Our Marin bench is now fully staffed with twelve judges. Yet we’re a bit light on kidneys and proud of it. This issue of the Judge’s Corner is not intended to address body parts on the bench, but to talk about kidney donation.

In June 2016, Judge Chernus donated his kidney to Penny Dufficy, the Honorable Michael Dufficy’s wife. In August 2012, Judge Lichtblau donated her kidney to a cousin. For each of us, the donation process was lengthy but relatively straightforward. It was also incredibly rewarding and life changing.

Live kidney transplants have been around for quite some time. The first successful live donor transplant occurred in 1945 when a man named Ronald Herrick donated his kidney to his twin brother, Richard. Mr. Herrick continued to live a healthy life for decades after his donation. (Richard lived eight more years. Their surgeon went on to win the Nobel prize.) Live kidney donation increased exponentially over the following decades, peaking in the early 2000s. Over the past decade, the number of live transplants has averaged approximately 16,000 per year. Unfortunately, the wait list for transplants has also increased over the years. As of August 2017, 115,000 remained on the national transplant waiting list, 20 of whom die each day waiting for a transplant. Simply put, there aren’t enough kidneys offered.

Although kidney transplants occur from both live and cadaver donors, living donor transplants have greater success. A kidney from a living donor usually functions immediately, which makes it easier to monitor. Donors are tested prior to the donation to ensure compatibility with the recipient and they are often relatives with close genetic matches. The recipient and donor can also schedule the surgery at a time that allows everyone to be ready and at their optimal health.

So how does the donation process work? Generally speaking, it takes time and commitment. First, a potential donor must give a blood sample to determine blood type compatibility. In this test, blood from the donor and recipient are mixed to ensure that the recipient’s cells do not attack the donor’s cells. Physicians also examine antigens and antibodies to determine compatibility. Although greater compatibility results in better outcomes, even transplants with little or no match can result in a good outcome with the use of immunosuppressive medications.

Even if your blood type is not compatible, you can still indirectly donate a kidney to your intended recipient. Through a “daisy chain” procedure, Judge Chernus donated his kidney to a compatible stranger in Colorado in order that Penny Dufficy could receive her kidney from a stranger from Maryland. In total, there were 16 kidney donors and 16 recipients all over the country in a daisy chain that took about two weeks to complete from start to finish. In fact, Penny Dufficy’s transplant was number 30, Judge Chernus’ donation was 31, and his recipient’s transplant was the 32nd and final operation.

Regardless of whether the kidney donation is directly to an intended recipient or through a daisy chain, the donor must undergo multiple exams over several months to ensure he or she is a healthy patient before being allowed to donate. If you have ever wanted to make sure your doctor takes all of your minor complaints seriously, we suggest you donate a kidney. You will undergo the most thorough physical you ever thought possible. Physicians will follow up on just about everything, from family history to blood pressure, even if just momentarily elevated. Tests will range from stress tests to renal ultrasounds. You are even required to submit to a psychological examination to ensure you are not donating for money or other improper reasons. The doctors want the transplant to be successful and they don’t want any surprises. Believe us when we tell you, they follow up on everything. Judge Chernus was required to wear a remote transmitting blood pressure monitor for 24 hours, which took and transmitted his blood pressure at random times during the day and night.

Finally the big day comes. It’s incredibly exciting to know that you are going to make a meaningful difference in the recipient’s life. Judge Lichtblau checked in the day before surgery and Judge Chernus checked in on the day of the surgery. A full team of doctors cram themselves into your tiny hospital room to greet you. The surgery itself lasts several hours.

The best news is when you hear that the recipient’s surgery is also successful. Knowing your kidney is working in another person’s body is truly the best medicine for a speedy recovery. Seeing the recipient for the first time following the surgery is incredibly moving because you know you have given them freedom from that awful dialysis machine.

Recovery time varies from person to person, but we found we were back to light activities within a few weeks. Although recovery time will cause you to take time off from work and other activities, recently enacted Labor Code section 1510 mandates that employers with 15 or more employees grant a paid leave of absence not to exceed 30 days for the purpose of donating an organ to another person. The hospital will follow up with you for the next couple of years to make sure you have fully recovered.

There is something weirdly special about knowing that one of your organs is working inside another body, allowing that person to resume a full life. It brings profound meaning to the phrase we often tell children that “sharing is caring.” While it’s a big decision to make and not one that should be taken lightly, we feel truly lucky to have said yes.