As a transplant coordinator at University of Colorado Hospital, Holly Strain, RN, knows the ins and outs of kidney donation. Strain works to find donor kidneys for people suffering end-stage renal failure. They face batteries of tests, screenings and interviews before they can become candidates for a donor organ, but in many cases, as Tom Petty said, the waiting is the hardest part.

At UCH alone, more than 1,000 people are on the waiting list for a donor kidney, notes transplant surgeon Thomas Bak, MD. But there is a way to cut the wait time: find a living person willing to donate one of his or her kidneys. A live donor eliminates the uncertainty of languishing for months or even years on a waiting list. A scheduled surgery with time to prepare replaces a last-minute call and a race to the hospital.

“I tell every person I see who needs a kidney that finding a live donor is their best option,” Strain said. In her first year with UCH, she’s contributed to the success of the hospital’s Living Kidney Donor program, which recently surpassed the 1,000-transplant milestone (see accompanying story, this issue).

Holly Strain, RN, a transplant coordinator at University of Colorado Hospital, donated a kidney to her sister-in-law, who suffered from polycystic kidney disease.
Today, Strain, 32, can speak to her patients with even greater authority than ever before because she is herself a living kidney donor. She will also have the satisfaction of regularly seeing the benefits of her donation. The recipient is her sister-in-law, Kate Bobrow-Strain, 45, who is married to the brother of Holly’s husband.

Urgent need

Kate, who has two kids and lives in Walla Walla, Wash., suffers from polycystic kidney disease, a genetic disorder. The disease produces cysts in the kidneys that gradually destroy their function. In 2014, she became eligible to go on a waiting list for a donor kidney and was referred to Swedish Medical Center in Seattle.

Holly was then working with transplant patients at Washington Hospital Center in the District of Columbia. She and her husband both immediately considered becoming donors. Her husband’s blood type wasn’t a good match for Kate, but Holly’s was. She decided to move ahead with the process, which included a thorough evaluation: blood work, urine testing (for infections and protein, which is a sign of kidney damage), a chest X-ray and an EKG (both necessary information for anesthesia).

After her last day at work in D.C. – she’d accepted a job with the Transplant Center at UCH – Holly flew to Seattle to meet with Kate and her providers, then returned home. She and her husband piled their belongings and cat into a Penske truck and headed to Colorado. She’d settled into her new job last December when Kate’s kidney function plummeted. Holly redid her blood and urine work at UCH, and the transplant surgery was scheduled for Monday, Feb. 1.

“At that point, Kate would have needed the transplant within a month or she would have had to go on dialysis,” Holly said.

Not quite sleepless in Seattle

The two couples were in Seattle for Holly’s pre-op visit the Thursday before the surgery . They rented an apartment and filled the time with one another’s company, including a ferry ride to an island outside Seattle. At 4 a.m. Monday, the alarm went off. The foursome pulled on sweatpants and walked through dark, rainy Seattle streets to the hospital for the procedures.

“I had never had surgery before, but this was a good way to do it,” Holly said. “I had time to think about it, ask questions, and learn about aspects of what it would be like.”

Both procedures went smoothly and Holly spent two days in the hospital recovering. She even got a photo of her donated kidney. Kate was hospitalized three days, then stayed in Seattle a couple of more months for follow-up. As of mid-April, she had full kidney function, Holly said. Her own recovery went well, the biggest challenge being the six-week post-op period that prohibited running and biking.

Both Holly and Kate have normal creatinine levels, a key measure of the kidneys’ ability to clear waste from the bloodstream. Holly got her lab work checked at six weeks, and will do so again at six months, one year, and annually thereafter, along with regular blood pressure checks. The follow-up schedule for Kate will be more frequent and intensive.

Closing the circle

As prominent as transplant is in Holly’s life, she didn’t plan it that way. She attended nursing school at Georgetown University and completed a practicum with rotations on various units at Washington Hospital Center. When it came time to choose a floor to work on regularly, however, she decided she wasn’t all that interested in any of them and asked her advisor if anything else was available. It turned out there was a spot available on the kidney transplant floor.

Fittingly, it turned out to be a perfect match. “The medications are interesting and there are always new and different ways to work,” Holly said. “Transplant patients are complicated, but they come up from surgery with a big smile on their face. It’s awesome to be such a huge part of someone’s life.”

This year she continued to learn about organ donation. “Everyone who works in transplant thinks about whether or not they would do it for a stranger,” Holly said. “It seems at first like a weird thing to do to give someone an organ. But people then see what it can do for another person and how much it benefits them.”

She says her experience has helped her as a provider. “I think I have a better understanding of what organ donation entails. It was amazing for me personally and amazing to be able to watch Kate avoid dialysis and be able to enjoy her life.”