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Twins Recover After Kidney Transplant : Medicine: Surgeons at UCI Medical Center say the organ is functioning well after the 4 1/2-hour operation, a first for the hospital. Both men ask, 'How's my brother?'


ORANGE — Waking up the morning after their kidney transplant surgery, identical twins Alfredo and Juan Gutierrez had the same question on their minds.

"The first thing they said was, 'How's my brother?' " Beverly Rogers, the nurse monitoring their recovery, said Friday.

Surgeons at UCI Medical Center on Thursday successfully transplanted Juan's left kidney to his twin, Alfredo, in a rare procedure that was the first for the hospital and only the second on record in Orange County.

"This is the unique situation in kidney transplantation," said Dr. Donald Martin, the surgeon who grafted the donor kidney to Alfredo.

Although there is a risk in most transplants that the recipient's body will reject the donor organ, Martin said there are virtually no such concerns with identical twins, whose organ tissue is the same. For Alfredo, that means he can recover without having to take anti-rejection drugs, Martin said.

The 25-year-old brothers, who live in Huntington Beach, were doing well Friday. Alfredo was reported in fair condition in the intensive care unit, and Juan was in good condition.

The transplant was done in a 4 1/2-hour procedure in adjoining operating rooms. Juan's kidney was removed in what his surgeon, Dr. Ervin Ruzics, called a "perfect" operation. Martin then grafted the organ below Alfredo's two existing kidneys, which were left in his body.

The doctors said a "perfectly healthy" Juan provided his brother with a "beefy" kidney that is expected to take up the slack of Alfredo's two failed organs.

"Alfredo's new kidney began making urine as the surgery was completed," Martin said, "and I expect him to have normal kidney function."

In the 40 years that kidney transplants have been performed, 59 involved identical twins, said Fran Tardiff, a hospital spokeswoman. The previous transplant in Orange County was in 1974 at St. Joseph Hospital in Orange.

More than 20,000 people are now on waiting lists nationwide for donor kidneys. In 1992, 10,108 patients received transplants.

Alfredo's kidneys last year stopped doing their job of cleaning his blood and discharging impurities by producing urine. Since then he has had to hook himself up to a dialysis machine three times a week to remove the life-threatening contaminants from his system.

The kidneys failed because of complications from untreated strep throat he had as a boy growing up in Mexico. And although people with failed kidneys can rely on dialysis for extended periods, Alfredo's health had been deteriorating because of related problems with high blood pressure and his heart, Martin said.

As his condition worsened, Alfredo was forced to give up his jobs as a landscape and restaurant worker and his weight dropped to 40 pounds below his brother's 180 pounds.

Juan, who lives with Alfredo and Alfredo's fiance in Huntington Beach, is expected to be released from the hospital early next week, and in about six weeks should be able to return to his jobs making pizza by night and delivering advertising circulars by day, Martin said. Alfredo's condition will be monitored further before a decision is made on his release.

Juan initially was reluctant about giving up one of his kidneys when doctors approached him with the idea--a reaction Ruzics said is normal with donors.

"I'd be a little concerned if he was not apprehensive," said Ruzics, noting that the hospital always screens donors physically and psychologically before a transplant. "Juan was a little nervous, but he was committed."

The brothers' parents, Victoria and Ezequiel Gutierrez, and Alfredo's fiance, Maria Valdibiezo, said at a hospital press conference Friday that they were surprised by how well both brothers seemed to be after the surgery.

"Juan (Thursday) night was very alert," Ezequiel Gutierrez said through an interpreter. "He was even joking with us."

The parents, who traveled here from their home in Acapulco to be with their sons during the operation, said Juan's donation of his kidney was not surprising since he and Alfredo have been virtually inseparable since they were born.

Ezequiel Gutierrez said he hopes to see Alfredo healthy enough to work again. But what he most wants to see is his son, once a competitive swimmer, again churning through the water.

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