For 30 years, Stephanie Kelble relied on injections of insulin to keep her alive. She dreamed of one day being a mother but was told it would be too dangerous, because of the many complications of severe diabetes. Then, in 2002, at age 32, the disease spun Kelble into kidney failure, dashing her last hopes of motherhood.
But that was then - and today, Kelble is not only mother to 6-month-old Alyson Marie Sauter, she is free of diabetes, thanks to a double transplant of a kidney and pancreas.
Yet the road to Alyson's birth was a treacherous one, and Kelble is the first women in the region, and only the second in the state, to deliver a healthy baby after having a kidney-pancreas transplant at Indiana University Medical Center in Indianapolis, part of Clarian Health.
“We don't tell women not to get pregnant after a transplant, but the biggest thing is monitoring the immunosuppressant meds,” said nurse Michelle Goble, clinical transplant coordinator at Clarian Health. “I had an ulcer for nine months,” she said of the time she waited for Alyson's birth.
The stress arose because Kelble had not planned to get pregnant and was on an anti-rejection drug that can cause birth defects. If a transplant patient wants to have a baby, Goble said, doctors will switch her to a different combination of anti-rejection drugs. Kelble was switched soon after the pregnancy was confirmed and monitored by high-risk obstetricians.
A history of diabetes exists among Kelble's grandparents on both sides of the family, but her apparent predisposition for the disease kicked in after routine immunizations. She took insulin injections daily starting at age 2 and had an insulin pump implanted at age 29. When kidney failure occurred in 2002, Kelble's Fort Wayne nephrologist, Dr. Samuel Eby, recommended a transplant.
For a diabetic, having a kidney transplant can have a positive outcome for a time, but the diabetes, which is caused by the pancreas' inability to make insulin, can wreak havoc again later in the transplanted kidney. By also transplanting a healthy pancreas, high success rates for removing the cause of the disease have been found in otherwise healthy individuals, said Sheryl Scott, senior program director for Parkview Hospital's Diabetes Treatment Center.
Kelble, a medical assistant with Parkview FirstCare, opted for the double transplant but had no idea how long the wait might be. Some people wait for years for a good match. On Feb. 24, for example, 2,247 Americans were waiting for a kidney-pancreas double transplant, which must be cadeveric organs; 78,541 people were waiting for a cadeveric or living-donor kidney, according to the United Network for Organ Sharing.
The all-important call came Aug. 30, 2005, just two months after Kelble's placement on the waiting list.
“I was working for Fort Wayne Cardiovascular Surgeons at the time, and they were having a bake sale to help raise money for my transplant,” said Kelble, 35. “I was picking up a cake at a bakery and taking it to the office. My cell phone rang. I saw it was a 317 number.”
Later that day, “I walked into the (operating room),” Kelble said, recalling how the surgeon, who was over to the side of the room checking out the organs, asked if she wanted to see them.
“What can you say? I wasn't sure at first, but I looked,” she said. “They came from a man my age, tall, who was killed in a motorcycle accident.”
Because Kelble was in a minority of transplant patients - she did not have high blood pressure and was not overweight - the transplant surgeon said he was eager to do her transplant. In 2008, IU Med Center, which is one of only 22 transplant centers in the country doing more than 10 of the double transplants a year, did 24 kidney-pancreas transplants.
Life for Kelble has changed: no more insulin shots or pump, for one; lots of diaper-changing and baby laundry, for another.
Alyson's healthy birth is a constant reminder that faith can overcome fear, Kelble said, particularly after doctors found a cyst on Alyson's brain during routine ultrasounds prior to her birth.
“It was very scary,” Kelble said, noting many prayers were said on behalf of Alyson, Kelble and John Sauter, Alyson's father, who Kelble said has been with her every step of the way. The cyst went away. Rejection of Kelble's transplanted organs could still come, but for now all is well.
Looking back at the whole ordeal, Kelble said, “I'm more appreciative of life and the little things these days.”
