Gift of a lifetime

Sister is kidney recipient's 'ace in the hole' after first transplant wears out

Lisa Ryckman, Rocky Mountain News

Published July 7, 2006 at midnight

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After 16 years, Kirk Derichsweiler's kidney came to a sudden stop, like a rebuilt engine that had cruised its last mile.

He'd always known it would happen eventually. And he had no complaints.

"It worked really well for me," says Kirk, of Pueblo. "But transplants don't last forever."

The 43-year-old had waited only a year for a cadaver kidney the first time around, but now there were 1,000 people ahead of him in Colorado, most of whom had yet to have their first transplants. It would take at least four years for him to make it to the head of the line, he was told. Maybe longer.

But Kirk had another option. Her name is Dana.

Diagnosed at 20

Of the four Derichsweiler kids, the middle two were the closest. Born just 14 months apart, Dana and Kirk grew up in Texas and Pueblo and shared a room and a bunk bed until their parents made them stop. A favorite family photo shows the two of them tucked in a tire swing, the older sister hugging the stuffing out of the younger brother she calls Rocky.

They did everything together, including having their tonsils removed when Dana was 5 and Kirk was 4. Dana remembers Kirk bopping her in the nose with the boxing gloves they got one Christmas; Kirk remembers Dana getting her long blond hair caught in a mixer. They both remember playing constantly, swimming, running and hiking in the summer, skiing every winter weekend.

"We were tight and we still really are. We're one of those families sitting around the table, everybody grabbing for everything. We just get all down and dirty. It was a great way to grow up," says Dana, 44, of Boulder. "Whatever it is, we find our way through it."

Kirk's kidney disease was first diagnosed when he was 20 after protein showed up in his urine during a routine physical. Kidney malfunction can happen without apparent symptoms, which explains why nearly half the people whose kidneys are failing don't know it.

Kirk was one of those.

"They didn't know if high blood pressure caused my kidneys to fail or whether the failure of my kidneys caused the high blood pressure," says Kirk, who lives in Pueblo. "It was a chicken-or-the-egg situation."

He began massive doses of steroids, but within three years, his kidneys had failed. He went on dialysis to await a cadaver kidney, but when the call came, he wasn't ready.

"I had a real bad cold, so I had to deny that one. You have to be in the best of health to receive a kidney - the best health you can be," Kirk says.

The second time, he was good to go. The kidney was an excellent match.

"I never went back to dialysis for 16 years after that transplant," he says. "I rode my bike, did my day hiking - just lived my life."

That changed abruptly one day with what began as a searing headache. By the time Kirk reached the emergency room, his blood pressure had rocketed into the stratosphere, and his head felt as if it would explode. He went on dialysis immediately while the doctors worked to save his kidney. They were unsure what was happening; a biopsy showed no rejection.

"It was just worn out," he says.

Treatment takes a toll

Thick bands of scar tissue snake across Kirk's left arm, the vestiges of a nightmare of monster needles.

Three times a week, a machine did the work of his failing kidneys, cleansing his blood of waste, salt and extra water and maintaining safe levels of sodium and potassium. The "run" required him to sit still for four hours, his blood pressure crashing and fingers cramping.

After the needle removal, it took time for the bleeding to stop. Sometimes, on the ride home, it would start again, soaking his shirt with red.

"Your fingers ball up. You can open your hand, and your fingers just ball right back up again," Kirk says. "They give you meds to ease the cramps, and that's all fine and dandy until you get home. Then it all starts again, cramping all night long."

The treatment exhausted him, but the next morning, he'd be back at work as a quality-control inspector.

"I'd have about two days a week that I would feel pretty good when I got off work that evening, and I had to really take advantage of it," he says. "I would want to go out to dinner, ride my bike - just really take advantage of the few hours I had off the machine."

The perfect candidate

More than 300,000 Americans are on dialysis, the purgatory before the transplant for most people, the last line of defense for others.

The wait can go on for years, so the dialysis-center staff becomes a de facto support group. The Pueblo center where Kirk went three times a week felt like its own little community, one built on compassion, empathy and pain. The odor of bleach hung heavy in the air; to Dana, it was the smell of blood.

