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First living liver recipient: Three months later and patient enjoys new life

IU Health University Hospital

First living liver recipient: Three months later and patient enjoys new life

When Kelly Kinkade’s health began to decline, she turned to IU Health’s top-ranked transplant program and a new procedure known as “living liver donation.”

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

She’s introspective as she thinks back over the past three months. On July 20, 2020, Kelly Kinkade became part of the history that makes up the year so many people will talk about for decades to come. She became the state’s first living donor liver transplant in 20 years.

And as many people refer to “2020” as a year with a not-so-clear vision, Kinkade is perfectly focused on a future filled with a new chance at life.

In 2013, the Greenwood resident was diagnosed with autoimmune hepatitis, a disease known to cause severe fatigue, abdominal and joint pain. In the most severe cases, like Kinkade’s, it results in liver failure.

The transplant was a long time in the making. Kinkade was on immune suppressant drugs and a number of medications to treat the symptoms. She said it wasn’t uncommon to gain 10 pounds in water weight overnight. There were drugs to rid her body of toxins, treatments for hypertension, and enlarged blood vessels along her esophagus. The disease was also attacking her brain, causing her to lose her short-term memory.

“I was in and out the hospital for various surgeries and procedures. It seemed like a symptom would pop up and I’d have to be treated and something else would pop up. Every six months I went in for a tune up. The liver damage was done so they were trying to make me comfortable,” said Kinkade, 34.

A native of the city’s eastside, Kinkade attended Center Grove High School until the age of 16. She went on to complete high school at Culver Academies where she was active in hockey, intramural sports, and French Club. After high school, she studied pre-law and political science at Taylor University. She obtained her law degree from IU School of Law and worked as a criminal defense attorney in Marion County. Her illness struck when she was just two years out of law school.

The daughter of Kent and Susan Kinkade, she has two younger brothers. In childhood, Christmases and Thanksgivings were often spent with Susan’s sister and her family. Kinkade was named after her Aunt Kelly. She enjoyed making family memories with her three male cousins. Later in life, it was her Aunt Kelly’s youngest son, Paul Stringfield, 11 years younger than Kinkade, who stepped forward to be a living liver donor. She remembers him as a quiet kid, interested in spending time with his pets. But when it came time for testing for a donor, Kinkade said Stringfield was adamant.

There are currently 14,000 patients on the liver wait list. As the number of people needing a liver transplant has grown, living donation has become an alternative treatment option for patients.

Living donors reduce or eliminate the need for patients to spend years waiting for a deceased donor liver transplant. By donating a portion of their liver, living donors also help increase the number of livers available for those still on the wait list.

An organ from a living donor can function better and last longer because the donor is healthy. It also functions better because the organ is transplanted into the recipient shortly after being removed from the donor. Because of this, patients receiving an organ from a living donor often have better outcomes than patients receiving an organ from a deceased donor.

A living donor does not have to be related to the recipient. Compatibility is based on blood type (ABO). If the blood types do not match, there may still be options for living donation. Age and size are also taken into consideration.

Living liver donation involves removing a portion of a donor’s liver and then using it to replace a diseased liver in the recipient. While a living liver donor faces the typical risks of surgery, the liver regenerates and returns to full function within a month. Donors are admitted to the hospital early the morning of surgery. The surgery lasts from six to eight hours.

After the donation surgery, liver donors are monitored in the IU Health Transplant Intensive Care Unit for one to two days and then moved to the Organ Transplant Unit. The care team works closely with the donor to manage and minimize post-operative pain. Donors will remain in the hospital as long as necessary but are usually discharged within one week after surgery.

On the morning of July 20, Stringfield, 24, arrived at IU Health at about 5 a.m. He was the first to go into surgery, under the care of Dr. Chandrashekhar Kubal, surgical director of the IU Health adult liver transplant program. During an hours-long surgery, 60 percent of Stringfield’s liver was removed and transplanted into Kinkade. About four hours after Stringfield was wheeled into the operating room, Kinkade was prepped for surgery.

“I had no real reservations. I had nothing but confidence in the doctors. The first time I met Dr. Kubal he said I was a great candidate and I had suffered long enough. It was the first time I felt like someone outside my family understood my pain,” said Kinkade. “For me, I had been sick for so long that I was more than ready to do this. I knew the risks and that I may not make it but that was fine with me. I have a very strong faith and I knew at the end of this I’d have a new body either one way or the other - either a new liver or go to heaven and Jesus would give me a new body.”

Both Kinkade and Stringfield remained hospitalized for more than a week. They were still in ICU when Stringfield wheeled into Kinkade’s room. They talked about their incisions and Kinkade had a chance to thank her cousin for his gift of life.

“Every time I say ‘you’re my hero’ he says ‘it’s no big deal,’” said Kinkade. “I imagine we’ll always celebrate the anniversary of the transplant, but he may never ever understand what a big deal it is for me.”

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