A life-saving gift

During the winter of her junior year at Augsburg University, Aaliyah Abdi ’23 received shocking and unimaginable news.

Her body was starting to reject a kidney transplant from when she was 14 years old.

There hadn’t been any problems in the seven years since Abdi had received the kidney, donated by her mother. But suddenly, Abdi’s doctor was telling her that she’d have to either go on dialysis—an ongoing medical treatment to clean a person’s blood amid kidney failure—or get another kidney transplant soon.

“It was just a sporadic rejection,” Abdi said. Her first kidney transplant was needed because of an autoimmune disease. But this time, “there wasn’t any underlying issue with my health that would have warranted the rejection of my kidney. It just happened. The doctor said that’s just what happens to some people.”

Abdi hoped to find a kidney donor quickly. Doing so would mean she could skip the exhausting and time-consuming dialysis treatment. However, she didn’t have any immediate options. Abdi’s mother had already donated for her first kidney transplant—she couldn’t donate again. And the rest of Abdi’s family members and close friends were unable to donate for other reasons.

“A handful of people were willing to,” she said. But when these prospective kidney donors did a Mayo Clinic online assessment to see if they were eligible, each one was rejected.

“I was like, ‘Oh wow, that kind of sucks. But it is what it is,’” Abdi said.

With her family and friends unable to donate, Abdi was unsure of who to ask next.

What she didn’t know at the time was that one of her teachers at Augsburg also had kidney donation on her mind. For years, French instructor Sharon Gerlach had felt called to donate a kidney, but she didn’t know anybody who needed one. Although Abdi was in her second semester of Gerlach’s class, she had not shared her health struggles with her teacher. Neither of them knew what the other was thinking.

‘It was on my heart’

Gerlach had thought about kidney donation since 2009, when she read a newspaper article about the need for these life-saving procedures. “It just kind of struck me as something I’d like to do someday, if I knew somebody and if I was a match,” she said.

Then, Gerlach’s mother was diagnosed with kidney disease. “I thought, ‘Well, if my mom needed a kidney someday, I’m totally on board with that.’ But her kidney disease was not progressive, so she never had a need for dialysis, and she never needed a kidney donor at any time,” Gerlach said.

Still, reflecting on her mother’s diagnosis got Gerlach thinking more and more about kidney donation. She contemplated it for years, saving articles on the topic whenever she’d come across them. In 2021, Gerlach even considered donating a kidney anonymously.

“It was still really on my radar and on my heart,” she said. “I was just thinking, ‘I’m healthy now, so now might be a good time to donate a kidney.’”

She asked her husband about whether she should donate anonymously, but he was concerned the procedure might affect her ability to care for their youngest son. He suggested she hold off for a few years, and since she didn’t personally know anyone who needed a kidney donor, Gerlach set the idea aside for a while.

Being a student on dialysis

In March 2022, a few months after Abdi’s body began to reject her kidney, her health got worse, and she could no longer put off dialysis treatment. She began to go to a dialysis facility three times a week, for three to four hours at a time. After each appointment, she’d feel completely drained.

“It was hard,” Abdi said. “Dialysis is so taxing on your body. Even though you’re sitting in a chair for three or four hours, it feels like you ran a mile. You’re out of breath; you’re so exhausted because your blood is being pulled out and drained and cleaned.”

As a psychology major approaching her senior year, Abdi worked hard to keep up with her schoolwork amid dealing with her health issues. She scheduled classes around her dialysis appointments, and she worked to finish her homework during the first hours of dialysis, before she became too tired to do it.

“It took a lot of time management,” she said. “Oh my gosh, it was so much time management.”

The exhaustion also affected Abdi’s life outside of class. “I felt like I missed out on a lot of things like just going out to a movie at night or going out to dinner because I would be so tired,” she said.

For the most part, Abdi kept her struggles to herself. Most people at school didn’t know she was on dialysis, she said. If she had to miss class because of an appointment, she’d usually just tell the professor she had “a medical issue” without getting into details.

“I would almost try to create two different versions of myself. There was my ‘dialysis and sick me,’ which a lot of my family and closest friends were involved with. But my ‘school self’ was completely normal,” Abdi said.

Then, one day in late April, she was so drained from dialysis that she wasn’t going to make it to French class. She emailed Gerlach.

“I just told her flat out, because I was tired of holding it. I was kind of at my last point,” Abdi said. “I told her, ‘I’m not coming to class because I’m exhausted from dialysis’—and that’s what kind of sparked the whole conversation.”

Making the connection

The weekend before she received Abdi’s email, Gerlach had decided to pray about kidney donation.

“I really felt like I should donate a kidney soon because I knew I was in good health and I’ve got the support network, and you never know what’s going to happen,” Gerlach said. “I remember, I just decided to pray about it. I’m a person of faith, and I kind of thought, ‘God, if you’re going to place this on my heart, open that door for me, or just make it clear if this is something I should pursue.’”

When Gerlach got to campus on Monday, she saw Abdi’s email about dialysis. “I thought, ‘Dialysis? I know what that means,’” Gerlach said. “And I’d had no clue. Aaliyah had never given any indication that she had any serious health problems or any kidney issues at all.”

