Optometrist Brad Kaster would give his right arm to help his father. But, all his father needed was a kidney.

Brad Kaster, O.D., donated a kidney to his father, Phil, in a breakthrough surgery.

In a breakthrough procedure performed at the Cleveland Clinic, Dr. Kaster became only the 10th donor to undergo a novel operation in which his kidney was removed through a small incision in his belly button. This single-incision organ removal procedure reduces recovery time, minimizes scarring, and hopefully makes organ donation much easier for donors.

In mid-July 2007, Dr. Kasters father, Phil Kaster, was diagnosed with end-stage renal disease. Two months later, with his energy level sapped away, Mr. Kaster began what could have been a life sentence on dialysis treatment.

Fortunately, his son proved to be a viable donor candidate. They test you from head to toe, Dr. Kaster says. I was nervous at first, but that wore off quickly. I just wanted all the testing to be over with.

Finally, on July 14, nearly a year to the day after his fathers diagnosis, Dr. Kaster and his father were wheeled into adjoining operating rooms and given general anesthesia. Dr. Kaster was positioned on his side, with his abdomen up, and his head and feet down.

Then the surgeon who pioneered this procedure, Inderbir S. Gill, M.D., created a small incision into Dr. Kasters belly button and inserted a tube-like port. The port has holes in it to insert a camera and other surgical tools into the abdomen. 

They pump your abdomen full of CO2 to better visualize the organs, Dr. Kaster says. Then they kind of move your organs to the side, pierce the retro-peritoneal cavity, isolate the kidney, and bag it up while its inside you. Once its all ready to go, they snip the blood vessels and pull the kidney out. They immediately prep the kidney for insertion into the recipient, and while thats going on, theyre closing you up.

Dr. Kasters operation took more than three hours. When he woke up, My abdomen felt like somebody kicked me several times, he says. Also, he had excruciating back pain from the unusual position on the surgical table. But, by that evening, he was up and walking around. Afterward, the CO2 gas caused some pain in his shoulders as it seeped out of his body.

This single-port procedure (though Dr. Kaster actually had two incisions) improves on current laparoscopic nephrectomy by speeding recovery time and reducing the days on pain medication. The few donors who have undergone this procedure recovered in less than a month. By comparison, donors who undergo the standard laparoscopic procedurewhich uses four to six incisionstake more than three months to recover.

In two weeks, Dr. Kaster was back to work at Eye Tech of Green, in Uniontown, Ohio, where co-workers and patients have been very supportive, he says.

Besides the recovery from the surgery, Dr. Kaster says the loss of a kidney hasnt affected him much. You can live just fine with one kidney without any major restrictions for rest of your life.

Meanwhile, his father said he felt like his energy level went up to 90% the first day, Dr. Kaster says. Two weeks later, he says he feels like hes at 110%. But, hes on several anti-rejection meds and has to avoid infection, so hes not allowed to garden or do all the outdoor activities he loves to do. Were having a hard time tying him down.

Vol. No: 145:08Issue: 8/15/2008