The Dalles twins celebrate birthday with successful transplant

Brenna, a mechanical engineer who lives in Fairview, had known all her life that someday she would be donating a kidney to Brita, who is finance manager for North Central Public Health District in The Dalles.

And now, in recognition of National Donate Life Month this April, which thanks living donors for their lifesaving generosity, the twins are telling the story of Brenna’s gift.

Born about three months premature, the twins spent time in NICU — Brenna for two months after birth, Brita for three.

In utero, they had twin-to-twin transfusion syndrome, when one twin doesn’t have enough blood (read nutrients) and the other has too much. After they were delivered by emergency C-section, Brita needed several blood transfusions, and Brenna had to have her blood reduced.

“As my dad put it, when we were born, we looked like a piece of liver and a piece of cod,” Brenna said. “My mom prefers to think of it as her pearl and ruby.”

Born severely anemic, Brita’s kidneys — which filter waste from blood and produce urine — were stressed, resulting in extensive scar tissue.

“She had so much scar tissue they never grew more than toddler size,” Brenna said.

As kids, they were told Brita would need a transplant when she was in her 60s or 70s, essentially a full lifetime away. By late high school, the timeframe shortened to her 50s or 60s. After college, it became her 40s.

In November 2022, she was given a 2–5-year window. Then, in February 2023, Brita was told it would be 1-2 years, and her doctors entered her into the transplant program.

The vetting process for Brenna as a potential donor was “intense. Like, what is my mental state, am I being coerced in any way, am I receiving something from anybody for my kidney, do I have any history of depression,” she recounted.

She was asked how she’d feel if she couldn’t be a donor, or if her sister refused her kidney. Kidney donation can produce something similar to post-partum depression, but she never experienced it.

Never once had Brenna or Brita ever doubted Brenna would give her sister a kidney: “If anything, it’s been more of a joke, like for Christmas this year I got her a shirt that says, ‘Kidney thief,’” Brenna said.

Brenna said of Brita, “For her too, it was always such a given. It doesn’t make her less grateful.” In fact, Brita wrote her sister a note before surgery, acknowledging that most of the attention had been on Brita, but that she was acknowledging, like others had, the great thing that Brenna was doing.

Brenna said of the note, “It’s not something I was looking for from her, I knew it was there.”

For Brita, transplant preparation was arduous. Last August, they needed 27 vials of blood drawn. She’s always been a hard stick, difficult to get blood out of. Her record is four tries: “Elbow, elbow, wrist, wrist, like a Cherry princess wave,” she quipped of the places they tried to draw blood.

At the appointment, she passed out after the eighth vial, a first for her. Then she threw up. They canceled the rest of the visit and she came back later, and that time they said they only needed four vials.

She was skeptical. They double checked, and again said it was just four. A few days later, an apologetic call: Yes, they needed more blood after all. A third visit then, for 11 vials.

By last May, she was at end stage renal failure. Fortunately, a few months earlier she’d started a diabetes drug — now commonly used for non-diabetic kidney patients — that had stopped her recent significant decline, right at the precipice of needing kidney dialysis.

In fact, Brita didn’t fear dying, she feared going on dialysis, which some people must endure for decades. She’d read about how some chose to die rather than continue dialysis, twice a week, six hours each time, having their entire blood supply filtered, machines doing the work of the kidneys.

She’d read about all sorts of complications that could happen, because doctors have to combine a vein and artery to make a large access point for dialysis.

Brenna couldn’t even begin her process until Brita was cleared for transplant. But in a frustration for Brita, she learned more about the upcoming surgery through her sister than from her transplant team.

By November, Brenna was cleared to donate, and then a surgery date — it’s donor’s choice, but Brenna cleared it with Brita — was set for Jan. 9 at Oregon Health and Science University (OHSU).

The day before, they had another big round of blood tests: 29 vials for Brita, and she didn’t pass out this time.

As Brenna underwent surgery, Brita waited for awhile alongside her family, and the pastors from both Brita and Brenna’s churches.

