In order for there to be a gift of life, there must be a giver.
Living donors are more common for some types of transplant procedures, especially kidney transplantation, but patients needing a heart, lung or pancreas rely nearly solely on deceased donation. For these transplants, the life-giving outcome comes after a high cost — the life of another.
In Jeff Granger’s case, that life belonged to Bryan Herrington. When Bryan, 35, died in 2004, Jeff received his pancreas and a kidney in a combined transplant.
Thank-you notes are customary for even the smallest of trinkets, and organs are far from the exception. Jeff and his wife, Pam, sent Bryan’s widow, Terri Herrington, and two children a thank-you letter within a month of the procedure, along with the occasional holiday card. They kept in touch anonymously for the first year, as required by LifeQuest Organ Recovery Services.
“Just hearing from them, and how much their life had changed, was a healing process for me and my boys in and of itself,” Terri Herrington said.
One year after the transplant, she replied for the first time and included her phone number.
“I remember sitting down and thinking, ‘Heck, I’ll give her a call,’ ” Jeff said. “I didn’t know a thing about her.”
The conversation lasted 45 minutes.
And they found ways to keep talking. That same year, Terri invited Jeff and Pam to her sister-in-law’s football party at their Pensacola home. Once again, Jeff found himself saying “What the heck?” and he decided to make the trip from Wacissa, a tiny town 25 miles east of Tallahassee. Expecting a low-key event, the Grangers pulled into the driveway and couldn’t find a parking space.
All of Bryan Herrington’s family was there. One by one, Jeff shook hands with each of them. By the end of the night, he was playing football with Bryan’s sons, Drake and Payton.
The families kept in touch for the next 15 years, alternating between phone calls, visits and social media. If Terri and her boys were going to Orlando, she’d make sure to go through Wacissa and stay for lunch, or the night.
One afternoon, Jeff was sitting in the house when Terri and Bryan’s youngest son, Payton, came up and put his hand on Jeff’s stomach.
“My dad’s in there,” he said.
“Sure is,” Jeff said. “And I’ll try to keep him alive as long as I can.”
Although their relationship was stronger than that of most deceased non-related donations, it was about to grow even closer.
In January 2019, the donated kidney from Bryan began failing. Jeff did the first thing he could think of: He called Terri.
“I’m losing Bryan’s kidney,” he told her. “I’m so sorry.”
“Well, I’ve got one,” Terri said.
Jeff shrugged it off, assuming she was joking. They didn’t address the subject again, until Jeff took to social media in search of a kidney donor. The post did well. Many people shared it and left comments — including Terri.
“I’ll email you a packet if you’re really interested,” Jeff commented.
“I’m not ‘really interested,’ ’’ Terri told him. “You’re getting mine.”
One phone call and a couple of UF Health Shands brochures later, Jeff knew she was serious. And, more importantly, she was a match.
‘This girl was an angel’
Kidney failure is many things. Nausea, muscle cramps and other discomforts. But mostly, kidney failure is a lot of waiting.
When Jeff’s kidneys started failing in 2004, he was on peritoneal dialysis to get well enough for a transplant. He was waiting to feel better and waiting for a kidney and pancreas. At the same time, he was waiting to hear about a job, and waiting for a back operation. He planned on telling the doctor he was ready to give up on waiting for a donation, and delay the procedure so he could undergo a different surgery for his bad back.
Around that same time, Bryan Herrington was working on a project in his Pensacola roofing business with his brother, Ed. On July 13, 2004, he called out to his brother that he was going to go check out the roof from the other side. He never made it. The slick roof caused Herrington to slip and fall. He never recovered from his head trauma.
Back in Wacissa, Jeff got a phone call.
You have two and a half hours to get down here. We have a match.
Because Bryan was already listed as an organ donor, the process was smooth: Four people received his heart, lungs, pancreas, liver and kidney. Terri kept in passing touch with all of them, but the Grangers left a particular mark.
But when his kidney began failing again, Jeff never expected her to give him his second chance. He was floored.
“This girl was an angel,” Jeff said. “She’s a single parent, and God’s gift of a parent, too. I don’t know how I could thank her, or repay her for such a wonderful life-giving gift.”
“It’s kind of a miracle, you know?”
But sometimes even miracles require waiting.
Reuniting with her late husband
In November 2019, Jeff and Terri were scheduled to undergo the transplant surgery. They arrived at UF Health Shands Hospital and moved into their temporary living quarters: Terri at an apartment complex nearby, helped in part by the National Living Donor Assistance Center, and Jeff and Pam in their camper they drove down from Wacissa.
On the morning of Jeff’s preoperative appointment, he was running a low fever. Any other time, it would have been a minor inconvenience. This time, it brought the scheduled transplant operation he’d been waiting for since January to a screeching halt.
A lab test confirmed an elevated white blood count — a sure sign of an infection.
Terri packed up and drove back to Pensacola. Jeff was admitted to the hospital and later diagnosed with pneumonia.
As he went through round after round of antibiotics, trying to beat the infection and elevate his red blood cell count, Terri waited.
After going to the Rose Bowl Parade with other donor families in 2018, where the Donate Life float is a fixture in the event, she’d decided to become an ambassador for the United Network for Organ Sharing, or UNOS, and educate people on the importance of organ donation. She felt suited to it. After all, Terri was used to explaining things to people (although those people were usually students in her ESE classroom).
