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Feb. 23--Late last year, two women each found a quiet moment and prayed for a husband sick with end-stage renal disease.
"Lord, help me find a way," Alfreda Torres recalls whispering to herself.
"Lord, bring us a donor," Paulette Chandler remembers asking.
The pleas of the two strangers, separated by 30 miles, seem to have been answered. On Thursday, the women are scheduled to make history in Illinois when both donate kidneys, each to the other woman's husband.
It's called a living donor kidney swap, and it's the first time the procedure is being done in the state.
This is how it will work: Chandler, 54, who lives in Park Forest, will have one of her kidneys removed through a 2-inch cut in her abdomen and implanted in Francisco Torres, 62, of Chicago. Two surgeons will direct medical teams in adjacent operating rooms.
A few hours later, Alfreda Torres, 40, will undergo the same procedure and give her kidney to Carl Chandler, 53.
The wives had wanted to donate to their own husbands, but they were discouraged from doing so because their blood types weren't a match, significantly heightening the risk of organ rejection. Alfreda has Type B blood; Francisco has Type A. Paulette's blood is Type A; Carl's is Type B.
A swap fixes the problem through an "I'll give to you and you'll give to me" arrangement. By choosing this option, each husband-wife pair gets to avoid long waiting lists for a kidney transplant; the average wait in the Chicago area is about five years. They also benefit from receiving a kidney from a living donor, which remains viable almost twice as long as an organ harvested after a donor's death.
Carl Chandler, a former machinist whose kidneys started to fail eight years ago, spoke of a racial dimension to the experience he's about to have.
"Let's talk about what's happening here," he said. "A black woman is donating to a Hispanic man, and a Hispanic woman is donating to a black man, and there's no fear or cause for concern.
"Too many people waiting for organs are afraid to go outside their communities because of prejudice or closed-mindedness," said Chandler, a minister. "We hope that this will motivate people to realize there's no color issue here. There's just a sickness issue."
When the Torreses and Chandlers first met Jan. 27, that theme was an important part of their discussion.
"We talked about how this was going to be something good for the community, because there are so many people who get sick the same way and we need all to try to help each other," Alfreda Torres said.
Later that day at home, she said, she and Francisco agreed: "If God gave us this chance, it is for a reason."
Statistics underscore the significance of race in organ transplants. Because African-Americans are more likely than whites to have diabetes and hypertension, they end up needing more transplants. But organs from black donors--the best source of good matches for genetic reasons--don't keep pace with the demand.
As a result, blacks are disproportionately represented on transplant waiting lists, accounting for 35 percent of all Americans waiting for a kidney.
Similar problems face Hispanics, who are three times more likely than non-Hispanic whites to have diabetes, a main cause of kidney failure.
"Minority patients may have to wait longer for matched kidneys and therefore may be sicker at the time of transplant or die waiting," notes a U.S. government organ-transplantation Web site.
The two couples found each other through UIC's medical center, where both men were patients. Only a few months earlier, the medical center had put in place internal procedures to facilitate paired living donor exchanges, the formal term for kidney swaps.
Also, UIC and several other Chicago-area medical institutions have joined a relatively new group called the Paired Donation Consortium, which helps arrange these procedures in 10 states, including Illinois, Indiana, Ohio, Michigan and Wisconsin. To date, 80 donor-recipient pairs have registered with the consortium and 12 kidney swaps have been completed.
Neither the Chandlers nor the Torreses had heard of kidney swaps before UIC's transplant staff approached them with the idea in January. But it didn't take long to decide they all wanted to go ahead.
"It made sense right away," Carl Chandler said.
"I was kind of semi-agreeing" at first, but "I still had to soul-search my heart and ask myself, do you want to go through with this?" acknowledged Paulette, his wife of 27 years.
Meeting the Torreses reassured the couple. "I was hesitant, like going to a school dance and not being sure of your surroundings," Carl said. "But then we met and I could see they were conscientious, plain, religious, caring people."
Francisco Torres said he had no doubts. Struck by severe kidney disease suddenly last fall, he had started dialysis in November and hated it.
"I wanted to live a normal life, not tied to a machine," said Torres, who works for the state's attorney's office as an administrative aide.
Alfreda worried about her husband, who had become moody and anxious. Usually, "he is always helpful to everyone," said Alfreda, who was running a carpentry shop in Monterrey, Mexico, in 1999 when Francisco's cousin suggested he meet her on a vacation. They married that year.
"When I married Francisco, I knew he was older. But he wanted a life with me, and I wanted a life with him," Alfreda said. "So now, he's sick and what are the choices? Either you love him or you don't. Either you help him or you don't. For me, God blessed us with this choice, and I thank him for it."
jegraham@tribune.com
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