If past is prologue, as Shakespeare suggested, Jason Stahl’s future appeared more gray than rosy when he landed at UW Medical Center (UWMC) in 2006. While he had led a relatively normal, active life for years, Stahl, then 34, might have legitimately wondered whether he would see 40, given past health pitfalls.
It was May when Stahl met with UWMC’s transplantation specialists after his kidney began to fail. Yes — kidney, singular.
The organ donated by his mom in 1988 had kept him in good stead for 17 years but now was showing signs of rejection. That transplant had been necessitated by the failure of successive transplants in the early 1980s after “plumbing problems,” as Stahl says, left his original kidneys useless.
And, at some point along the transplant continuum, Stahl acquired hepatitis C, a virus that attacks the liver and whose complications can lead to kidney disease.
“I had a number of blood transfusions before 1990,” Stahl says, looking back. “It’s speculation, but I never had any of the lifestyle events that would lead to that.” (Testing for hepatitis in donated blood didn’t start until 1992.)
Stahl presented his remarkable narrative to UWMC’s transplant team. Dr. Connie Davis, UWMC’s director of kidney care and transplantation, summarized the challenge.
“He came with factors that would have dissuaded other hospitals from transplanting him, or trying. He has hepatitis C. This was transplant number four, so he was highly sensitized. Therefore, he’ll need high doses of immunosuppression, and he runs the risk of worsening the hepatitis and getting very sick.”
Nonetheless, Stahl was deemed a transplant candidate, Davis said, because “I think we’re uniquely able to manage a case like Jason’s. And I think that’s exactly what our mission is: to make things happen.”
Stahl was in elementary school in Lawrence, Kan., when problems arose. An atypically small bladder and other urinary dysfunction led to a urostomy and his first transplant at University of Kansas Medical Center.
The first cadaveric kidney rejected within a month. The second organ, after two years, developed stones, which were removed but the incision on the kidney failed to heal. After a month in the hospital, Stahl asked doctors to remove the organ. During the third transplant, the one involving his mom at Children’s Hospital in Boston, he had his bladder reconstructed and the urostomy pouch was no longer needed.
The family relocated to Olympia in 1990, just after Stahl finished high school. Having been through the wringer, he could have been forgiven for losing his lust for life. But instead he thrived, finding time for golf, tennis and biking. He traveled to Western Washington University in Bellingham and embarked on a degree in broadcast communications.
Life was full. Stahl knew that transplanted kidneys survive, on average, for 12-15
years; the fact that his mom’s transplant lasted 17 years is a point of pride.
But then it grew sluggish.
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“I started leaking proteins and they put me on a diet to watch my protein intake. But things just started snowballing,” he said. “By September of 2006, I was on dialysis in Olympia.”
Seeing her brother on dialysis again, Stahl’s sister, Ericka Boysen, 32, decided to undergo antibody testing to see if she was a viable donor. The results surprised them both.
“Though we're three years apart, our match was that of identical twins,” Jason Stahl said.
Even so, Davis knew that Stahl’s pre- and postoperative care had to tread a thin line.
“We tried to design things specifically for him,” Davis said. “We knew we had to give him more immunosuppression, but if we gave him too much in the long term, he was going to run into trouble with infectious complications.
“We had to do higher intensity monitoring, very focused, including donor-specific antibody monitoring, and then if he had anything suspicious at all, we’d have to bring him back in and biopsy or take some other look,” Davis said.
On May 14, 2008, Boysen donated a kidney to her brother, with Davis’ colleague, Dr. Ramasamy Bakthavatsalam, presiding in the operating room.
Early in recovery Stahl was introduced to Team Transplant, a UWMC program started by dietitian Alysun Deckert to promote the virtues of fitness and organ donation. Team members train for Seattle’s Half Marathon, held Thanksgiving weekend, and for the Rock ’n’ Roll Half Marathon, in June.
“I joined them in August, after surgery and by November, I was up to almost 140 pounds from eating well and exercising and working out. I was gaining muscle that I probably had never had,” said Stahl, who before surgery had struggled to comply with Davis’ request to add weight to his slight frame.
“Being part of Team Transplant has taught me the benefit of making exercise part of my life four to five days a week. We have runners and walkers on the team, and I'm one of the walkers right now.
“Even if I stop exercising tomorrow, I still would want to be part of Team Transplant because it's a vehicle to make people aware of organ and tissue donation. I've really benefited from that and I want to inform and educate others that they can, too – not only by signing up on your driver's license, but if some friend or relative gets sick, take a step and get tested to see if you can help.”