"It's just bad," she says. "There are people in there who are old or sick, and you know they're never going to get a kidney. They're going to die on those machines."

Every year, nearly 4,000 kidney patients die while waiting for transplants - but Kirk wouldn't be among them. All three of his siblings were ready to donate one of their kidneys to him.

Dana was the best match.

"My immediate thought was that I'd just have to donate right then," she says. "I remember them saying that because he was young and healthy, to get a cadaver donation, that he would do pretty well on the list - a year, maybe two, tops. So the doctor said I could be the ace in the hole. I always knew there would come a time when he really needed a donation. And I was a perfect candidate."

Dana's energy fills every minute of every day, a distinct contrast to her low-key younger brother. When she's not biking 100 miles or snowboarding, she's whipping up six kinds of pie for her Boulder restaurants, the Walnut Cafe and Southside Walnut.

"I just love living," Dana says. "And I just couldn't imagine not giving him that same opportunity. I know he loves me that way, too - if he had to give one and I needed it, he would give it to me. There's just no way that I couldn't have."

The decision was tougher for Kirk.

"I was very scared. It's my sister, y'know? But she wouldn't take 'no' for an answer."

Dana's excellent health helped, but she also matched Kirk on most of the critical physiological factors, which include blood and tissue type, antibody screening and cross-matching, which determines how the recipient will react to the donor organ.

The better the match, the better the outcome.

Last Christmas, one test showed protein in Dana's urine, a development that would make a transplant out of the question. She retook the test and waited anxiously for the results.

The all-clear came four days later.

Mountains to climb

Porter Adventist Hospital has done more than 700 transplants in the past 20 years, and its team includes a pair of surgeons who happen to be brothers. On that Friday in February, Dr. Warren Kortz would remove Dana's kidney, and Dr. Eric Kortz would transplant it into Kirk.

"See you later," Dana told Kirk as they were wheeled into the operating room.

Three days after the surgery, she was walking laps around the hospital, dragging Kirk with her.

"I think I will absolutely fully recover. That's part of the challenge. Now it's up to me," she says.

The transplant has given Dana a forum for pushing organ donation, letting people know that signing on the back of a driver's license isn't enough: They need a living will to make sure that their families follow through.

"The wait list would disappear for organs if we weren't burying them," Dana says. "Meanwhile, people are sitting on machines dying. We wouldn't let that happen if it were more personal."

In a year, each of their kidneys will be doing the work of two. In the meantime, they have plans: Dana intends to enter bike races, like she always has, and she'll climb Longs Peak, an annual tradition.

"And I told Kirk he has to climb it with me, because that kidney had been to the top for the last eight summers in a row," she says.

Kirk intends to offer comfort to the people still on dialysis.

"After my first transplant, I went on about my life. I really didn't pursue helping other people," he says. "This time, I'm going to be more supportive of people on the machines."

The simple things mean a lot to Kirk now. Eating anything and everything. Sipping a huge glass of ice water, as much as he wants. Tinkering in the garage with his muscle cars, never giving up any part of his time to any other machines. Just living.

Thanks to his big sister.

"Before the surgery, so many people were telling me that I was so brave, so courageous," Dana says. "It just seems to me in the journey of my life, it is an honor and a privilege to be in a place that I could give such an extraordinary gift."

The day she gave her brother his life felt just like Christmas.

Watch online: A 13-minute documentary in three parts at www.RockyMountainNews.com.

• Part 1: Meet Dana and Kirk

Kirk Derichsweiler faces years on dialysis unless he accepts his sister's gift of one of her kidneys. Dana Derichsweiler prepares to put her life as an endurance athlete on hold.

• Part 2: The kidney is transplanted

At Porter Adventist Hospital in Denver, the Derichsweiler family waits throughout the day to hear how Dana and Kirk fare in surgery.

• Part 3: The recovery begins

Kirk enjoys rebuilding the life he had ceded to the dialysis machine, while Dana takes on the physical challenges of recovery.

Ryckmanl@rockymountainnews.com or 303-892-2736

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