BAINBRIDGE -- Kim Johnston of Bainbridge will often go months at a time without hearing from her younger half-brother David Buranich, who lives in California.
But whether she hears from him or not, Johnston knows there is a piece of her that is always with her brother -- quite literally.
On March 23, 2003, Johnston traveled to California to donate a kidney to her brother, who was diagnosed in 1992 at the age of 14 with membranoproliferative glomerulonephritis type II (also knows as dense deposit disease).
The disease, which mainly affects children and young adults, is rare. It affects the glomeruli, the tiny filtering mechanism in the kidney.
According to information at aolhealth.com, when a person has dense deposit disease, deposits of material spread through the membranes of the kidney, leading to a thickening of the capillary walls in the glomeruli. This disrupts kidney function and causes the patient to have altered levels of some blood proteins related to the immune system. Blood and proteins may also be present in the urine of patients with the disease.
The damage the disease causes is progressive, and in most cases the end result is kidney failure. Most patients with dense deposit disease end up on dialysis or undergo kidney transplants.
The reason Buranich went to the doctor for testing was that he "had a twitch," Johnston said. He was diagnosed with Tourette's syndrome in addition to the kidney disease.
Johnston and her brother grew up together and were living in Ohio with their mother, Joanie Mountford, when Buranich was diagnosed. The illness took its toll on the family.
"(Buranich) got real depressed and down," Johnston said. "He loved milk -- he could drink a gallon a day -- and he was told he could only have a half-cup a day. He ran track, and he had to quit."
Then behavior problems began.
"Davey started acting out," Johnston, a soft-spoken woman, said. "He went to live with his dad in California when he was 16."
The doctor told Mountford that her son's disease was "like a casebook study."
"I remember asking why we couldn't do a kidney transplant right away," Mountford said. "He told me that as of that date there was no cure for the disease and that even if (Buranich) had a transplant it would come back because the disease is caused by the blood, not the kidney -- so (Buranich) would have to live with the same kidney as long as possible."
Buranich did better in California. His disease progressed, as he and his family had been told it would, and eventually it happened that Buranich needed a new kidney.
By that time, Buranich was in his early 20s and had been undergoing dialysis treatments three times a week for two years.
"There was no question that I was going to donate my kidney for my brother if I could," Johnston said simply. "When he was diagnosed I told him and my mom that when the time came, I would do it."
Johnston, who had been living in Bainbridge since 1994, was determined in 2002 to be a match for her brother. For the next year, she underwent testing and counseling in preparation for the transplant.
Johnston, her husband Tom and their two daughters, who were both preteens at the time, discussed at length Johnston's decision to be a kidney donor for her brother.
"My kids thought it was nice of me to do that for my brother," Johnston said.
Extended family members had varied opinions.
"Some were mad that I did it, some were grateful," Johnston said.
The operation took place in Riverside, Calif. Johnston's part, which was performed laparoscopically, took about four hours.
"It wasn't bad," she said. "I was up walking an hour later. I was only in the hospital for a day."
Johnston's brother was in the hospital for a week, and she and her husband stayed in California until Buranich was released.
Even though they don't speak often, Johnston still feels close to her brother and is glad she did what she could to improve his quality of life.
"I said from the beginning I was going to do it, and I wasn't going to back down," she said.
One possibility with dense deposit disease, since it originates in the blood, is that it can recur.
"They told my mom that the disease could still be in my brother's system, and that it could take the kidney I gave him," Johnston said. "But so far, everything's gone smoothly."
Since the transplant, Buranich has gotten married and become a father. His color has improved, Johnston said, and he has gained weight.
Johnston hasn't had any ill effects, either. She has her kidney function checked once a year, and so far has been fine.
The last time Johnston heard from her little brother was in June.
"I didn't even really talk to him," she said. "He left a message on my answering machine wishing me a happy birthday."
Still, when she does hear from her brother, Johnston is happy to know that he's doing well -- and that she had a hand in making that happen.
"I know it's just not in his nature to keep in touch," she said with a smile. "He doesn't like talking on the phone much, and neither do I. But that's OK."
Johnston said she has never regretted her decision, and she encourages anyone who can help a family member in a similar way to do so.
"If you're able to handle it, it gives your family member more life to spend with you," she said. "It's also nice to know that you did what you could to help somebody."