The bond between sisters Jesica Valenzuela and Raquel Matamoros was always strong, despite their seven years of age difference. After Raquel gave birth to her daughter (who is now a teenager), she learned she had polycystic kidney disease (PKD). It’s an inherited condition that causes clusters of cysts to develop on the kidneys. People with PKD may develop several cysts that can grow very large and eventually damage the kidneys. Over several years or even decades, the person loses kidney function and will need additional treatment.
Raquel went to see a nephrologist, who told her the condition would likely progress to the point she would need either dialysis or a new kidney. She was in her 30s at the time and remembers feeling like that potential future sounded really far away. She made a few changes to her diet and exercise regimen. But she didn’t have any symptoms and, as a result, didn’t think much about her PKD for many years.
She had regular checkups with the nephrologist to check kidney function, and they started to notice a decline in her early 40s. She realized she would need to take the condition more seriously and started learning as much as she could about how to minimize her risk of disease progression. About five years ago, her kidney function was stable, which was good news.
A Cardiac Event Changes Everything
Then in 2020, everything changed. Raquel was sitting in her home office and suddenly felt extreme chest pain and shortness of breath. At that time, it seemed likely to be COVID-19, which was rapidly spreading. She called her husband, who rushed home from work and took her to the emergency room. After an electrocardiogram, doctors told her she would need emergency heart surgery and rushed her to University of Utah Health.
U of U Health cardiologists performed emergency surgery to repair an aortic dissection, a severe cardiac event that is far more common in men and over 70 than women in their 40s like Raquel. During the 12-hour surgery, she nearly died, and for the first 24 hours after the procedure they didn’t know if she would make it. She recovered completely, but the heart attack and ongoing high blood pressure did significant damage to her already struggling kidneys.
In subsequent checkups with her nephrologist, the doctor said her kidney function was declining. It wasn’t completely gone, but she would need to start the process of looking for a kidney donor. Without one, she would end up on dialysis, which would likely lead to a shorter life and lower quality of life.
When I was visiting Salt Lake City in 2022, Raquel shared with me that she would most likely need a kidney transplant and would be going through the process of approval to be put on the list for kidney donation. In my heart, I knew without a question I would go through whatever process was needed to give her a kidney.
Their family includes four total sisters, so when the news came that Raquel needed a kidney, all her sisters and her mom started the process of checking whether they were a match. Everyone except Jesica was ruled out because they had the wrong blood type. But Jesica was a blood type match, so she continued in the donor matching process. Fortunately, Jesica and Raquel have different fathers, so Jesica didn’t have to worry about whether she had also inherited PKD.
When the whole process began, Jesica was living in San Diego. She decided to move to Salt Lake City with her wife to be closer to Raquel. She went through several months of testing, receiving the news that her antigens were a match in November 2023.
Guided Through the Living Kidney Donor Process
“Back in April 2023, when Raquel got approval to receive a kidney donation, I started filling out paperwork to become a donor,” Jesica said. “I was put in contact with Amanda Boyd, a coordinator from the U of U transplant team, who helped me understand the steps I needed to take and what to expect throughout the process.” Those steps included training and multiple appointments to see a wide range of specialists—the surgeon, a mental health professional, and a nutritionist among them—before she could donate a kidney to her sister.
“Living kidney donors are unique because they choose to undergo a surgery that will not benefit them,” said Michael Zimmerman, MD, FACS, director of the adult kidney and pancreas transplant program at U of U Health. “Whenever you go into a situation like that voluntarily, you have to feel good about what you are doing. The best thing we can do at U of U Health is make sure we take good care of this person and help them feel comfortable through the process.”
The number of living kidney donors is growing as technology expands to help match more people who need kidneys with those willing to give. Even if a person in need of kidney donation doesn’t have a close family member who is a match, there are extensive networks of multi-donor matches to help fill the gaps. These programs help create a chain of kidney donors who give to total strangers, and eventually that circle comes back to provide a match for their family member or friend.
The surgery itself is also easier on both the recipient and the donor, Zimmerman said. Patients no longer have to spend a week or more in the hospital, so they can fit kidney donation into a busy life.
Support from the U of U transplant team through this process was phenomenal. Amanda was so supportive and so communicative. She was there for me with any question I had and has even been in contact with me after the surgery during recovery. It’s such a mentally and physically challenging thing you are doing. Having that support and someone to answer questions made me feel so safe and comfortable with what I was going to put my body through.
Jesica was a healthy person to begin with, regularly running half-marathons and recently completing training to become a yoga teacher. She meditates and goes to therapy and felt mentally ready for what was coming. However, the team warned her that it was still going to be very difficult physically, despite her excellent health.
Surgery and Recovery Give New Hope to Two Sisters
When it was time for surgery, Jesica and Raquel—along with a few family members—went to the check-in together. Jesica was given one last opportunity to change her mind (something all living donors can do, without judgment, if they decide they cannot go through with it at any point in the process). But she was ready. They took her back first, and surgeons removed one of her healthy kidneys. When they placed the kidney in Raquel’s body, it started working immediately.
“The kidney recipient has usually been sick for many years, experiencing significant decline in their kidney function,” Zimmerman said. “They almost immediately feel better after the surgery.”
That was certainly true for Raquel. Even though she didn’t have a lot of symptoms before the transplant, she remembers feeling “like a million bucks” during the early part of her recovery. They were in separate hospital rooms, but she felt good enough with help from the nurses and a walker to go visit Jesica. Down the hall in Jesica’s room, it wasn’t going as well.
“My body doesn’t do well with anesthesia, so the first 48 hours were very challenging,” Jesica said. “But seeing Raquel after surgery and how healthy she looked, my few days of misery were worth it.” The coming days and weeks did not get much easier for Jesica. Even with the extensive preparation from doctors and her coordinator about the physical toll on her body, she thought she would bounce back quickly. But the fatigue and pain were relentless. She wasn’t allowed to do any physical activity for at least eight weeks, which was very difficult for someone who regularly works out.
I am such a ‘go-go-go’ person, and I don’t like to be a burden to others. But when I reminded myself it is okay to ask for help, to be patient and allow my body to heal on its own time and not push it, it got easier.
Today, both sisters are recovering well and looking forward to what comes next. Raquel is closely monitoring her diet and planning to attend yoga classes where her sister is the instructor soon. She knows that the gift she has been given of potentially many decades of a healthy life isn’t something she can take lightly. She will continue to see a nephrologist to monitor her kidney function, but doctors said her healthy kidney could last for 30 years or more.
Jesica loves knowing that she could provide that for her sister and her family. “There was never a time I was not going to give her my kidney,” she said. “I want Raquel to have a long life so she can be there to watch her daughter grow up.”
“My experience with this transplant was amazing. U of U Health is really the best,” Raquel said. “And sisters are the best. Jesica is my best friend. I love her to pieces.”