VCU news

By Marcia Meredith

Twenty-five-year-old Stephanie Fedro has two people to thank for two new organs and her second chance at life. She is believed to be the first patient in the United States to receive both a kidney and a liver from two living donors.

"They risked their lives to save mine," Fedro said, a resident of Chesapeake. "I feel like I could never repay them for what they did for me."

Fedro received the organs in two separate transplant operations at Virginia Commonwealth University’s Medical College of Virginia Hospitals. Last September, long-time family friend David Rogers gave Fedro the right half of his liver. Then in May, her sister Pamela Christenbury donated a kidney.

Fedro suffered from a rare metabolic disease called hyperoxaluria, where the liver lacks an enzyme that filters out small calcium crystals called oxalates. The resulting calcium buildup leads to kidney stones, eventual kidney failure and a deadly accumulation of toxins and calcium deposits in the blood. Left untreated, the disease puts patients at risk for blindness and heart problems.

The signs of Fedro’s disease began when she was a baby. She developed kidney stones as an infant and was diagnosed with the disease at age 12. But her doctors believed she would outgrow it.

Eleven years later, feeling fatigued, nauseous and concerned about a peculiar taste in her mouth, Fedro went to her physician for a check-up. She discovered that her kidneys were failing

because her liver disorder had led to the deterioration of a large portion of her kidneys. Doctors

told her she needed immediate dialysis to filter and clean her blood and ultimately would need a kidney transplant. They also recommended a liver transplant because her disease would eventually destroy even a transplanted new kidney.

Fedro was referred to VCU’s MCV Hospitals to be evaluated for the two transplants but she faced a five-year-wait on the organ transplant list. Doctors told her about another option – living donor organ transplants, where adult family members or even unrelated adults donate a kidney or a portion of their own liver to the recipient.

"Living donor organ procedures make transplants possible for patients who otherwise might have to wait years for an organ," said Amadeo Marcos, M.D., director of VCU’s living donor liver transplant program. "These procedures often allow us to schedule the surgery when the recipient is still healthy and also choose the best organ possible."

With more than 4,000 living donor kidney transplants performed in 1998, the procedure is the third most common organ transplant in the nation. Living donor liver transplants are relatively rare, with fewer than 100 performed in the United States in the past year-and-a-half. Doctors at VCU’s MCV Hospitals performed what is believed to be the first living donor liver transplant from an unrelated donor in July of 1998.

To be considered a match, eligible donors must have the same blood type and a healthy liver that is large enough for the recipient.

"Once the physicians told me about the possibility of a living donor, everyone started coming forward. My cousins, friends and siblings all wanted to help me," Fedro said.

Her 41-year-old sister qualified for the living donor kidney donation. It was her mother’s boss, 38-year-old Rogers, who was determined eligible for the living donor liver surgery. "I’ve known Stephanie since she was 13," said Rogers, who also lives in Chesapeake. "I knew in my heart that stepping up to the plate for her was the right thing to do."

During the procedure, surgeons removed the right lobe, approximately 50 percent, of Rogers’ liver and transplanted it into Fedro. Because the liver is the only organ that regenerates, Rogers’ remaining liver and Fedro’s transplanted liver grew back to nearly full size within a few weeks. Seven days after surgery, Rogers left the hospital and returned home to his wife and two children. Within a month, he was back at work.

By May 1999, Fedro was ready to receive her sister’s kidney. The siblings’ four-hour kidney operations were a success.

Now Fedro is fully recovered and volunteers with the National Kidney Foundation. Without Rogers and her sister, she says she would not have had that chance or many others. This summer, she and her family even went on a week-long cruise to Alaska.

"My vacation was an enormous step for me. When I was sick, I couldn’t travel very far. Now, I’ve got my freedom back."