Gerlach responded with sympathy for what Abdi was going through and asked if this meant she needed a kidney donor. Gerlach wasn’t offering, but she wanted to know more about Abdi’s situation.

“When I saw her ask that,” Abdi said, “I was like, ‘Stop! Do you know somebody?’ It was such a weird email thread because I just kind of woke up. I was like, ‘No, she can’t be talking like this.’”

The email connection moved Gerlach, too. “It really hit me,” she said. “I honestly wanted to say ‘yes’ right away, but I had to check with my family first.”

Gerlach took time to research the process of kidney donation and to discuss the implications with her husband.

In the meantime, Abdi had her final exam for Gerlach’s class. As Abdi was leaving the classroom, Gerlach stopped her to say she’d been thinking about her ever since their email exchange.

Gerlach recalled, “She kind of looked at me and asked, ‘Have you thought about it? Would you be willing to donate?’”

But Gerlach was still in the process of discussing it with her family. “That was really hard to have her ask me directly and not be able to say ‘yes’ right away because I really wanted to,” Gerlach said.

After that conversation, Abdi assumed Gerlach would not donate her kidney. She was disappointed, but she understood. “I was like, ‘Okay, no worries,’” Abdi said, “and I left that school year, my junior year, thinking, ‘It’s okay. I’m just going to have to keep doing dialysis.’”

Saying ‘yes’

Several weeks later, while Abdi was on campus doing research with the McNair Scholars Program, she got an email from Gerlach.

It said Gerlach wanted to donate her kidney.

“I was like, ‘Oh my god, no way,’” Abdi said. She didn’t want to get her hopes up because her other potential donors had turned out to be ineligible.

“But then,” Abdi said, “I hopped on a Zoom call with Sharon. She was telling me the story of how she understood and how kidney disease had affected her life.”

Abdi could barely believe what she was hearing. “It felt like she needed to do it. And I was like, ‘You’re joking with me right now. You’re joking!’”

During that Zoom call, Gerlach and Abdi shared their blood types and discovered they wouldn’t be a match for a direct donation, Gerlach said.

However, they decided to proceed because, if eligible, Gerlach could donate on Abdi’s behalf, putting Abdi in line to receive a kidney from another living donor via exchange through the National Kidney Registry. The benefit of connecting with a living donor, according to Mayo Clinic, is that the recipient can have their transplant sooner than if they were on a waitlist for a kidney from a deceased donor.

Abdi sent Gerlach the link to the Mayo Clinic online questionnaire to see if she was eligible—and Gerlach passed. Then, Gerlach had to participate in a couple of phone interviews followed by two days of in-person testing at the clinic in Rochester to confirm her eligibility to donate.

On June 29, Gerlach was officially approved to donate her kidney on Abdi’s behalf.

When Abdi heard this news, the donation finally felt real. “When Sharon told me again—after she did all the Mayo Clinic things—that she was accepted, I cried,” Abdi said. “I think I was walking somewhere when I got the email, and I just stopped. I sat down, and I cried.”

Abdi’s family and friends were relieved and overjoyed, too. “They saw me struggle for a long time,” she said.

“I was so happy and thankful,” Abdi continued. “How could I not be thankful? It’s somebody who’s not related to me, who had just met me over the course of a year and, out of the kindness of her heart, was able to do something so selfless and give me another chance of just living a normal life.”

The donation process

Gerlach’s kidney would be given to someone on the National Kidney Registry waitlist, and, in exchange for this donation, Abdi would be placed on the waitlist to be matched with a living kidney donor.

Gerlach’s donation surgery was scheduled for August 11 at Mayo Clinic. She wanted to be able to recover in time to teach the Fall 2022 semester.

“I figured that would give me at least three weeks to recover before classes started. That was kind of my criteria,” she said.

The surgery went smoothly. When Gerlach woke up in her hospital room, she had an email from the son of the person who received her kidney.

“When you’re donating like that, you may not ever know who you donated to because they keep each person’s confidentiality,” Gerlach said. “I had signed a release saying it’s fine to share my contact information with my recipient, and I didn’t necessarily expect to hear back from them.”

But the email meant a lot to her. “It said, ‘Thank you for saving my father’s life,’” Gerlach said.

Gerlach stayed in Rochester for a few nights after her surgery, then continued her recovery at home. The process went quicker than she expected. “I felt up to driving after 10 days, and the first place I came to, actually, was a faculty workshop at Augsburg,” she said.

“Two weeks to the day after my surgery, I was feeling so good I decided to go to the State Fair,” she added. “I did get tired more quickly and had to sit down to take a little nap, but I had a great day.”

Eventually, Gerlach fully recovered without any problems. “Some people wonder, are there lasting effects of donating a kidney? For me, none at all,” she said. “They did all kinds of follow-up tests on me. You can live perfectly healthy with good kidney function with one kidney.”

A long wait

Meanwhile, Gerlach stayed in touch with Abdi, who was waiting for a donor match from the kidney exchange.

