Saeeda Hafiz is winding down a four-month visit from Pakistan.
But she hasn’t been here simply to see her sister and family. She came to give a kidney to her nephew, Ahmed Khan.
In what she calls her “lifetime achievement,” Hafiz, 49, donated a kidney to Khan, 22, on Sept. 15.
“It was a big thing for me to leave my kids and husband in Pakistan, but when I decided, I really wanted it to happen,” she says. “It was my utmost desire.”
Khan’s kidneys began to fail last year, and he was diagnosed with chronic renal failure. In November, he began dialysis three times a week. “It was like a part-time job for 15 to 16 hours a week,” Khan says.
Everyone in his immediate family was willing to donate, but each person was eliminated for one reason or another. And while no one asked Hafiz to make such a sacrifice, she offered to do so without hesitation.
“In our culture, family means a lot,” Hafiz says, on the eve of her discharge from St. Michael’s Hospital. “This nephew of mine is very close to me as well.”
Each year up to 10 people travel to Ontario from overseas to provide a kidney or piece of their liver to a loved one.
A program by the provincial organ transplant agency Trillium Gift of Life Network picks up much of the expense, including flights, accommodation and meals while donors are in the province before and after the surgery.
“Our goal is to minimize the financial burden,” says Ronnie Gavsie, CEO of the network. “We can’t totally remove it, but we do work very hard to minimize it.”
The Program for Reimbursing Expenses of Living Organ Donors (PRELOD) reimburses about 200 people annually, but the vast majority are Canadians, Gavsie says. Applications for the PRELOD program are on their website.
Toronto’s large immigrant population often has a more extensive network in their home country than here, says Dr. Jeffrey Zaltzman, director of the transplant program at St. Mike’s.
That was the case for Sergiy Tyulenyev, whose friend came from Armenia and donated a kidney in August. Tyulenyev’s kidney problems started in 2005, but were managed with medication until late last year.
“I was prepared to start dialysis, but then my friend proposed that he help,” says Tyulenyev, 49. “For me, (the offer) was a shock,” says the Ukrainian-born IT professional and married father of one. “I didn’t expect it, I didn’t ask. He proposed it himself and for me, it was like a miracle.”
There is a strong economic case for covering the expenses of out-of-country donors. Dialysis costs between $70,000 and $90,000 each year per person. As of Monday, there were 1,078 people awaiting kidneys in Ontario — all on dialysis. Wait times vary, but in Toronto it often takes up to 10 years before a kidney from a deceased donor becomes available.
For living donation, people are never solicited by hospitals. Interested parties must initiate contact with a transplant program, Zaltzman says. A list of required baseline tests — health background and blood work — are done before anyone considers a trip to Ontario.
The biggest hurdle for potential donors is usually the requested six-month medical visa, Zaltzman notes. “They have to go through the Canadian embassy in their country and often that’s where we run into difficulties,” he says.
Immigration departments are sometimes leery to allow entry, because there have been cases in the past when individuals did not leave, Zaltzman says. The hospital typically provides a letter for the application, explaining the circumstances.
Hafiz was first denied her request and the family, who live in Ajax, had to engage their city’s mayor before Hafiz arrived in June. Tyulenyev’s friend was granted a visa in two weeks.
Full evaluation, pre-transplant screening, surgery and recovery time require months. “It’s a very intense procedure to be worked up as a donor,” Zaltzman says.
Tyulenyev says the first three weeks after the transplant were tough, but he’s noticeably stronger. “Now I can walk two hours per day,” he says. “I have much more energy than before.”
He compares the feeling to that of a warrior, forced to wear heavy armour constantly. “You have a lot of ammunition on you and even moving is hard,” he says. “Now I’m like an archer, I’m light.”
The donor and recipient have grown closer since the procedure. “I have a piece of him inside me,” Tyulenyev says.
Though it’s early in his recovery, Khan looks forward to a diet without the severe restrictions imposed by dialysis. “Steak, burgers, everything,” he says. “One big meat platter.”
The thought of travelling for more than two days also appeals. And he looks forward to finishing his accounting courses at Durham College and finding a job. He still sounds incredulous at the gift of life his aunt has given him.
“I didn’t think anyone would do this for me,” he says. “I thought I would be waiting for 15 years before getting a kidney.”
Hafiz, who is excited to go home next week, says her adult children were initially opposed to the idea, but quickly came around.
“Now they are really proud,” she says.
Bringing donors in from other countries saves lives, Gavsie says. “But we still encourage people to register and tell their family of their wishes, so we can build a culture of donation right here.”