LOS ANGELES (January 4, 2000) – Thanks to the generosity of a virtual stranger who gave up one of her kidneys for him, and to a relatively new therapeutic approach, known as intravenous immunoglobulin (IVIG) that reduces the rejection risk of transplanted organs, Jay Cohen, 38, of Tarzana, CA, is enjoying the new year with his family -- with a healthy new kidney and a new lease on life. Despite the fact that a donor with an exact tissue match could not be found for him, Jay was successfully transplanted last July, is back to work and doing very well.
According to Dwight Makoff, M.D., Jay’s nephrologist at Cedars-Sinai Medical Center, what made this transplant unique was that the donor and the recipient were virtual strangers to each other. At least, they were strangers when they first met and the donor, Suzy Landolphi, offered one of her kidneys. Since then, though, they have become very good friends – teaming up to cheer each other on in what would be the fight of Jay’s life.
“In the hospital we went into pre-op together,” Suzi said. “We were lying side-by-side on gurneys, and I was asking him how he was feeling, and he was asking me the same thing. We were making each other laugh like two nervous athletes before the big game!”
When they came out of their respective surgeries after the transplant the first words out of Suzi’s mouth were “How’s Jay?” and the first question he asked was “How’s Suzi?”
The father of 3-year-old and 6-year-old daughters, Jay is a Hollywood film producer and has suffered with a lifelong kidney disease. When he turned 36, his creatinine levels began increasing. For a normal person, creatinine levels are at 1. Within nine months, though, Jay’s levels had soared to 13, and his condition worsened significantly. He began to experience severe and extremely painful leg cramps, daily nausea, weakness and weight loss – losing 30 pounds.
No stranger to the world of kidney disease, Jay’s two brothers had already had transplants. His wife, Laura, and other relatives offered to donate a kidney to him, but they were not suitable matches.
As he waited without a suitable donor available, Jay was placed on kidney dialysis three days a week for four hours each day. “I’d go in after work, from 4 – 9 p.m. on Mondays, Wednesdays, Fridays, and sometimes on Saturdays,” he said. “There, I would read scripts and make telephone calls.” During the five months that he was on dialysis, Jay lost another 10 pounds.
As time went on, a couple of friends offered to donate – one was not a match, and the other, while a match, backed out at the last minute. “I had such conflicting emotions,” Jay recalls now. “I knew I needed the transplant in order to live, but how could I ask someone – anyone – to make that kind of sacrifice? It’s just not the kind of thing you can ask of someone.”
Enter Suzi, a former radio talk show host, who is an expert on humor and sexuality and has appeared on a host of nationally syndicated television talk shows. Although Suzi’s husband, David Pritchard, knew Jay through work, the two men were not close friends, and Suzi didn’t know him at all. Then early this year, they happened to be attending a party that Jay and Laura were also attending. Something about him reached out to Suzi, and she couldn’t get him out of her mind. Several months later, on a Saturday morning, she turned to her husband and announced, “I want to give Jay one of my kidneys.” David gaped at her. “I was just going to tell you the same thing,” he said. “I want to give him one of mine.”
When they told Jay, though, his reaction was less than enthusiastic. “I had mixed feelings,” he remembers. “I’d had my hopes raised several times already, only to be dashed. I didn’t know if I could make it through another roller-coaster ride of waiting to see if our tissues were compatible, and then if they were, having the donor perhaps change her mind at the last minute. Plus, I wasn’t sure I wanted to have the responsibility of Suzi only having one kidney for the rest of her life.”
As it turned out, neither David nor Suzi were a suitable match for the transplant, but Suzi appeared to be a “closer match” than David, and Jay’s transplant surgeon, J. Louis Cohen, M.D. (no relation to Jay), sent them to see Stan Jordan, M.D., a nephrologist at Cedars-Sinai who pioneered the concept of using gammaglobulin in the transplant environment.
“Dr. Jordan made this transplant possible,” said Jay. “When we went through the initial tissue matching process to see if Suzi was a suitable donor, our tissues didn’t match. I basically had an antibody to Suzi’s kidney.” In the past, an incompatible cross-match generally meant no transplant. But Dr. Jordan was not about to give up so easily.
He decided to test Jay’s blood after an infusion of intravenous immunoglobulin (IVIG), a therapy that appears to be helpful in preventing rejection in difficult cases when other medications have failed.
Back in the late 1980s, as IVIG was becoming established as a therapy for immune system disorders, Dr. Jordan and other researchers at Cedars-Sinai Medical Center began to develop the concept of using gammaglobulin in a transplant environment. “IVIG treatment has given the gift of life to many patients – including Jay -- who would not have had a chance at transplantation or would have died or spent long periods of time on dialysis without the hope of a life-saving transplant,” Dr. Jordan said.
After treating Jay with IVIG therapy, Dr. Jordan tested again and found that Jay and Suzi were indeed a match. About 30 days after the transplant Jay needed one more IVIG treatment, and like all other kidney transplant recipients, he will take immune-suppresive drugs throughout his lifetime.
Jay is back to reading scripts, producing films and feeling great some five months after the transplant. And Suzi? She considers that while she may have lost a kidney, she gained two wonderful friends, and would do it again in a heartbeat. Then she adds as an afterthought, “I’d challenge anyone to try to keep up with me in kickboxing now!”
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