Morning Sentinel
Former state senator awaits kidney transplant
By GARY REMAL
Staff Writer Kennebec Journal & Morning Sentinel 01/22/2008

By GARY REMAL

Staff Writer

Former Sen. Beverly Daggett has a kidney. It's not hers. It's her mother's, a gift given to a daughter suffering from a genetic disease.

But that gift only had a shelf life of about 10 years.

So now Daggett, the first female president of the Maine Senate, needs another.

She may have to wait awhile -- the average wait for a kidney transplant is four years.

And while she waits, she remains on dialysis, a process that removes toxins from the blood.

Daggett, who served more than two decades in the Maine Legislature, agreed to talk about her treatment to raise awareness about kidney disease and advances in dialysis, and to demonstrate the human impact of organ donation.

"When we're not touched by it personally, we don't give it much thought," she said. "Most of us are caught up and have more than enough to do in our own lives. We don't go looking for causes to get caught up in."

The Augusta Democrat received her mother's kidney in 1996.

Few people realized that as Daggett neared the end of her two-year term as Senate president in 2004 her transplanted kidney had begun to give out and her health was failing. The Maine Constitution designates the Senate president to take over as chief executive should anything happen to the governor.

"They say the average (life of a transplanted kidney) is five to 15 years," she said. "Mine lasted just under 10, so I was really pretty average."

By 2005, her mother's gift declined to the point where Daggett needed to begin dialysis to cleanse her blood of the impurities taken from her body.

She was placed on the state's organ transplant waiting list later that year. But a heart attack in April 2006 made her ineligible. Since then, other health problems have kept her off the waiting list. She fractured her pelvis while bicycling to build up her strengh after the heart attack and gashed her leg.

She said the battle to regain her health to qualify for another transplant has been difficult.

"I almost feel like I've been coming back from something for the last five years," Daggett said.

Daggett, 62, has known since childhood that she inherited a genetic abnormality known as polycystic kidney disease, a condition she shared with her father. The disease creates cysts in the kidneys, crowding out the active kidney tissue, reducing and then halting the organs' function of cleaning the blood, she explained.

There are two types of dialysis: hemodialysis, which Daggett employs, and peritoneal dialysis, which cleanses the blood with fluid injected into the abdomen. Peritoneal dialysis is regularly used by patients at home through a tube permanently implanted in the abdomen, but it is not useful to many patients who require the more complex hemodialsysis.

NEW, PORTABLE MACHINE

Daggett is one of just a handful of people in Maine to regularly hook up to an advanced, new portable dialysis machine made available through MaineGeneral Medical Center. The machine allows her to cleanse her blood more frequently and more conveniently than when she traveled to a dialysis center three times a week.

"Because you do it daily, it allows less toxins to build up in your blood and you're much healthier, Daggett said. "In the (dialysis) center, it's only done three times a week. When I say it's working, the proof is in the patient. I'm doing well on it."

The machine, known as Nx Stage, weighs 75 pounds and requires myriad filters and fluids for each use, she said.

The process requires she have a partner trained in the machine's use to make sure she is safe during treatments. Both her husband, Thomas, and a friend share in helping her with the therapy sessions.

About the size of a large portable television, her home dialysis machine comes with a wheeled travel case, but Daggett said her husband is reluctant to travel too far or too often for fear of damaging it. Company officials promise 24-hour replacement anywhere in the continential U.S.

If not for her desire to travel more easily to visit her grandchildren in California, the ease of the new machine might convince Daggett to remain on dialysis and avoid the discomfort and severe side effects of the anti-rejection medications she will be required to take if another donated kidney can be found to transplant into her body.

"I'm sure I would have the transplant" if it becomes available to her, she said. "But I do remember it being quite oppressive."

SILENT DISEASE

Aimee Seratore from the Maine chapter of the National Kidney Foundation said one in nine Mainers, or 146,000 residents, have some form of kidney disease but do not know it.

"The biggest thing about kidney disease is it's a silent disease," Seratore said. "You can have it and not have any clue until it's in the end stages."

Seratore said nearly 74,000 Americans are on transplant lists waiting for a kidney.

Daggett credits MaineGeneral Medical Center kidney specialist Dmitry Opolinsky with identifying the Nx Stage home dialysis machine and arranging her transition from traditional dialysis to six times a week at home.

Opolinsky said a handful of Mainers are able to use the new system.

The advantage of the new system is its simplified operation, allowing patients to use it more frequently, he said.

Daggett said she feels little discomfort with the new, more frequent dialysis treatment.

"Because you don't have to take out as much fluid, you don't feel so drained," she explained. "Imagine taking out eight pounds of fluid and how drained you would feel after that. With the daily schedule, typically I don't feel much different before and after."

Studies are now under way to determine if people using more frequent blood-cleansing live longer and suffer fewer complications, Opolinsky said. If the studies show that to be true, he hopes Congress will approve payment for more frequent treatments.

In the interim, Opolinsky said MaineGeneral is the only hospital in Maine that has authorized the use of the home dialysis.

The number of people using dialysis of some kind has risen dramatically in recent years, he said, largely due to an aging population and an increase in diabetes.

In contrast, the number of kidney transplants has remained relatively stable because the number of available and useable organs from dead donors is relatively constant and the pool of living people willing to donate a kidney is usually limited to family and close friends.

New forms of dialysis are useful, he said, but dialysis patients have relatively high mortality rates, around 20 percent, and being tied to regular treatments is limiting.

Daggett said she looks forward to the day when doctors will be able to use stem cells or some other mechanism to repair or even regrow a person's own organs.

"For now," Opolinsky said, "that's still more like science fiction."

Gary Remal -- 621-5642

gremal@centralmaine.com

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