During a decade of working as partners at the Milwaukee Police Department, detectives John Kuspa and Mark Wagner developed a solid friendship, a brotherly bond that only cops who share a squad car for years can understand.
But now the two are intrinsically linked on an even deeper level: John has one of Mark’s kidneys.
Appropriately enough for a story about a renewed life, Mark called John on Easter Sunday last year with some great news: John’s roughly year-long wait for a kidney was over. John was taken aback by the news because Mark never told him he had stepped forward as a possible donor.
“I was completely shocked … I got all choked up,” said John, 50, of Milwaukee. “I’m not one to ask people for things, much less an organ.”
“I knew we had the same blood type, so I decided to get tested to see if I was a good candidate,” said Mark, 48, a Pewaukee resident. “I didn’t tell him I was going through the testing process because I didn’t want to get his hopes up.”
The transplant was performed May 27, 2020, at Froedtert Hospital by a team including Joohyun Kim, MD, PhD, a transplant surgeon and Medical College of Wisconsin faculty member. Froedtert Hospital is the academic medical center of the Froedtert & MCW health network.
The COVID-19 pandemic did not affect the transplant process, aside from the roughly six weeks between Easter and the surgery when John and Mark limited contact with people and avoided travel. Their diligence paid off.
Timing Is Everything for Routine Transplant Procedures
A kidney transplant typically takes two to three hours and has become a relatively routine procedure," Dr. Kim said.
Nonetheless, a kidney transplant remains a delicate exercise in timing. While one surgeon removed Mark’s kidney laparoscopically, a minimally invasive surgical method, Dr. Kim prepared the transplant site near John’s pelvis.
Mark’s procedure required only an incision by his navel and two smaller incisions on his left side. For John, the transplant required an incision similar location-wise to an appendectomy. Next, Dr. Kim gently pushed aside abdominal contents to make room for the new kidney. The nonfunctioning kidney remains in place.
After removing the kidney from the donor, it’s put straight into the recipient. The two operating rooms are next to each other, so the kidney travels only about 20 feet.
John was familiar with transplants, having received a new liver about 13 months before his kidney transplant.
Making the Big Decision to Donate Life
There are many things to consider when deciding to donate a kidney. At Froedtert Hospital, donors are supported by an independent living donor advocate.
“The advocate helps donors consider all aspects of a transplant, both physical and mental,” said Ami Blatter, living donor kidney coordinator. “For example, donors need to consider the possibility that the transplant could fail, even though that’s uncommon, which would render their donation unusable.”
They also need to consider that donating a kidney means they can’t give one to a family member if the need arises, something that Mark said crossed his mind because he has two sons.
Donors also must prepare mentally for the fact that they, too, might need a kidney someday. But Mark said his concerns were eased because kidney donors get a degree of preferential treatment if they ever need a kidney. “There’s much more to think about than just the physical aspects of a transplant,” Blatter said. “We want to make sure donors consider all the angles.”
Searching for the Right Donor Match
Donors must go through a comprehensive battery of tests, screening and exams to determine their donor eligibility. A multidisciplinary team handles the process: a nurse coordinator, a nephrologist (a kidney doctor), a transplant surgeon, a dietitian, a pharmacist, a social worker and an independent living donor advocate.
After reviewing all the assembled data, a selection committee decides whether or not a donor is qualified. The process typically takes about three months, but the goal is to make it as convenient as possible, including scheduling as many tests as possible on one day.
“They’re coming forward to save a life, so the least we can do is make that process as easy as possible,” she said. “We definitely cater to our donors.”
The Froedtert & MCW nephrology team evaluate donors, guides them through the extensive testing process and sees them as outpatients after surgery.
If donors aren’t compatible with their intended recipients but still want to donate, they can be matched to a different recipient through kidney exchange programs. For Mark and John, the stars aligned.
Transplant ICU: Quick Recoveries and Quality Care
After the surgery, John stayed in the transplant intensive care unit (ICU) for five days; Mark was there for about three days.
“Our transplant ICU is quite unique in the country,” Dr. Kim said. “It’s dedicated solely to transplant patients, which makes a big difference in the level and continuity of care. We couldn’t be as successful as we are without the transplant ICU.”
Mark said he experienced no side effects after the procedure.
“I don’t feel like I donated a kidney,” he said. “I still can do everything I did before.”
For John, the transplant’s main result was much more profound — a new lease on life, free of dialysis. While he must take anti-rejection drugs for the rest of his life, he has no other major restrictions.
“Physically, I don’t notice any difference,” he said. “But I find it pretty mind-boggling that your body can accept a new organ and still function.”
John said he can’t say enough good things about the care he received.
“Everyone was exemplary, from nurses to aides to the surgeons that do the magic,” he said. “It was a team effort throughout – that’s what most stands out to me. I actually enjoy going back for check-ups because they make everything so comfortable. I wouldn’t go anywhere else.”
Would Mark consider being a donor all over again? “Absolutely — if I had a third kidney,” he said.
For John, the transplant marked the culmination of a long journey from alcoholism to sobriety. He said he still participates periodically in a support group for liver transplant recipients and enjoys counseling people as they prepare for a transplant.
“Some organ transplants stem from some kind of substance abuse, so if a person receives a new organ, it’s important they don’t abuse substances again,” John said of the initial 12-class program Froedtert Hospital provides for organ transplant recipients.
“Helping others is the least I can do,” he said. “I was drinking myself to death, but now I’ve been sober for more than two years and have a completely new outlook on life.”
John also said it’s hard to find the words to thank Mark for the kidney donation.
“To say I’m grateful is an understatement,” John said. “It’s like someone taking a bullet for you when you’re in the line of duty. But that’s what we do in law enforcement. We sacrifice for others, and that’s just how Mark is. He’s very loyal to his family and his friends. If the situation had been reversed, I’d do the same thing for him.”
