Tuesday, May 15, 2018, is a day that Brandi and Matt Lloyd have been waiting for a long time.
That's the day the couple, from Mooers, New York, are scheduled to undergo surgery. Matt will go first and have one of his kidneys removed. Then Brandi's surgery will follow.
Her diseased kidneys will be removed and Matt's donor kidney will be placed in her body. If all goes well, they should each have one functioning kidney by the end of the day and be on their way to recovery.
The Lloyds path to this point started more than 20 years ago when Brandi was diagnosed with polycystic kidney disease, or PKD, an inherited condition where cysts develop and grow inside the kidneys.
"Mine are both now, which is common, the size of footballs," she says matter-of-factly. "And they're covered with cysts the size of your fist."
Her kidney function has also declined over the years and she has been on dialysis for about a year.
The Lloyds knew that the time would come when Brandi would need a kidney transplant in order to maintain a good quality of life. And although many people stay on dialysis for years, the Lloyds say their lives have already become harder to manage since Brandi, 44, started home dialysis.
Matt administers the dialysis four times a week. Each procedure takes a couple of hours and the couple and their teenage son feel like they're tethered to their home. The dialysis is painful and makes Brandi feel sick. Plus her disease is painful, difficult to manage and constricts her ability to live a normal life.
"I tell my husband I don't feel like I'm sick," Brandi explains. "But I think I've felt like this for so long that this is just how I feel."
"Just walking from the elevators to here wears her out," Matt adds.
"He knew from the beginning that he wanted to donate. I said no from the beginning for him to donate to me ... But he's stubborn, so it's a go." — Brandi Lloyd
Matt Lloyd says he always knew he wanted to donate a kidney to his wife, but he didn't realize how complicated the process can be.
"I was always under the impression that it was just a blood type [match]" he says. Turns out there's a lot more to it.
Donors need to get tissue-typed to see if they have the same antigen markers. If all six markers match it's known as a perfect match. Most perfect matches are between siblings. Matt and Brandi match on 3 markers, which Matt says is very lucky, considering they're not related by blood. Tests are also done to ensure that the recipient has no pre-established antibodies to the donor kidney, which would cause the recipient to attack and reject the organ.
So far, all of the signs are good for the Lloyds.
Matt will enter surgery first and have one of his kidneys removed. Meanwhile, Brandi will be prepped for surgery and hers will begin shortly after Matt's.
Brandi's surgery is much more complicated. She's undergoing what's known as a double nephrectomy. Both of her kidneys will be removed.
In most kidney transplant surgeries, the recipient's original kidneys are left in place and the new donor kidney is attached nearby.
In Brandi's case, her kidneys are so enlarged that they are taking up a massive amount of room in her abdomen. So both of her kidneys will be removed prior to the placement and attachment of her husband's kidney.
Her recovery will also be more complicated, requiring more than a week in the hospital, frequent monitoring and medication that she'll have to take for the rest of her life to make sure her body doesn't reject her new kidney. However, this new kidney won't grow the cysts that are the hallmark of PKD and Brandi is hopeful her life will return to some semblance of normal.
"Oh, 100 percent," she says. "We're very hopeful for it. We don't have blinders on; we know there's going to be healing, there's going to be pain, there's going to be adjustments. It's not a cure, but for me, it's a way better option than living on dialysis."
"The organ supply is extremely limited. And if we can do something to increase more the mode of transplantation to help more people get out of dialysis, I think this is the way we have to go." — Dr. Abhishek Kumar
As it turns out, the Lloyds surgery is the first kidney transplant for the UVM Medical Center in 2018.
Annually, the hospital averages 25 to 30 transplant surgeries. There are about 65 people currently on the kidney transplant waitlist in Vermont and Dr. Abhishek Kumar, assistant professor of transplant medicine at the Larner College of Medicine at the University of Vermont, says the average wait time is three to four years.
In other states the wait time can be a decade or more.
Most kidney donations come from deceased donors, so patients wait on the list until a match is found, and then are rushed into surgery when the organ becomes available.
The Lloyd's surgery is atypical, since Matt is a living donor. Occasionally, live donors decide to donate to a stranger — the next person on the list (who matches) — but usually a live donor decides to donate to one person in particular, a close friend or family member.
The Lloyds and Dr. Kumar hope that more people will think about becoming a live organ donor.
"Everybody's got two [kidneys]," Matt says.
"There is such a big shortage," agrees Dr. Kumar. "The organ supply is extremely limited. And if we can do something to increase more the mode of transplantation to help more people get out of dialysis, I think this is the way we have to go."
Dr. Kumar says the number of transplants across the United States has stayed fairly stagnant over the years, with any growth largely occurring in deceased donors. But the need for kidneys continues to rise. So he hopes the Lloyds' story will help raise awareness of the possibilities of live donation.
Matt Lloyd says if there's a problem when his kidney is removed, and it can't be transplanted into his wife, he'll donate it to the next person on the list.
"Whenever we have a pair, living donation," Dr. Kumar says, "we always have a backup. Just in case for some reason we are not able to put it in the recipient, we will have a backup who has already been cross-matched, who has already been evaluated ... so that's always a fallback option."
The Lloyds are, of course, hoping for smooth sailing, and optimistic about their future.
"Just getting back our normal life," Brandi Lloyd says. "Being able to go on bike rides, being able to go for walks, hanging out with the family. Trips again will be fantastic. Having the energy level."
And Brandi says she's grateful to her husband. "He's a fixer. And this is a big fix."