Brenna had made kidney-shaped decorated sugar cookies for the wait, and both twins laughed that their dad, who both said “will eat anything,” wouldn’t touch the cookies. “Those were too much for him,” Brenna said.

The twins’ mom, Dana Meyer, said surgery day was “pretty hard on me,” despite the fact that neither twin felt any anxiety about the operation itself. Between them, the twins were in surgery from about 6 a.m. until 9:30 p.m. Dana could only be one child’s primary care person (she was Brita’s), but she needed to know how both were doing.

“You have to understand,” she recounted feeling, “I have two daughters going under the knife today.”

The family’s faith, and even their profession as orchardists, all helped them to make it through the whole process. “We’re farmers,” Dana said. “You just have to take it as it comes, and do what you have to do. And we’ve got our faith that sustains us too. We know God’s watching us, and there’s good things beyond this earth and if it’s your time, we’re going to have to take it, but we’re happy it’s not the time with our girls.”

Doctors “geeked out” a bit when they learned shortly before the transplant that Brenna and Brita were a total, identical match. They’d been born at OHSU, and the doctors found their mother’s records from their delivery. C-sections traditionally have placenta pathology reports, Brita said. Her mom’s showed the twins shared one placenta.

“If you share a placenta, it will be a perfect match, no issues, which should’ve been a given because this whole thing was caused because we were sharing an umbilical cord,” Brenna said. It’s so rare that the last time it happened at OHSU was more than 10 years ago.

This perfect match means that, unlike other transplant recipients, Brita’s body recognizes the new kidney as if it were her own. That means Brita will be weaned off anti-rejection drugs, which carry their own risk to health.

“It’s still amazing that by nine months I’ll be off everything,” Brita said, “when most other people are on them for the rest of their lives, or the life of the kidney.”

Deceased donor kidneys last 15-20 years on average, living donor kidneys 20-25 years, Brita said.

Brenna sailed through surgery, and left the hospital two days later. Recovery was significantly easier than she expected. She feels just like she did before the surgery. She’s reduced her protein intake a bit, since it’s hard for kidneys to process. She’s less interested in meat also. She’s trying to drink more water to stay hydrated and she’s also reducing salt intake.

Her remaining kidney will grow 50%, leaving her with 75% of her original kidney capacity.

Brita was supposed to leave the day after Brenna, but her recovery was bumpier. Her new kidney was so much more robust than her old kidneys that she quickly began producing a huge amount of urine.

Normal adult output is 2.5 liters per day. She was peeing 6-7 liters most days — one day it was 9.3 liters. She passed out one day because of her fluid imbalance.

“It was insane for like those first couple of weeks,” Brenna said. “Like she just did not stop peeing.”

Eventually her new kidney settled down. She spent nine days in the hospital, the last one because her mom couldn’t come get her the day before due to an ice storm.

Now, Brita has more energy, especially in the morning and evening, and her urine is no longer foamy. She’s no longer cold all the time. She’s thinking more clearly, mostly because she’s not tired all the time.

Always weighing barely 100 pounds, Brita has put on about eight pounds since the transplant, due to an improved appetite, including for meat.

Especially in the six months before her transplant, meat had become unappealing. People with kidney failure often lose a taste for meat, because it is a high protein food that’s difficult for the kidneys to process.

She’d never been able to gain weight no matter what she tried. She’d like to put on about five more pounds.

Dana said, “What I am enjoying is how much Brita is enjoying food. She has never enjoyed eating. I’m looking forward to watching as she blossoms in new ways. I think it’s always been a bit of a cloud over her head, and she had kind of a sense that she’s damaged goods. She never said that, but you kind of get a sense. ‘Do I really feel like I’m 100%?’ And now I think she does, and I hope to see her embrace that, and not have that cloud over her head.”

Now, both are fully recovered, just in time for Brenna’s wedding at the end of this month.

And yes, it turns out that Brenna does still give her sister gifts. For her birthday, she gave her a decorative cutting board shaped like Oregon.