Doing Good Feels Good: The Journey of an Altruistic Kidney Donor
Annie Hoffnung—a wife, mother, and chief human resources officer at a public relations firm—donated a kidney to a stranger on February 28, 2023. Considered an “altruistic donor,” she belongs to a small group of organ donors who care so much about the welfare of others that they’re willing to take significant time out of their lives and undergo surgery to save the life of someone they don’t know.
“It was something I felt I could and should do,” she says, ever since she saw an ad in her synagogue bulletin announcing that a community member needed a kidney and inviting people to consider becoming his donor. “That person, who my husband knew, needed a donor with an A or O positive blood type.” So far, so good. Annie believed she fit the bill.
She went ahead and submitted an application form to Weill Cornell Medicine’s Kidney Transplant Program, and four weeks later, went in for initial blood work. As hoped, she was compatible with the person from her community who urgently needed a kidney.
However, another prospective donor was ahead of her in the queue, so her kidney wouldn’t be needed after all.
That was when Annie was introduced to the concept of becoming a non-direct, or altruistic kidney donor, where you give the gift of life to someone you don’t know.
No small decision
Annie lives in the Riverdale section of the Bronx with her husband, Ari, and their three school-aged children. They spoke about what it means to be a kidney donor, how life-changing it would be for the recipient, and decided as a family that this was something important to pursue despite the inherent risks. They agreed that the recipient didn’t need to be a friend or family member, since “everyone deserves a chance to spend more time with the people they love.”
Annie’s mother and mother-in-law were both a bit harder to persuade, “understandably so,” Annie said. They feared the risks of major surgery, including a tough recovery and even, heaven forbid, a fatal outcome.
Such fears are reasonable, says Dr. Joseph Del Pizzo, the E. Darracott Vaughan Distinguished Professor of Urology and Surgery and Director of the Advanced Minimally Invasive Kidney Donor Program at Weill Cornell Medicine. “Donating a kidney back in the 1980s and 1990s involved open surgery, a large incision and scar and a prolonged recovery.
“Then, in the late 1990s, minimally invasive laparoscopic surgery soon became the gold standard for kidney donation, and everything changed,” he continues. “Patients recovered in two to three weeks instead of two months. Living donation is also quite safe. The vast majority—roughly 99 percent—come through the surgery without incident, and they tend to resume all of their normal activities in a month.”
About 10 years ago, Dr. Del Pizzo helped improve the laparoscopic technique for the removal of a kidney from a living donor by pioneering a method called laparo-endoscopic single-site (LESS) surgery, which allows for the removal of a kidney through a single, small incision. That’s the method he used with Annie. “Her scar is well hidden in her belly button,” he says, making it barely discernible to the naked eye.
Conversations, tests and education
Annie went through extensive medical, radiographic and psychological evaluation in the run up to her procedure. “We always want to make sure that the donor goes into the process with a clear mind,” Dr. Del Pizzo says.
The 46-year-old mom from Riverdale interacted with every member of the kidney transplant team, including an internist, psychologist, social worker, nurse practitioner, program coordinator, and patient educator. She met her surgeon—Dr. Del Pizzo—last of all. “That makes sense,” he says. “Everyone focuses on the surgery, but there’s so much more that needs to happen before the patient is wheeled into the Operating Room.”
Is living kidney donation common?
Far fewer than half of the transplanted kidneys in this country come from living donors. Most people don’t have access to someone who is willing and able to give them a kidney. It’s also possible that doctors aren’t educating their patients about the living donor option. Patient and referring physician education is key, Dr. Del Pizzo says. Kidneys from living donors work better than those from deceased donors, where it may take a day or two before a suitable recipient is found.
Without a living donor, patients with advanced kidney disease may end up on dialysis for years while they languish on a very long waiting list.
Dialysis, whether performed at a dialysis center or at home, takes several hours per day for three days each week. It’s effective in cleansing the body from toxins that are normally handled by the kidneys. However, patients who are on dialysis for an extended period of time can develop skin problems, as well as abnormal growths on their kidneys. And it takes a huge psychological toll, upending a patient’s ability to work and participate in family and community life.
But living donation is a growing option. At Weill Cornell Medicine, the ratio between living and deceased kidney donation is about 50-50, he says. Soon, he hopes, “living donors will outnumber deceased donors at our medical center.” And that will be great news for all concerned.
As for altruistic donors, they are still rare, but not as rare as you might think. “At Weill Cornell, we actually see about two altruistic donors each month.”
Social media are also playing a role in the uptick in altruistic organ donation, he adds. Annie herself says she has been spreading the word to “create more awareness about an opportunity that most people have never really thought about.”
A deeply rewarding process
One of the most meaningful moments came when Annie learned that her kidney, which was immediately transported by a courier on a commercial airline from New York to Tennessee, was successfully transplanted in a patient at Vanderbilt University Hospital. “It was a deeply emotional moment when I learned that my former kidney was working in its new owner’s body.”
She also found it extremely rewarding to experience the power of community. “My recovery would have felt very different if I hadn’t had the support of my amazing family, friends and colleagues. I felt surrounded by so much love,” from frequent visits to daily meals for the entire month following her surgery.
Annie’s kids, ages 9, 11 and 13 at the time, were very proud of her and excited to share in the good deed by helping a little more at home while she recovered. “It is really important for donors to have a support system in place during recovery.”
And finally, she says, “doing good feels great. I wish everyone could feel the sense of joy and pride I’ve experienced throughout this journey. I’m not a doctor and never thought I would have the opportunity to help save someone’s life. At the end of the day, this only had a minimal impact on me as the donor but was life-changing for the recipient.”
Annie described the care she received at Weill Cornell Medicine in glowing terms. “Not only was the staff amazing, but unlimited La Croix sparkling water and ice cream didn’t hurt either. I also love my special ‘living kidney donor’ pillow!”
She wasn’t totally prepared for the first couple of weeks after surgery, which were harder than she expected. Otherwise, her recovery has gone smoothly, and she has since returned to her normal activities at work, at home and out in the world, including family bike rides and getting back to Broadway theater, one of her favorite pastimes.
Annie confesses to being the kind of person who always feels she should be doing more for others. “There are so many people who experience indescribable hardships that what I did seems easy by comparison,” she says. “I’m continually working on finding meaningful ways to contribute and lead by example for my kids.”
Her altruistic act did far more than help one individual in dire need of a kidney, says Dr. Del Pizzo. “Annie not only helped the recipient but indirectly helped tens of thousands of people. Once her recipient came off the national registry list, everyone else moved up.”
To learn more about Weill Cornell Medicine’s Kidney and Pancreas Transplant Program or to consult with a surgeon, please visit their website or call 212-746-3099.