Jun 14, 2023
Home Dialysis Patient Receives a Second Chance at Life Through a Paired Kidney Exchange

After a year and a half of managing her kidney health with peritoneal dialysis, 24-year-old Taiylor Kriss is entering the next stage of her kidney journey: living with a transplanted kidney.

She has her friend, Pat Giannaccini to thank—even if she’s not currently living with his donated kidney.

Kriss and Giannaccini met in 2018, three years before Kriss experienced kidney failure and began dialysis. From the start, Giannaccini was aware of Kriss’s health needs. She was diagnosed with Alport Syndrome, a rare genetic disease that affects the kidneys, inner ear and eye, when she was a baby.

When she started dialysis treatments as a young adult, Kriss took to social media to find community with other young adults facing similar health experiences. She helped educate others on Alport Syndrome and kidney health—and asked for people to consider living kidney donation.

With nearly 100,000 people currently on the national waitlist for kidney transplantation, living donation provides an opportunity for individuals eligible for the procedure to receive a transplant sooner. Living donation also comes with the potential of better health outcomes, including the likelihood that a transplanted kidney will last longer.

While Kriss continued to share her story across social media channels—even connecting with a few potential donors that didn’t pan out—Giannaccini became more aware of his opportunity to help.

“I’ve always known Taiylor has this rare disease and that she’d need to be on dialysis at some point, but it wasn’t something we really talked about,” Giannaccini says. “So when my mom told me about one of her posts I said, ‘alright, let’s get tested and see if I can help her out.’”

In September 2022, Giannaccini drove 50 miles to MedStar Georgetown Transplant Institute in Washington D.C., to determine if he was a viable donor and a match for Kriss. The news he received in early February 2023 was disappointing. Although he was determined to be able to donate a kidney, he was not a match for his friend.

Creating Living Donation Opportunities

Sometimes a transplant candidate has someone who wants to donate a kidney to them, but tests reveal that the kidney would not be a good medical match. The PKE process gives transplant candidates another option. 

If the recipient from one pair is compatible with the donor from another pair, a transplant center may arrange for a "swap", where two simultaneous transplants take place. This allows two transplant candidates to receive living donor kidneys and two donors to still be able to donate, though the original recipient/donor pairs were unable to do so with each other. 

Kidneys that come from a living donor last longer, on average, then kidneys from a deceased donor, and more than 98% of transplanted kidneys from living donors are still working one year post-transplant.

Although Kriss and Giannaccini were not a viable match, a type of living donation known as paired kidney exchange (PKE) meant the friends didn't need to lose hope.

Through PKE, donated kidneys are essentially "swapped" between two or more pairs of recipient candidates and living donors who are not compatible for transplantation. This creates a chain of transplantation that can be limited to two pairs, with two recipients and two donors, although algorithms have also made it possible to create larger chains. Eligible recipient candidates are effectively and efficiently matched to maximize access to transplantation in a short amount of time. 

For this reason, Giannaccini still wanted to donate his kidney to help Kriss receive one, even if his donation wouldn’t directly benefit her.

He returned to the transplant institute just two weeks later, and on Feb. 16, 2023, underwent surgery to donate his kidney, setting in motion an opportunity for Kriss to receive a transplant.

“I had some nerves ahead of the surgery, but knowing that I’d help both Taiylor and someone else lead healthier lives definitely helped me through it,” he says.

For Giannaccini, the recovery post-surgery was quick and uneventful. He returned home the following day and was back to work in just a few days.  

“I think the best way to support more kidney patients getting a transplant is through living donation,” says Maggie Igl, senior manager of clinical transformations for DaVita’s national transplant team. “And PKE is going to increase the likelihood that living donation can take place.”

This creates an opportunity for eligible and willing donors to make a difference in their loved ones’ lives as well as in the lives of people they do not know.

“I can’t say enough about how committed and motivated Pat was from the very beginning of the process,” Alex Radomsky, lead social worker for MedStar Georgetown Transplant Institute, says. “His act of generosity not only allowed Taiylor to receive a kidney, but others in the process.”

Just six weeks after Giannaccini had his surgery, Kriss received a call. A match had been identified, and Kriss was scheduled for surgery for May 10, 2023.

“I didn’t believe it at first, I was shell shocked,” she says. “It felt like an enormous weight lifted off my chest. I felt like I wasn’t going to have to fight anymore.”

Kriss texted Giannaccini after receiving the call to let him know her wait for a kidney was over.

“I was really excited for her,” Giannaccini says. “I knew how relieved she was to finally be getting a kidney.”

Kriss says the first few days of her recovery were challenging and surreal. She documented her recovery online, sharing information about her labs and daily milestones like walking up and down stairs. After three days in the hospital, she returned home.

The next stage of Kriss’s kidney journey includes adjusting to life without dialysis and managing her health with immunosuppressant medications to keep her body from rejecting her new kidney. She’s taking it one day at a time, but also allowing herself to think about what’s next.

“I’ve been thinking a lot about how I’ll have more mental capacity to simply live my life,” Kriss says. “I’ll be able to experience and appreciate more of the small things I’ve missed out on.”

Kriss plans to continue advocating for and supporting others in her online community, and says several advocacy programs have contacted her to express interest in working with them. She’s passionate about home dialysis and living donation, and especially interested in learning more about the interpersonal challenges patients face while on dialysis.

Most importantly, she’s grateful to have another chance at life.

“I know there’s so much more I can do for others and I want to continue using my experience to raise awareness,” Kriss says. “It feels incredible knowing this isn’t the end of my journey.”

Read more about living kidney donation here.