One Bainbridge Woman’s Quest for a Kidney Transplant and the Friend who made it Happen

Susan Balch considers herself one of the “lucky ones”. The 57-year-old Bainbridge resident is back to an active life after undergoing a kidney transplant in February of 2020 in her hometown of San Diego, CA. She received a “live donor” kidney – not from a stranger – but from a friend and former college roommate, Audrey Natal.

“My amazing and selfless friend completed the lengthy process of testing, and more testing, and happened to be a perfect match for me,” says Balch. “I will be forever grateful for her selfless act.”

Balch and her husband, Jeff, moved from Southern California to Bainbridge Island about a year and a half ago. Susan’s taken up pickleball and she’s involved in other activities, such as volunteering at the Bainbridge Island Historical Museum.

While her story may not be unique, it is certainly worth recounting. “As a live-donor organ recipient, I know how fortunate I am that I received my life-saving kidney,” says Balch, who owes her good health to her friend of 35 years. Indeed, if Natal’s kidney hadn’t worked out and Balch was unable to find another match, she more than likely would have been put on dialysis until she found another live donor, or possibly sought out a cadaver kidney.

Not everyone in her circumstance is so lucky. According to the National Kidney Foundation (https://www.kidney.org/), more than 120,000 people are waiting for an organ transplant, with about 3,000 new patients added each month. Sadly, about 1,000 people a year with kidney disease die while waiting for a live donor.

Like a lot of people with kidney issues, Balch’s so-called PKD, or Polycystic Kidney Disease, is hereditary. Her grandfather on her mom’s side contracted it and died from it in the 1950s. Her mom, one of four children, inherited the disease, and had a cadaver kidney transplant performed in the 1990s and lived another 20 years. Balch, an only child, knew what to expect as she was growing up.

In 1988, during a routine medical exam “hundreds if not thousands of cysts” were discovered on her kidneys. Balch immediately “went on blood pressure drugs and a low sodium diet.” She said her affliction “progressed at a normal rate” until around 2018 when she “reached the magic number” for potential transplants when her GFR, or Glomerular Filtration Rate, sunk below 20.

GFR is a blood test that checks how well your kidneys are working. Your kidneys have tiny filters called glomeruli. These filters help remove waste and excess fluid from the blood. A GFR test estimates how much blood passes through these filters each minute. A normal rate is between 90 and 120 per minute. The higher the number, the better. Before deciding on surgery, Balch’s GFR was around 12.

It was at this juncture that her Nephrologist (a doctor who treats kidney disease) at Scripps Green in San Diego encouraged her to begin telling her story and looking for a potential donor. “It took me three months to write my story,” she recalls. “I had a lot of fear of the unknown: am I going to find a match? Will (the surgery) be successful?” and so on.

“Anyone who was (or is interested) in being a donor has to apply because of the HIPPA (the Health Insurance Portability and Accountability Act of 1996) laws,” Balch explains. “If you have cancer, mental illness, depression (or other conditions), you’ll be kicked off” of the testing protocols.

“To a recipient they say, ‘don’t get your hopes up,’” she says. “To (potential) donors, they say ‘you’re in the driver’s seat.’” Donors can back out at any time.

Unbeknownst to Balch, Natal put her name in as a potential donor in the summer of 2019. That fall she surprised her friend by showing up at Balch’s father’s memorial service in San Diego, and telling her “she was a match. … I was thrilled,” Balch recalls. “It was a very emotional thing. … Audrey is like a sister to me (the two attended UC San Diego together). I’ve known her half my life. … (She) was checked inside and out, and so was I.”

Another lifelong friend of Balch’s Kelly Arnett placed herself in the so-called kidney “chain of life,” a position where someone says they are willing to donate a kidney. “Even if someone is not a perfect match,” says Balch, “they can still test and potentially donate a kidney to someone they don’t even know and create the potential ‘chain of life.’ This is the part of my story that I think is so important.”

Balch says that if Natal’s kidney hadn’t worked out for some reason, “Kelly’s donated kidney would have (at least) helped me move up the list.”

The transplant occurred on Feb. 24, 2020, just weeks prior to the Covid-19 Pandemic spreading across the world and impacting hospitals, surgeries and all phases of life. Natal, who now lives in the Dallas area, had to arrive at Scripps Green two weeks prior to the procedure to undergo preparation. “You just hold your breath,” Balch recalls of that tenuous time, not wanting anything to go wrong, “’cause life’s so fragile.”

“I knew from our college days that Susie would need a kidney someday,” says the 55-year-old Natal. “We didn’t talk about it all the time, but it was in the back of our minds. … I couldn’t imagine life without her, so if I could do something, I wanted to.”

The delicate surgery, which involved removing one of Natal’s kidneys and transplanting it into the right groin of Balch, went off, seemingly, without a hitch. The operation took place on a Monday and Natal – originally from San Diego – went to her mom’s home nearby on Thursday to further recuperate. Balch, who still has her own non-functioning kidneys in place, went home on that Friday and was walking her dog on Torrey Pines Beach the following week.

“I knew they (Scripps) wouldn’t select me if I couldn’t live a quality life,” says Natal, who has had no setbacks since the transplant. “I know it doesn’t always go so smoothly (for all donors), but I never think on a daily basis that I have (just) one kidney.”

Balch, meanwhile, began taking anti-rejection medications three weeks prior to the surgery and has been taking them ever since. “They don’t want that kidney to reject,” she says. Balch had one “blip on the screen” about a year after the transplant when she felt some major discomfort. “We thought it was a rejection, but they think it was just inflammation.”

She and Natal are both pretty active, and last summer decided to enter the Transplant Games of America (https://www.transplantgamesofamerica.org/), held in San Diego, where thousands of people with various transplant experiences gather to play a wide of assortment of fun games and activities. The two friends were part of the Pacific Northwest contingent and each medaled – Balch nabbing a gold in Corn Hole and a bronze in pickleball and Natal earning a gold in pickleball.

“It was amazing to see all these people who were given a second chance,” Natal recalls, and “seeing how active they were.” Being a kidney donor “doesn’t change your quality of life,” she notes, “but it can change the quality of life of someone who gets one.”

The reality of Balch’s good fortune occurred to her recently during a check-up with her Nephrologist at the UW Medical Center. “I got weepy sitting in the waiting room and looking around,” she says. “There (were) people there in wheelchairs, (and) on oxygen (who) were maybe waiting for a kidney or maybe had a transplant that was rejected. … And, here I am sitting there healthy as a horse. It really puts in in perspective.”

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