Unbreakable Bonds: The First Robotic Kidney Transplant Is a Testament to Lifelong Friendship

The first thing John and Declan did together after the transplant, was see a football game.
The first thing John and Declan did together after the transplant, was see a football game.

“There’s no friends like the old friends.”
James Joyce, Dubliners

Christmas last year was the day John Kennedy learned his brother-in-law Declan Donovan was giving him a kidney.

John and Declan’s connection runs deep, reaching back over four decades. Growing up together in Cork, Ireland, they lived minutes apart in the same neighborhood. “Declan knew me when I was a little boy just running around,” says John. “And he was a teenager trying to date my sister.”

Fast forward to the present, where Declan and John’s sister Susan are now married. They moved to New York in 1992 and have a son in college. John followed them across the pond four years later in 1996. Now engaged to his fiancé Jess, the foursome remains a tight-knit crew. So tight in fact, that John and Declan have seen each other every day for the last decade, working together at the same company.

Declan, John, Jess, and Susan.
Declan, John, Jess, and Susan.

“It was the end of October last year, and he just kept saying he wasn’t feeling good,” says Declan. “Every day he was coming into work, he was under the weather.”

“My fiancé kept saying, ‘Go to the doctor.’ But I just kept thinking it’s a cold, it will go away,” says John. Things only escalated. Persistent fatigue, vomiting, and a frightening incident where John fell asleep at the wheel on his way home from work led him to seek medical attention.

“My local doctor took my blood pressure, and it was 200/160,” says John. “He’s like, ‘You've got to go to the emergency room immediately.’ After that, it all happened fast.” The first thing they found was pneumonia, then blood work revealed his kidneys were functioning at only four percent. John had chronic kidney failure.

“They couldn’t understand how he was even alive,” adds Declan. “And they couldn’t understand why he didn’t have worse symptoms.”

That very day John started dialysis, and a kidney transplant needed to happen soon.

“As you can imagine, that was world-shattering,” says John.

Jess stayed by his side, and Susan took up the mantle of researching where to get a kidney transplant, quickly landing on NewYork Presbyterian/Columbia. “She said, ‘These are the people to go with,” says Declan. They contacted the Kidney and Pancreas Transplant Program at Columbia, and John’s family went in for testing.

Declan and Quinn on the hiking trail.
Declan and Quinn on the hiking trail.

On Christmas Eve, they received a call from transplant coordinator Dorothy Perry, turns out, that Susan and Declan were a match. “That was our Christmas discussion. We sat down and said, ‘Who should go forward from here?’ It was a very emotional day,” says Declan. Together, they decided that Declan was the best choice.

But little can be predicted in life, and the required testing for donors prior to surgery revealed some blood pressure issues—Declan needed to go on medication or lose some weight. Without skipping a beat, he changed his lifestyle, spent a lot of time on the hiking trail, and lost 35 pounds over the next few months.

“Dialysis was misery. It was misery. I would get up at 4 am every other day, go to dialysis, and then go to work. I lost hope a bit,” says John. “But it was just wild watching him do it. Declan was so determined. We would take our blood pressures together, and watching his come down started to give me hope again. He gave me hope again.”

By May, Declan was in great shape, and ready to save John’s life.

A Candidate for Cutting-Edge Robotic Surgery

When John and Declan went to their pre-op appointments with Lloyd Ratner, MD, Director of the Renal and Pancreatic Transplant Program, they both immediately felt at ease.

“Dr. Ratner is amazing. When I met him, he just inspired confidence in me right away. We talked a little bit about the transplant, and he asked me if I would be interested in this new robotic technology. He explained it would be his first time, but Dr. Ratner is just the kind of guy that would inspire confidence in everybody,” says John. “I said, ‘You can do whatever you want to me.’ Regular or robotic, it made no difference.”

In robotic-assisted kidney transplant, Dr. Ratner would be seated at a console, operating the surgical instruments on three robotic arms by viewing the surgical site with a camera through the screen. The robotic method allows for smaller incisions and is associated with a host of post-operative benefits like faster recovery time. As for Declan, the kidney donor, robotic surgery was not yet a viable option. “It was still a little too complicated to do robotic on the donor then,” says Dr. Ratner. “We wanted to get in and out.”

