe doesn\u2019t want to hear it,\u201d she says through tears. \u201cShe 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\u2019t help but hold her up.\u201d<\/span><\/p>\n Paul Lee echoes his wife.<\/span><\/p>\n \u201cThere\u2019s nothing in it for her!\u201d he exclaims. \u201cThere really isn\u2019t. She never wavered. I just wonder how many people would do that.\u201d<\/span><\/p>\n 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 \u2014 thanks to a scar that looks like a shark bite and an old friend from Clemson. <\/span><\/p>\n \u201cShe has given me the gift of life,\u201d Lee says. \u201cShe really has.\u201d<\/span><\/p>\n<\/div><\/section><\/div>
\nIllustrations by Chris Koelle<\/b><\/p>\n<\/div><\/section><\/div>
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\nThe Gift<\/b><\/span><\/p>\n
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