Transplant Transformation

A new kidney transplantation technique breathed new life into Dr. Robert Jaffe
Niki Stojnic  |   Seattle Health Spring/Summer 2014   |  FROM THE PRINT EDITION
Dr. Robert Jaffe Had a kidney transplant breakthrough

“I  basically got a death sentence in my last year of medical school,” says Dr. Robert Jaffe. He was 28 years old and a family physician at Providence Health and Services in Rainier Valley when he began to experience symptoms, such as urinating blood, that made him realize something was very wrong with his body. It turned out to be kidney failure.
Jaffe initially got a kidney transplant from his sister, but that organ never functioned. Instead, his body rejected the transplanted kidney and also developed antibodies that would reject any other potential donated organ. To stay alive, he went on dialysis, a machine that stands in to function for the missing kidney.
Jaffe underwent dialysis both at the Northwest Kidney Center and on a home machine in his basement for seven years, and it was the mark of a huge life transition. “Dialysis is almost a part-time job; you spend 20 hours a week at it,” he says. “I went from being a family physician to going on Medicare and Social Security.”
In 2004, Jaffe was contacted by the University of Washington (UW) nephrology department; it had a donor and, more importantly, nephrologist Connie Davis had been researching kidney patients like Jaffe whose systems were rejecting transplants. The UW team had come up with a treatment that could possibly change that—they removed the “B” cells, which develop antibodies to resist foreign things, such as transplanted organs, from his blood by running it through a centrifuge and returning it to Jaffe. This essentially tricked his body into not noticing that he would be getting a new kidney from a young woman with whom Jaffe “wasn’t really a compatible match.”
This year, he is celebrating his 10th year with the transplanted kidney. “It’s still working for me!” he says. He’s back to working full time, at the north Seattle branch of the King County Health Department—his kidney ordeal reinvigorated his attitude toward his work, to which he had become somewhat jaded. “When I went off to get my transplant in 2004, I wasn’t sure if I was going to return to medicine; primary care was becoming like the fast-food industry,” he says, with doctors serving too many patients with too little quality time. “But when I got transplanted, I developed an affinity for people facing illness. The transplant gave me a feeling of empathy that I had no inkling of before. It’s like you have this key to a club; when you have a serious illness a lot of people end up identifying together as with a tribe—one of the things that helped me cope was getting to know people.”
As a patient, Jaffe gained a lot of compassion for patients navigating the medical system. “You place yourself in a very vulnerable place as a patient. You have to be an advocate for yourself, but your judgment can be unreliable under stress.” Jaffe writes things down for patients now, “even if they look like they’re paying attention, because I know it’ll take them several instructions to understand.”
Jaffe also says he’s come away from his experience as both a patient and a physician inspired by those who do medical research. “Ten years ago, I would be dialyzing without a chance of a transplant. This is new technology. What I think is remarkable as a kidney patient and as a physician is that there are so many people working so hard trying to figure out how to extend people’s lives and improve the quality of our lives. Kidney failure has this fatalistic title to it, but the game has changed. It’s not end-stage any more.” +