I gave my mom a kidney. Here are 7 things you need to know about donation.

I’m really not the crusading type. Honestly, I don’t have the time or energy to pick up a righteous cause, after all the full-time working and momming and volunteering and writing is done. But, if I were a crusader for a cause, it would be organ donation. More specifically, kidney donation. 

My mom, Sherry, had a horrible, hereditary kidney disease: focal segmental glomerulosclerosis. (Say that even one time fast.) Of course, she was One Tough Mother™ first and foremost, so you never would have realized just how devastating this disease was for her. She was still cracking jokes, still running fried catfish plates out to customers at our family’s restaurant, still showing up unexpectedly to mine and Scott’s starter home to help me clean on Sundays. Yet, the disease was always in the background, taking its slow toll. 

Three days a week for two years, she drove her Yukon an hour to dialysis to have every liquid ounce of her blood removed and mechanically detoxified over the course of four hours — and then drove an hour back home. The day after dialysis, she would be almost completely non-functional which was so rare for her. The next morning, she would awake feeling rested and in good spirits, only to have to devote the rest of the day to dialysis again. 

All this time she was in kidney failure, Sher was on the transplant list, thanks to the careful stewardship of her nephrologist. She knew she didn’t stand any real chance of securing a new kidney, though. She’d begun smoking cigarettes when she was 14 and had never been able to kick them, and had a spate of health issues on top of the kidney disease. Diabetes. Congestive heart failure. Hypertension. Barrett’s esophagus. Hiatal hernia. Coca-Cola addiction. 

She had a better chance of winning the bronze in men’s gymnastics than of moving up on that list. 

Here’s thing one you need to know: The top cadaver donor spots are reserved for a. those whose need is the most dire, and b. those who have a reasonable chance of living a long and productive life following transplant. 

AKA, not my mom. 

So, I persuaded her to let me be tested to see if I was a potential match for donation. She agreed, begrudgingly, only because she thought there would be a next to zero chance that enough of my antigens would match hers for transplant to be a viable option. I’m adopted, after all. 

The joke was on her. The two of us had three of the same antigens, which, although not the ideal six-out-of-six, meant there was a pretty good shot her body wouldn’t reject my kidney. 

Thing two you need to know: An organ from a living donor, even if it’s not a perfect antigen match, is typically still a better option than an organ from a cadaver donor, as the tissue hasn’t begun to necrotize. This is a word I know now… necrotize. (editor’s note: means tissue death)

Once I knew our antigens were compatible, the decision was an easy one to make. I’ve had a harder time deciding what I wanted to eat at Waffle House. I think I knew all along that it was going to be me, but my mom had been less than convinced. 

“You drank a lot in college. You drink a lot now. Who says I even want your pickled kidney?” 

“If we put your kidney in my body, do you think I’ll turn into a smart ass like you?”

“I still can’t believe you passed that test. It must not have been a math test.”

I desperately wanted more time with her. 

Sher’s condition had worsened dramatically over the summer, and she’d become a frequent flyer at our small-town hospital’s emergency room. She was plagued with infections, blood pressure drops, and what we would find out later was latent tuberculosis. Neverending malaise was not a good look on a woman known for her imposing vibrancy. 

So, after a battery of assessments to determine my general degree of health, we booked the transplant at Piedmont Atlanta’s earliest availability… six weeks before my Labor Day weekend wedding. At the time, in 2007, Piedmont’s transplant team was the only group in Georgia offering laparoscopic nephrectomies. 

The third thing you need to know: a laparoscopic nephrectomy means the difference between a four-inch scar on the donor’s abdomen and the traditional 10-to-12-incher that runs catty-corner around the donor’s side. 

“We were prepped in separate rooms, which was a sensation that set both of us on edge. As a child, you want to be with your mom before she goes into surgery, and, as a mom, you want to be with your child before she goes into surgery.”

The day of the procedure was a nervous one. My mom and I arrived at Piedmont at an ungodly hour — something like 5 a.m. — and filled out the paperwork, speaking in quick whispers and looking bleary-eyed around the waiting room. What does one talk about with her mother before a set of surgeries that could save one of us, or kill us both? The last episode of Law & Order: SVU, as it turns out. 

We were prepped in separate rooms, which was a sensation that set both of us on edge. As a child, you want to be with your mom before she goes into surgery, and, as a mom, you want to be with your child before she goes into surgery. 

My surgeon, Dr. Johnson, arrived, his pale blue eyes and spray of gray hair stood out more than usual against a tan that suggested he’d summered somewhere that people surf. 

“You ready to have one really huge right kidney?” 

He was kidding, but only somewhat, which brings me to thing four you need to know: We really don’t need two kidneys. When a kidney is removed from a living donor, the remaining one doubles in size within 48 hours to accommodate the same filtration load. The human body really is an unmatched marvel. 

Dr. Johnson once again explained what I already knew… that I would be ready to resume normal activities in about six weeks, but I wouldn’t be back to my usual self for the better part of a year. I would come to understand this reality within a couple weeks of being home. 

Aside from the abdominal soreness (you truly don’t realize how often you engage your core until you have a horizontal incision bisecting your muscles), I tired very easily for the first nine months. Mid-day naps, once reserved for #sundaybumday, became must haves. Still, my mom had it worse.

Thing five: Most people think transplantation is tougher on the donor, but it’s really the recipient who has the worse go of it. While the donor’s body adjusts to its new norm with relative ease (see thing four), the recipient’s body has detected a foreign entity and kicked the immune system into high gear to make it GTFO. And the immunosuppressive anti-rejection medications that tell that immune system to chill are thousands of dollars. My mom’s medications, specifically, cost north of $4,000 monthly.

We both recovered beautifully in the months following the transplant. There were small changes we each had to make — she could no longer enjoy grapefruits as they would interfere with her anti-rejection meds, I had to add water to the list of beverages I regularly imbibed — but our lives carried on mostly as they had before. Until they didn’t.

Sher is gone now. The same disease that blighted the kidneys she was born with came for mine also, and this time it won. But that kidney bought her seven more years on this earth. In those seven years, she got to watch her daughter get married. She was able to see her first two grandchildren born. She started attending church on Sundays again — something she had once loved but had given up in the years when she’d been so sick. Yes, it was only seven years, but it was seven years.

If you think you may want to be an organ donor, sign up with United Network for Organ Sharing’s (UNOS) at unos.org, because…

Thing six to know is that checking the organ donation box on your driver’s license application doesn’t actually ensure your organs will be donated upon your demise. Unless you’re present on a national registry such as UNOS, the decision will ultimately be your family’s. 

Finally, here’s the seventh, and the most important, thing you need to know about kidney donation: It is absolutely worth it. 

Editor’s note: the entire Conversational editorial board is now registered as organ donors with UNOS.