“After Bryan’s death, I had to take a different approach toward what I was going to do with the rest of my life,” Terri said. Her hope is that people realize they have something to give.
In Terri’s eyes, the organ donation process is simple. It’s a yes-or-no question. All you have to do is say yes.
“As we got closer to the surgery date, I had a lot of people coming up to me and asking, “What if you need it?’ ” Terri recalled. “And I said, ‘Well, what if I don’t?’ ”
People asked Terri’s now 16-year-old son, Payton, what would happen if there was an emergency and his mother needed a kidney. His answer was always the same, and came without hesitation.
“She can have mine.”
Terri is familiar with how unpredictable the future can be. Bryan’s death was an accident. She reminds people that, for all she knows, she could get in a car and get hit tomorrow.
“If I lived off of what ifs, I wouldn’t live,” Terri said.
Terri had been thinking about becoming a living donor for sometime. Seeing the joy of donors at the Rose Bowl Parade stuck out in her mind. There was always a reason to put it off, however, whether it was a lack of vacation days for recovery or family obligations. She assumed she’d get to it eventually.
But when Jeff called to tell her Bryan’s kidney was failing, she took it as a sign.
“Jeff will still have Bryan’s pancreas,” Terri said. “In a way, we’d be back together again.”
Any nervousness regarding the eventual surgery?
“Well, I have a little apprehension because y’all are Gator people,” the Seminole fan said.
This time, it was Terri’s turn to wait for a call.
Timing is everything
The process of managing a transplant between a living donor and a recipient is a bit like conducting an orchestra.
There are multiple things going on at once, several different key players and a precise order in which everything has to happen. Transplant coordinators exist for every kind of organ and donor type and act as conductors to a song that, if played correctly, results in a longer life.
“Sometimes donors want to donate because they’re family,” said Stephanie Sharpe, R.N., B.S.N., a kidney transplant coordinator at UF Health Shands Hospital. “Other times, people know all about the process and don’t have anyone in mind. But they know they want to help.”
Once donors fill out a packet, then Sharpe reviews their questionnaire and medical records. She looks for things like healthy weight, blood pressure and how well their kidneys function, as well as some red flags — like the results of a cancer screening.
When those are all deemed good to go, the donor meets with everyone on the team: the coordinator, nephrologist, surgeon, social worker, dietitian and financial representative.
“Donating kidneys is a great thing but can be a big ask,” Sharpe said.
Donation requires individuals to take time off from work for the procedure, if applicable, as well as time for recovery. They need to book a hotel if they’re staying outside a two-hour radius of UF Health Shands Hospital and must account for food as well as the occasional plane ticket.
Recipients who are on a wait list for organ transplants are expected to be ready for a call 24/7. Consequently, living donor transplant processes are typically run according to the donor’s timeline.
“One of the main reasons living donor transplant surgeries tend to do better overall with the recipients is due to our ability to optimize their medical condition,” said Kenneth Andreoni, M.D., an associate professor and chief of the division of transplantation surgery at the University of Florida College of Medicine, who was one of two surgeons handling the recipient side of the procedure.
“So, in regards to the living donor, you pick a time that works for them, like summer vacation if they’re a student or teacher. On the recipient side, we try to optimize their care.”
By contrast, potential recipients of organs from a deceased donor need to be ready at a moment’s notice. This means they could show up with suboptimal health conditions or symptoms that might lead to complications. At that point, surgeons have to make the decision to cancel the procedure or take the risk and proceed.
When Andreoni saw Jeff’s lab work indicating infection, he postponed the surgery, knowing the difference an optimal health state would make.
“Even if you’ve been working with both donor and recipient for months, and something occurs at the last minute, you need to be flexible enough to optimize that event — both the living donation as well as the recipient’s operation,” Andreoni said.
Nowadays, 20% to 40% of kidney transplants are through living donation. Although there are more living donors than there used to be, these are often between first-degree relatives, such as parents of children, or siblings (living related donors). More and more donors are distant relatives, or even spouses and friends (living unrelated donors).
Patients who receive organs from living donors do much better on average, Andreoni said. Their grafts last twice as long, there are fewer hospitalizations and complications, and much fewer rejections, largely due to the fact that surgeons have more control over the timing of the transplant itself and the usual immediate function of the transplant.
Has he ever heard of someone donating to the same recipient as their late spouse?
He hasn’t. Jeff Granger and Terri Herrington appear to be a first.
Lives eternally linked
When the transplant was rescheduled, it was March 3, almost 14 months after Jeff’s kidney first began failing. Despite the moments of worry, the procedure went off without a hitch.
In recovery, Jeff and Terri walked together down the hospital hallway.
“I couldn’t ask for better care at a hospital,’’ Jeff said. “And we are Gators fans, so it means a lot to us to come down and see all this blue and orange.”
When his kidney first started failing last year, Jeff was overcome with fatigue, having only enough energy to sit through dialysis and then rest in his chair. Pam would come home from work and find he hadn’t moved.
Now, he looks forward to doing the things he missed out on — like getting together with neighbors over a big campfire, or taking long walks around the country.
He and Terri will continue to stay in touch, closer than before.
“We were a perfect match,” Jeff said. “Just like me and Bryan were. And I hope to stay in touch with them the rest of our lives.”
Terri shares those sentiments.
“We aren’t organ donor and transplant recipient,” she said. “Through this connection, we’ve become family.”