Mom needs a 2nd transplant
First kidney lasted 15-years
By Caitlyn Kelleher

Anne sits with her 10-year-old daughter, Abby, and her husband, Tim, in their Ashburnham house.

Fifteen years ago, Anne

Montalto was on the

Fs a m e list she is on right now.

It's a list that

doesn't care how long you have been waiting, it doesn't care how much you are hoping and the only way to move up it is to get sicker.

The 35-yearold mother is waiting for her second kidney transplant.

"My first transplant lasted me 15 years," said the Ashburnham resident, while sitting in her kitchen with her husband, Tim, and daughter, Abby. "I can't complain about that. At the time (of the transplant) it usually lasted about 10 years."

At 18, Anne she began suffering kidney failure because of a birth defect. Now, she is back on the transplant list because the medication she took to stop her body from rejecting the organ has caused the organ to stop functioning.

"The kidney's function is to filter the waste functions of metabolism out of the body," said Jayne Galley-Riley, a transplant coordinator at Massachusetts General Hospital. "It fails gradually and we are looking at the filtration levels."

When a kidney's function drops to less than 20 percent, then a person is placed on the transplant list, and while waiting is placed on dialysis.

Anne goes through the dialysis process three times a week for 3.5 hours each time. The dialysis machine replaces the kidney function.

"Usually towards the end of the treatment you start to feel lousy," Anne said. "My day off is usually my good day."

The process is exhausting because it takes some of the electrolytes that give people energy, said GalleyRiley. The other side effects include a lower than average blood sugar levels, a low amount of iron and a lower amount of fluid in blood stream, she said.

"Before Anne was sick we shared a lot of different things like household duties," Tim said.

Anne had to stop working as a microbiology medical technologist because of both the time commitments to the dialysis and her lack of energy.

This is the second time since her first transplant that she is back on dialysis. In 2000, doctors thought that she was going through a rejection of the transplanted kidney. But after a few months of medical treatments and a change in medical facilities, doctors adjusted the medicines correctly and the kidney began to function normally again. There is no hope of medication adjustments helping this time.

There is no time limit as to how long Anne can continue on dialysis for. She has been back on dialysis for about seven months now.

"As time goes on it begins to take its toll," Tim said. "It's bad for your heart, bad for your bones, bad for your circulation."

Anne is already is losing bone density because of the dialysis, which will increase her chances for osteoporosis as she gets older.

The couple's goal is to find a living donor as quickly as possible.

"It's not just first come first serve," Tim said.

The most likely type of transplant for Anne right now is a living donor transplant because the donor can designate a recipient. There are two types of living donors - related and non-related.

"My brother was going to donate but they've discovered he has kidney problems and is not healthy enough to donate," Anne said.

A non-related donor is a person that matches with blood and tissue types, doesn't have any medical issues that rule them out and have a kidney the "right" size.

"If someone was to be a donor (the surgery) would be scheduled around their own schedule," Tim said.

Galley-Riley said a donor must be in very good health. The donor can not have a family history of diabetes and they can't suffer from hypertension among other health screening issues.

"After donation the donor's remaining kidney gets a little larger to accommodate them," she said.

The other type of transplant is a cadaver transplant, which is also broken down into two categories. GalleyRiley said the two types of transplants here are because a person with severe brain damage was taken off life-support or because a person is considered a "cardiac death donor."

A cardiac death donor is typically a person whose been involved in a massive car accident and received injuries of severe they won't survive.

In each case, if a family decides to remove the life-support measures then the organs can be donates, GalleyRiley said.

Anne is on the waiting list for a cadaver kidney but these are selected based on a patient's illness level and Anne is one the bottom of that list.

The final type of kidney transplants that Mass General performers are for recipients and donors who are over 50-and 60-years-old.

The wait for a transplant is effecting many aspects of the family's life from the way they plan their day to trying to plan a vacation.

"I have to go in late because she goes early in the morning (to dialysis) and Abby has to get off to school," Tim said.

Tim and his brother own Beacon Site Development and Consultants, based out of Holden.

"It's depressing that you have to plan vacation around dialysis," he said. "She doesn't feel well on a lot of days so it's hard to plan other things."

The couple each has different fears about this process. Tim's is simply Anne "not getting a transplant."

Anne is worried about the mounting medical bills.

"The long she is on dialysis the more costly it gets for all of it," Tim said. "The co-pays are ridiculous."

Anne and Tim have kept their daughter educated on Anne's health struggles.

"I don't want to hide it from her," Anne said. "I think that would hurt her in the long run."

Keeping Abby aware of the medical process is helping Tim's longterm goal of making the general public more aware of transplant issues.

"We just want to ask people to learn about living donors," Tim said. "There are a lot of people out there that have really good kidney function."