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Transplant Perfect Match – Brothers Cut from Same Cloth

Patient Stories

January 23, 2019

They knew they were twins, but two brothers didn’t know they were identical until one was tested to be a kidney donor for the other.

Sitting side-by-side, Andrew “Drew” and Austin Leach look like reflections in a mirror. Standing, Drew is just a hair taller than Austin and has been told his eyes squint a little more than his brother.

But when they order their morning beverage, they both ask for steaming cups of caramel macchiato and when asked if they are best friends, in unison they respond: “Basically yeah.”

These brothers, born to Christi Leach and Jeremy Leach on Oct. 15, 1996 always knew they were twins. They didn’t find out they were identical twins until Austin needed a kidney. When Drew expressed a desire to become a living kidney donor, a twin zygosity test – comparing the DNA of the two brothers – revealed that they are identical twins.

What does that mean for Austin?

“There’s zero percent chance of rejection. That’s why there’s no immunosuppression,” said IU Health transplant surgeon Dr. William C. Goggins. On July 20, 2018 Dr. Goggins was in one operating room with Austin. Next door, Dr. Chandru P. Sundaram was in surgery with Drew. Dr. Goggins said the Leach brothers were only his third set of identical twins where one donated a kidney to a sibling.

“This is very unusual. It happens only about once every five years. I’ve done around 900 living donor transplants so that’s about one in 300 living donors,” said Dr. Goggins. For Dr. Sundaram, who has been performing laparoscopic robotic kidney surgery at IU Health since 2002, the identical twins were a first.

“Living donor surgery is held to the highest standards since the donor as well the kidney need to be taken care of, hence the living donor program is closely monitored by a team of nephrologists, nurses, psychologists, and surgeons,” said Sundaram, adding that the height difference between the twins is a result of Austin’s renal failure. It’s estimated that a third of children with chronic kidney disease have growth failure. In addition to removing wastes, and extra fluid in the blood, the kidneys help regulate the amounts of nutrients and vitamins that support growth.

***

Christi Leach was about 17 weeks into her pregnancy when she learned she was having twins. She went on bed rest and maintained a healthy pregnancy. “The testing for identical twins is not routine. They had a 19-month-old sister at the time and my hands were full. I just didn’t think about requesting a special blood test at the time,” said Christi Leach.

“Austin was about 18 months old when I noticed I was changing Drew’s diapers more often,” said Leach. “He developed a strep infection and was given Amoxicillin which we learned he was allergic to. He then developed a rash and was diagnosed with scarlatina. His diapers were dry and he started swelling.” By the time Austin got to Riley Hospital he was diagnosed with Nephrotic syndrome, complications from kidney failure. He was teamed up with a renal doctor and over time he developed Focal Segmental Glomerulosclerosis (FSGS), a rare disease that attacks the kidneys. By the time he was six he was on dialysis and by seven he received his first transplant. That was in 2004.

“Austin is unique. Anything that could go wrong did go wrong,” said his mom. Within 24 hours of his first transplant he rejected and did 40 rounds of apheresis. Once he finally recovered six months post transplant his neck began to swell and doctors determined he had Post transplant lymph proliferative disease (PTLD), one of the most common post transplant malignancies. He was treated with six rounds of chemotherapy. His tonsils were removed and then without explanation they grew back.

Time went by. Austin, and his twin graduated from Hamilton Heights High School in 2015. But his health was again declining. His kidneys were again compromised.

***

“About a year before his second transplant, his creatinine levels were going up. We talked to Drew and he was ready to be a donor. We just didn’t know that he’d be a perfect match,” said Christi Leach.

A week before the scheduled transplant, the twins learned they are identical. They were not surprised.

“Ever since people were mixing us up at school, we thought we were identical,” said Austin. “The gym teacher always called me ‘Drew.’”

As youngsters, the boys shared a bedroom, played on the same baseball teams, and communicated with each other in a special language they describe as “Rug Rat speech.” Their mom dressed Austin in red and Drew in blue.

“The only ones who could really tell us apart were our mom, dad, and sister,” said Austin. Over the years, there were varied interests that distinguished them – some minor, others determined by Austin’s health - but for the most part these brothers are cut from the same cloth. They’ve both had their share of boyish injuries either through sports or mishaps – and they both work third shift at Kroger.

“Drew’s a zip up guy, I’m a pullover guy,” said Austin describing his brother’s gray sweatshirt and beanie. Drew wears a black pullover and matching beanie. “I steal your socks and you steal my pajamas,” added Drew. The brothers attended college for a short time after graduation. Now that Austin is on the road to better health, they are both focusing on getting back to the gym and their career goals.

Drew is interested in digital art and voice acting. Austin likes building computers and streaming strategy games like “Twitch.” They both enjoy eating out with their grandparents and watching animated movies.

When it comes to dating, Drew says he’s oblivious to social cues and Austin says he hasn’t met the right one yet.

***

For now, they just enjoy hanging out together. Drew drives them to and from work, appointments, and social activities in his black 2010 Equinox. He’s also teaching Austin to drive. They recently moved into their first apartment together and they’re experimenting with simple cooking – macaroni and cheese is a favorite.

How does their mom feel about them moving out on their own?

“For the first time since he was 18 months old Austin is not on any medication,” said Christi Leach. “It’s a relief because I was constantly reminding him to take his medication, and now that he doesn’t have to take any medications, it’s a relief. He’s like a different person – eating better and taking care of himself.”

Besides macaroni and cheese, Austin has started eating more vegetables and discovered he likes asparagus.

“Things are different. I feel better and it’s been great living together. We pretty much do everything together,” said Austin of his twin brother. “My medical history speaks volumes so it’s nice to start feeling better and be able to actually plan a little more for the future.”

-- By T.J. Banes, Journalist, IU Health.
Reach Banes via email tfender1@iuhealth.org.

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