Dr. Ratner is no stranger to firsts. He’s been a trailblazer in the field of transplant surgery for decades. He did the first laparoscopic live kidney donor operation in the world in 1995, as well as creating new standards of care with paired kidney exchange transplants and the art of matching. As John said, “I wouldn’t want anybody else doing my transplant.”

Those long months of Spring before the transplant were some of the hardest days in John’s life. He needed several dental surgeries and moved to a new house, on top of having dialysis three times a week. “My fiancé and her family were amazing. My sister was amazing. Declan…they would help me every step of the way,” says John. “Every minute I was on dialysis, I think they felt it, too.”

John with his puppy, Archie.
John with his puppy, Archie.

Finally, the moment came. His transplant was scheduled for June 21st. And just in time, some joy scampered in; John and Jess got a puppy, Archie. The darkness began to lift.

With the first event of cutting-edge operation, there is a lot of planning, and with any transplant, there are several moving parts. Dr. Ratner was joined by several surgeons in the OR, including one who taught him the technique, and more watched from the gallery.

As for Declan, his surgery was straightforward, a conventional open procedure, four hours in and out. But for John, as the first person to get a robotic kidney transplant at Columbia, the surgery took nine hours.

“The way they described it was because it was the first time, it was going to go a little slower. They wanted to make sure everything was okay. I didn’t know the difference because I was asleep, but I know my fiancé and my sister were climbing the walls,” says John.

For both John and Declan, the transplant operations went beautifully.

Recovery Leads to the Joys of Post-Transplant Life

“I remember waking up from surgery, and the first thing I asked was, ‘How was Declan?’ As soon as I heard, ‘He's all good,’ I took a breath, and the most extreme pain in my life just hit me like a freight train,” John recalls.

The initial days in the hospital were difficult for John, his pain was immense. But about a week post-surgery, he started to feel anew. The absence of dialysis was a huge mental lift and boost in recovery, too.

“The best part is that I wasn’t surprised by anything,” says Declan. “Dorothy Perry, the coordinator, is amazing. They pretty much explained how everything would go, how surgery and recovery would go, and they were right on. It was such an accurate portrayal of what would happen. Everyone there, they’re just awesome people.”

In the immediate healing period after receiving a new organ, it can take some time to get the immunosuppressant drugs just right for each person. After a few months of tinkering with John’s medications to eliminate side effects, and his body adjusting to his new kidney, John’s return to a health was rapid.

As for his donor, Declan spent several days in the hospital and, within a week of going home, was back at work.

“We’re still fascinated and amazed by it. What they’ve done. What the technology did, and that John rebounded so quickly,” says Declan. “I keep saying that, basically, the surgery team just handed him his life back.”

But for John, it’s Declan he’ll be most grateful to forever. “I still can’t believe he did it. It’s such an amazing thing. I just can’t believe he did that for me. I really can’t.”

Declan’s recovery included a return to his favorite means of exercise, hiking with his dog Quinn. It took a few months to feel back to himself both mentally and physically, and hitting the trail aided his body and mind.

“I was doing a lot of Catskills hikes, but what I really wanted to do was Mt. Marcy in the Adirondacks.” Mt. Marcy rests over 5,000 ft., it’s the highest peak in New York State. “I said to my wife, as soon as I feel physically good after surgery, I’m doing Mount Marcy. I’ve got to do it.” In September, Declan bagged that peak.

Declan at the top of Mt. Marcy in the Adirondacks.
Declan at the top of Mt. Marcy in the Adirondacks.

John’s life with a healthy kidney is hard for him to describe. “It’s miraculous, that’s the only explanation I can give. Miraculous. I feel like a new man, I really do,” says John. “I feel like I’m in my 30s.”

This year, Christmas will be an entirely different affair. John, Jess, Declan, and Susan will spend it together, but this time it’s all celebration and gratitude.

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