Cesar Duran – kidney transplant success story

Making up for lost time

A new kidney brings an end to 24 years of dialysis for Cesar Duran

Cesar Duran “I was hopeful but never thought I would get
another transplant, and now I feel so much better.”

Exceptional.

It’s not a word spoken often from a physician’s mouth about his patient, but that’s exactly how Jose “Tony” Castillo-Lugo, MD, transplant nephrologist on the medical staff at Methodist Dallas Medical Center, describes Cesar Duran.

Cesar, 65, has endured a long journey with chronic glomerulonephritis, a condition that causes gradual inflammation of the tiny filters in the kidneys that remove excess fluid, electrolytes, and waste from the bloodstream and pass them into the urine. This condition can often lead to chronic kidney disease and, consequently, dialysis treatments.

Cesar, a Puerto Rico resident, began his treatments in January 1986 and continued until he received a kidney transplant in 1990. He immediately began anti-rejection medication so that his body would accept the new organ, but Dr. Castillo says he developed antibodies that caused kidney failure within two years.

Starting over

Back to dialysis Cesar went, from 1992 until 2016. Three days a week for 24 years, he drove to a dialysis center to be hooked up to a machine for hours. He ultimately had to use a neck catheter because none of his other veins were accessible. In recent months, though, he grew despondent about his future.

“I’ve seen more than a hundred people in dialysis with me die waiting for a new kidney, and lately, I had given up,” Cesar says. “I didn’t think they would find a kidney.”

Dr. Castillo says prolonged dialysis most often causes complications and damage to the heart. Cesar required open heart surgery in 2007 because of calcium buildup.

“It’s very rare to have a patient who can survive dialysis for 24 years; it’s practically unheard of,” Dr. Castillo says. “Patients who take care of themselves and who don’t have comorbidities, like diabetes, do well.”

From failure to success

Like several physicians at Methodist Dallas, Dr. Castillo sees patients in his native Puerto Rico; he first met Cesar in his clinic five years ago. Cesar had been on the transplant list in Puerto Rico for years, but doctors told him his antibody levels were too high for most available kidneys. Dr. Castillo, though, believed Cesar could receive a new kidney soon based on recent protocol changes.

In December 2014, the Organ Procurement and Transplantation Network changed the rules for how patients could be ranked in priority to receive a new organ. For the first time in nearly three decades, Cesar would receive credit for the amount of time he spent on dialysis. Plus, his high antibody levels moved him up. Within a few weeks, Cesar went from being just another number to the top of the list.

undefinedOn Saturday, March 12, Cesar and his wife got the call saying a perfect-match kidney had been found.

“Really, I was in shock,” Cesar says. “I even asked the transplant coordinator if she was sure.”

They flew to Dallas, arriving only hours before the transplant was successfully performed by transplant surgeon Richard Dickerman, MD, FACS, also on the Methodist Dallas medical staff.

“The only reason Cesar got transplanted was because of the new allocation system,” Dr. Castillo says. “He is living proof it is possible to spend years on dialysis, so don’t lose hope.”

Months after his transplant, Cesar believes his new kidney was worth the wait.

“I was hopeful but never thought I would get another transplant, and now I feel so much better.”

From the fall 2016 edition of Shine magazine