Lynn Cosgrove will give to a total stranger

ANNE T. DENOGEAN
adenogea@tucsoncitizen.com

Tucsonan Lynn Cosgrove will enter University Medical Center on Tuesday to "pay it forward" by donating a kidney to a perfect stranger.
Her only motivation is to do a good deed and hope that it may inspire more good deeds, just as she was inspired to give up her kidney by another altruistic Arizonan.

About a year ago, Cosgrove read an article in the Tucson Citizen about Dr. David Spence, a Flagstaff doctor who on Oct. 14, 2003, became he first person in Arizona to make a "nondirected" donation, or donate a kidney without specifying the recipient. Most kidney donations from living patients are made to a family member, a fellow churchgoer, a friend or acquaintance.

But this relatively new phenomenon in donation - called nondirected, anonymous or altruistic donation - benefits any appropriate candidate on the waiting list. There have been 228 nondirected kidney donations in the United States recorded by the United Network for Organ Network since 1998, including 35 this year.

The trend of nondirected donations is being driven by the length of the waiting list and encouraged by new surgical techniques that have reduced the pain and recovery time for the kidney donor, said Dr. Sanjay Ramakumar, the UMC surgeon who will remove Cosgrove's kidney.

Spence's story was covered by all the Tucson media outlets, and the publicity led 16 people to come forward as prospective donors.

Cosgrove is the first to actually donate. One more is in the pipeline to donate soon, and four are undergoing testing.

Because the screening is extensive to ensure that the donor is not putting his own health in jeopardy, nine of the other people didn't qualify. Only one person withdrew.

Cosgrove, 37, said she likes to help people, but with two children and a full-time job as the operations manager at Kohl's department store, she has little to give in terms of time. Nor is she rich enough to donate a lot of money to her favorite causes.

"I give as much time as I can. I give blood, and I give platelets. This is just kind of the next step, and it doesn't seem like a big sacrifice to me," she said. "I think I'm getting just as much out of this as the person getting kidney. It gives you a really great feeling inside."

All Cosgrove knows about the person who will receive her kidney is that he's a Tucson man who has been on dialysis for four years and on the transplant list for two years.

Spence, who recovered from his donation without complications, said this is exactly what he hoped would happen.

"I certainly wanted to be public about the donation so that other people would consider the idea. I'm extremely pleased that a few other people have come up with the willingness to do it," he said.

A 2000 book and movie of the same name, "Pay it Forward" espouses the idea that you do a good deed for somebody and ask him to "pay it forward" by doing something nice for three other people. In this way, good deeds increase exponentially.

Though the "pay it forward" concept isn't the exact description for the actions of Cosgrove and Spence, it's close. Spence was inspired to donate a kidney by a chance meeting with a man who was bicycling across the country three months after his own altruistic kidney donation.

Cosgrove, like Spence, is not worried that her remaining kidney will cease to function or that someone in her own family might need a donation. She said she wants to help somebody live a better life today. She's in great health, and there's no family history of kidney disease or diabetes.

"When you are evaluating someone to be a kidney donor, they have to be extremely healthy," Ramakumar said. "The philosophy behind the extensive workup is, is this person going to be able to live the rest of their life with one kidney?"

On Tuesday, Ramakumar, doing the procedure laparoscopically to keep pain and recovery time to a minimum, will make several small incisions to insert instruments and one about 5 inches long, curving around Cosgrove's belly button, for the kidney removal. If all goes well, she'll be out of the hospital the next day, Cosgrove said.

She faces the normal risks of most surgeries, which include postsurgical pain and the possibility of complications such as infection, bleeding, pneumonia, blood clots or allergic reaction to the anesthetic. As with any abdominal surgery, there is a theoretical risk of injuring another organ, Ramakumar said. And there is a small risk that if the surgery doesn't go as planned, he might have to revert to the traditional open surgery to remove the kidney. That would mean a longer incision, more pain and a longer recovery time.

It is extremely rare - three deaths for every 10,000 procedures, according to medical literature - for a kidney donor to die while donating.

"I've told every donor that their safety is my first priority and giving a perfect kidney to a recipient is the second priority. And that's the order," Ramakumar said.

Cosgrove's husband, David, who coaches Pima Community College's soccer team, and her mother support her decision.

"She's a generous soul," Susan Nomura said of her daughter.

Nomura said she's not concerned about the surgery and the donation because her daughter is so calm and happy.

"It doesn't feel stressful at all. It feels natural," she said.

Ramakumar said nondirected donation may be the best way to make a serious dent in the waiting list for a kidney, a desperately long list with 62,895 names nationally, 676 in the state and 254 at UMC.

"That is a huge potential and the untapped market," he said

He said he tells all the donors he operates on, "You are a hero, and what you are doing is heroic."

Tucsonans seem to have the heart for donating. After stories last month about PCC police officer Jeffery Yoha, who needs a kidney, 19 people called UMC to talk about donating. While they are asking specifically to direct their kidney to Yoha, a few have said they would be willing to give to someone else if they are not a match for him, UMC spokeswoman Katie Riley said.

TO LEARN MORE:

Hundreds of Arizonans are waiting for kidneys. For information on the donation process, call the Kidney Transplant Program at UMC, 694-7365.

STATUS OF VOLUNTEERS:

Of the 16 people who came forward to offer a kidney after the Oct. 14, 2003, donation by Dr. David Spence:

2 are in the pipeline for a donation (Cosgrove being the first)

5 were ineligible because they have diabetes or are closely related to a diabetic

1 was over the age limit of 70 (UMC is considering raising the age limit.)

3 were ineligible because their Body Mass Index was over 30

1 withdrew

4 are still being evaluated

Source: University Medical Center