Facing a long wait ; Co-worker tries to help friend with failing kidney [Capital (Annapolis, MD)]

Every few weeks, Shane Seremet dials the number stored under "Tara Kidney" on his cellphone, ringing up the coordinator at the transplant center.

"Of course, she's going to call me when there's a match," Seremet said. "But I call her once a month."

Seremet, 24, is a waiter at an Annapolis restaurant. Both of his kidneys are fine. And he can't wait to give one away.

"All you can do is wait," he said.

Ambrocio Garcia, 33, knows the feeling.

The week his daughter was born in December 2010, Garcia was lying in a hospital bed in another wing at Anne Arundel Medical Center, fighting tears of panic. What Garcia had first written off as symptoms of a new father's sleepless nights were actually signals of end-stage renal disease.

The only cure is a kidney transplant.

Within a few months, doctors predicted he'd be inviting death if he didn't get treatment. His job as a cook at an Annapolis restaurant didn't provide insurance. The medical bills topped $100,000 for his week-long hospital stay, and didn't includethe costs for his newborn daughter, Jessica.

"I have a little girl, my wife was sick," Garcia said. "I didn't know what to do. I was about ready to cry, you know?"

When Jessica was 3 weeks old, Garcia returned alone to his childhood home in Oaxaca, Mexico, where he spent his savings and those of his brother to have a dialysis device installed in his belly. It'd take weeks for Maryland to approve his Medicare application.

By the time Garcia could order dialysis medication, the reality of his disease began to settle in: along with treating his blood four times a day, Garcia would begin his three- to five-year wait for a new kidney. Jessica would probably learn to walk, talk and draw before Garcia's surgery was scheduled.

Experts say about 90,000 people in the United States are waiting for a kidney, and 16,000 people get one each year. About 25 percent or 30 percent die while on the waiting list.

"I had a little daughter to take care of," Garcia said. "If I had a surgery, and then - then what?"

He went back to cooking on the line at Federal House in downtown Annapolis. In April, a waiter named Shane Seremet started working there.

Friendship

Seremet moved to Annapolis for the Great Books graduate program at St. John's College, but found himself employed at Federal House and striking up a friendship with a cook who immigrated from Mexico when Seremet was in grade school.

Seremet admired the way Garcia helped cousins, friends and strangers with the transition from life in Mexico, securing them jobs or lending money. Garcia would make frequent trips to the hospital to help translate the medical jargon into Spanish for friends who fell ill.

As they chatted over prep work, Seremet became enamored by tales of Garcia's village, Santiago Llano Grande, a town of 2,000 people where, Garcia swears, no women have to cook on Mother's Day. Garcia had raised chickens, farmed corn and tended to coffee trees in the days before his brother brought him to America at age 17 to work as a dishwasher.

Seremet liked the way Garcia pulled himself out of a dishwashing job by learning to cook from a chef at an Italian restaurant. At Federal House, Garcia would slip Seremet plates of habanero chicken wings, which Seremet gobbles up even though spicy food makes him feel awful.

He noticed Garcia's bloodshot eyes one evening, and Garcia confessed he hadn't been sleeping well. Seremet coaxed out of Garcia that dialysis treatments were keeping him up at night, but Garcia left out the other details of his disease. It was weeks later that Seremet learned Garcia needed a kidney - and a month later that his own was found to not be a match.

Quiet killer

Without a transplant, the 10-year survival rate for someone on peritoneal dialysis is 9 percent, said Dr. Matthew Cooper, director of kidney transplantation for the University of Maryland Medical Center, where Garcia is being treated.

"Dialysis is trying to mimic what kidneys naturally do 24 hours day in three or four one-hour sittings," Cooper said.

Many patients discover they're sick after being treated for swollen ankles, fatigue or headaches, Cooper said. Garcia's podiatrist had sent him to the emergency room after one look at Gonzales' blood pressure reading.

The kidneys remove waste and excess fluids from the blood stream, but failing kidneys don't present doctors with a lot of symptoms until 75 or 80 percent of the kidneys' function is lost, Cooper said. By then, a new kidney is the only remedy, and demand far exceeds supply.

At least a quarter of patients die before a new kidney becomes available, a statistic that Cooper said pushed science to come up with better alternatives.

Most transplants are from anonymous donors, people who died in car crashes or from heart attacks but left healthy kidneys behind. Living donors give recipients better odds for long survival, and the pool of people willing to donate has expanded beyond siblings, brothers and friends.

A living donor takes someone like Garcia off the waiting list for an anonymous organ. His brother volunteered to give him one, but the brothers' own kidney problems made it impossible.

About 300 pairs of mismatched donors are registered on a national kidney exchange database run by the United Network for Organ sharing. The organization said 15 transplants across the country, made possible by matches from the database, were scheduled to take place in the last three months of 2011.

About 100 pairs are registered on a Maryland network for kidney exchange, including Garcia and Seremet.

A surprising offer

One evening during the dinner rush, Seremet mentioned he was thinking of donating a kidney.

"At first, I thought that was a joke," Garcia said. "Because, I mean, nobody comes to you and says, 'I can give you a kidney.' "

The pair spent a day at the University of Maryland Medical Center, having tests done and enduring presentations on the risks of surgery to Seremet and the life of a donor afterwards.

"I realized I wanted to do it once I realized how low-risk it was," Seremet said. "We're not a match, but what they do is a paired exchange. My kidney goes to someone else, and he gets one that matches him."

They've been waiting for a companion donors since August.

"I don't know how to thank him," Garcia said.

"Sunday dinner?" Seremet suggested. "I get Sunday dinner for the rest of my life?"

Garcia said sure - after the surgery. For now, he gets those free spicy habanero wings.

---

[email protected]