The wait was longer than anticipated. Abdi had tried to work with her medical team to get a kidney transplant around the same time as Gerlach’s donation surgery, but another unrelated health problem came up. Abdi had to be pulled off the kidney waitlist until she was healthy enough for surgery.

“This other health issue affected my eye,” Abdi said, “and it just kind of happened randomly. So, my kidney team was like, ‘We’re going to pump the brakes on you.’”

In November 2022, her doctor gave her the green light for transplant surgery and she got back on the waitlist. But it would still be months before she’d get matched with a donor.

“I had waited for so long already,” Abdi recalled. “I was trying to get that kidney so that I could finish off the rest of my senior year feeling OK.”

In March 2023, she finally got the call. She’d been matched with a donor. Her transplant was scheduled for April 19 at Mayo Clinic.

Abdi would have to stay in Rochester for two to three weeks after surgery for recovery and follow-up tests. Determined to graduate on time, she emailed her professors so they could help her plan to finish her schoolwork before the surgery or remotely.

In those emails, Abdi finally told her professors that she’d be having a kidney transplant. They offered a lot of support, she said. “They were like, ‘Congratulations! We didn’t even know you were dealing with that.’”

On April 19, Abdi headed to Mayo Clinic for her surgery—but she was feeling sick.

After preoperative testing, Abdi’s doctor told her she had a high fever and could not go through with the transplant.

“I was fighting,” Abdi said, “and I was so sad that day when they said I couldn’t get the kidney.”

‘Such a sweet gift’

When Abdi got back to Minneapolis, she felt deeply disappointed. “It was like the wind was kicked out of me,” she said. She’d have to wait to get matched with another donor, and she didn’t know how long that would take.

“It was so sad,” Abdi said. “I had already said goodbye to all my friends and family and my teachers. So, when I came back, everyone was super sad. But I was like, ‘It is what it is. I’ll get a call eventually, when it’s my time.’”

With most of her schoolwork done, Abdi mostly just rested and spent time with her family until she could graduate. She also continued dialysis.

On May 3, Abdi proudly walked in Augsburg’s commencement ceremony with her family and Gerlach supporting her.

Then, the next day, Abdi got a call from her medical team. They told her she’d been matched with another donor.

“They got me a kidney. It was such a sweet gift,” she said. “Yes, I graduated on dialysis and with all my health issues, but to be done with it during the same year was such a gift for me. I was so thankful for that.”

Abdi’s transplant surgery was scheduled for May 30, and in the week leading up to it, she essentially quarantined herself. She didn’t want to get sick again.

“I was like, ‘Nobody come see me, and I’m not going out. I’m not trying to get sick this time.’ I was not playing,” she said.

On May 30, Abdi returned to Mayo Clinic and her surgery went well. She recalled, “I woke up and asked, ‘They gave me the kidney, right?’ and the nurse told me, ‘Yeah, you got a kidney. You’re all good; you’re all fine.’ And then I just started crying. I was so happy.”

Abdi’s recovery went smoothly, and she stayed in touch with Gerlach throughout the process.

She also contacted her donor to express her gratitude. “I loved having my Zoom conversation with him,” Abdi said. “Much like Sharon, he felt like it was something he needed to do. He was not donating on anybody’s behalf. He just did it. … Nobody technically had any ties where they had to do it for somebody else. They just did it, and then I ended up with a new kidney. That’s just very sweet.”

Moving forward

To Gerlach, the donation experience felt impactful for several reasons.

“I can’t think of anyone I would rather donate my kidney for than Aaliyah. She’s got so much potential and so much life ahead of her. I was just really, really glad that I could help someone like her,” Gerlach said. “And the other part of the story is knowing that I helped two people kind of get their normal lives back, because we did the exchange. That was really meaningful to me.”

Gerlach encourages anyone interested in donating a kidney to seriously look into it. “If someone feels like they might be willing to do it, I would say definitely consider it. Definitely be open to it if you’re in good health and if you have the support. It’s something you can do to save somebody’s life, and there’s so many people on the waitlist,” she said.

“Not everybody’s called to do everything,” Gerlach said, “but I’ve been blessed with really good health, and so this is something that I could do. It’s not often that you can do something that will save someone’s life. That’s pretty rare.”

Abdi has been in good health since the transplant. She said she’s working at two mental health clinics in the Twin Cities and has just been enjoying life.

“My kidney is working great,” she said. “My energy levels have increased, my appetite has increased, and I feel like my outlook has changed, too.”

Abdi added that she hopes students who hear her story will be inspired to be more open about their own struggles. She made the personal decision to keep her health issues to herself for a long time, she said, “but everybody at school was really sweet and supportive of me once I was able to tell them.”

“It can be very difficult to share the things that are affecting you with other people aside from your immediate family and friends,” Abdi said. “But the more I spoke about it, I realized, the better I felt. Just be more open to any relationship you have and to your own personal story. Because if you need something, the person that might be able to give it to you might just be teaching you.”

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Top image: French instructor Sharon Gerlach and Aaliyah Abdi ’23 in the quad on Augsburg’s campus (Courtesy photo)