June 22, 2009

In Sickness and in Health: UCSF Clinical Fellow Donates Kidney to Ailing Wife

Daniel Ranch, MD, a pediatric nephrology fellow at UCSF, donated one of his kidneys to his wife of five years, Kana Kornsawad, MD, a research coordinator who, like Ranch, works in the Nephrology division of UCSF Department of Pediatrics.

As a pediatric nephrology fellow at UCSF, Daniel Ranch, MD, has witnessed time and again the transformative power of a donated kidney.

On April 28, he traded his lab coat for a hospital gown and gave one of his own kidneys to the person who already has his heart: his wife of five years, Kana Kornsawad, MD.

“I had always been an advocate for organ donation, and I knew the risks and benefits, so it was easy to make a decision very quickly,” said Ranch, 34, who had watched his wife’s health decline slowly but steadily since she first discovered blood in her urine in 2000.

“I was very tired a lot and I had a lot of muscle cramps,” said Kornsawad, 35, a research coordinator who, like Ranch, works in the Nephrology division of UCSF Department of Pediatrics. “By the end, I couldn’t even wake up in the morning.”

Kornsawad, whose kidney function had been weakening for years, had been warned that a transplant would eventually be necessary. But it was only when her kidneys reached a certain level of deterioration in mid-2008 that her doctors began performing the extensive medical tests that showed she and Ranch were a viable organ match.

“With the shortage of donors, it’s always good if you can find someone you know who’s a match,” Ranch said.

Nearly 80,000 people in the United States including more than 16,000 in California alone are currently on the waiting list for a kidney transplant, according to the US Department of Health and Human Services.

Ranch, who had held off registering as an organ donor in order to “save” his kidney for his wife, said he “didn’t have to think twice” about going through with the procedure, even though it would be his first time in the hospital as a patient.

The couple, who first met in medical school in Thailand, was admitted to UCSF Medical Center on a Tuesday. Ranch was home by Thursday, with Kornsawad joining him the following day.

Testament to Transplant Team

“It’s really a testament to the great work they do here at UCSF,” Ranch said of the top-quality care the pair received from a team that included lead transplant surgeons Peter Stock, MD, PhD, and Chris Freise, MD, and kidney transplant coordinator Melissa Danko, RN.

In 2008, UCSF celebrated its 45th year of transplantation, with more than 10,000 successful operations under its belt. Kidney transplants comprise about 80 percent of transplant procedures at the medical center, making it the world leader in kidney transplantation. In addition, the hospital is currently the nation’s second-largest center for living-donor kidney transplants.

Kornsawad said the first two weeks after surgery were “really tough,” but she had ample help from Ranch and her mother, who traveled to San Francisco from Thailand to care for her daughter and son-in-law.

One month after the transplant, the large bowl of prescription pill bottles in the couple’s kitchen was the only outwardly visible sign that anything had taken place. Kornsawad must take multiple immunosuppressive medications to avoid infection and prevent her body from rejecting the new organ.

“She hasn’t felt this well in two or three years,” Ranch said of his wife, who has since returned to work and is in the process of applying to residency programs in internal medicine a career goal her illness had threatened to derail.

Of course, Ranch and Kornsawad realize that the kidney transplant is a treatment, not a cure. From the time of surgery, the typical kidney transplant lasts 10 to 15 years, Ranch said, and that timeline can be much shorter if patients fail to take their medication.

Ranch said he hopes the day will soon come when new treatments such as stem cell therapy offer a longer-term solution to his wife and the many others suffering from kidney disease.

Such innovations could very well originate at UCSF, which has long been on the cutting edge of stem cell research and in 2010 will open a research building on the Parnassus campus entirely devoted to the field.

“That’s our hope that 10 to 15 years from now, there will be a whole new set of options out there,” Ranch said.

Photos by Susan Merrell

Testament to Transplant Team

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