Arlene Busher (left), kidney donor, and longtime friend Bobbi Crawford, kidney recipient, hug just over three months after a kidney transplant operation.  Photo by Marshall Smith
Arlene Busher (left), kidney donor, and longtime friend Bobbi Crawford, kidney recipient, hug just over three months after a kidney transplant operation.
Photo by Marshall Smith

Idyllwild resident Bobbi Crawford needed a kidney. Hers were failing and she was rapidly losing kidney function. She began home dialysis in 2011. This meant she was connected to an in-home dialysis machine for seven hours, seven nights a week, in a room that had to be as sterile and pollutant-free as possible.

She had known she would eventually have to make a decision regarding kidney donation, either from a friend or relative who would be a donor match or from a cadaver bank since the dialysis process would only sustain her for so long.

When longtime friend Arlene Busher suggested she would donate the kidney, Crawford balked. “We had known this day was coming for the last eight years,” said Busher.

But Crawford was uncertain, feeling the gift too great to accept. “At the time she suggested it, it was just too hard for me to deal with the concept,” said Crawford.

Busher said they just began talking about the process, making it more familiar to each of them. They talked, they researched and they talked more. Their connection, as friends facing a challenge, was further tested during the Mountain Fire evacuation in July 2013. Crawford her husband and all her dialysis equipment, including the cycler machine that performed the kidney cleansing, left the Hill to go with Busher to her son’s home for the duration of the evacuation. That shared experience deepened their bond.

Finally, in October 2013, Crawford agreed. “I’m going to do it,” she remembered telling Busher. By that time, Crawford’s kidney function was down to 10-percent. Without a kidney donor, her long-term survival prospects were limited. Kidneys from live donors improve lifespan prognoses significantly over kidneys from cadavers. Plus, the waiting list for cadaver kidneys is long, always growing longer and sometimes does not yield a kidney in time.

Kidney-transplant surgery, pioneered more than 51 years ago, has gone from being a medical miracle to relatively commonplace. Although the surgery may have become commonplace, the availability of kidneys for transplant continues to be far less than needed to prevent high mortality from renal failure.

According to the National Kidney Foundation, as of May 2014, 100,602 people are awaiting kidney transplants. Last year, 14,000 kidney transplant operations took place in the U.S. and of these, 9,300 came from deceased donors and 4,700 from live donors. Nearly 2,500 new patients are added to the kidney waiting list each month. Fourteen people die each day while waiting for a life-saving kidney transplant. Last year, 3,381 people died because there were no kidneys available for them.

These facts, known to both Arlene and Bobbi, made the gift and its acceptance even more extraordinary — a gift of life from friend to friend that greatly improved the donee’s chance to live a long and satisfying life. A gift of this magnitude is almost unquantifiable in value. And it was the enormity of the gift, and the potential risks to the donor, that caused Crawford to hesitate before accepting Busher’s offer.

Busher said she had to confer with all her family members, including her grandchildren, before making the offer. And Crawford, asked why she finally agreed to Busher’s offer, said, “It’s because she pushed.”

“Once we started the road to the operation, it was all about scheduling,” said Busher. Tests, consultations, literature to read, more tests to take. “I could have backed out at any moment, including once on the operating table,” said Busher. And it was that fact that allowed Crawford to feel comfortable with her friend’s process. “I felt very secure with that,” she said. Busher had to drink more water daily and stop all medications and any alcohol consumption six weeks prior to the operation.

The two friends discussed what it was like the day of the operation. “She had her team, and I had mine,” said Busher, whose four-hour operation took place before Crawford’s. “They had to make sure I was all sewed up and in recovery before they moved on to Bobbi,” she said. Crawford’s operation ran about five hours and followed immediately after Busher’s. Hers lasted longer because doctors had to ensure the kidney was fully functioning and not showing signs of rejection.

But it was in recovery that the difference in their two operations could be noted, remembered Busher. “She was sitting up and eating and her color was great,” said Busher. “I was still in a lot of pain.”

Said Crawford, “I immediately felt so much better when I came out of the anesthetic, so much better. It was because I now had my kidneys functioning 24 hours a day rather than the seven hours a night when they were on the cycling machine as part of the in-home dialysis.”

“We wanted other people to know how important this process can be and to know that, for the donor, it is an important decision, not without risk, but one that yields such huge rewards,” said Busher. And smiling at her smiling and now-far-healthier friend, it was clear how important this had all been to them both.

“This is the most valuable gift of my life,” said Crawford. “And it shows how important it is to consider donating.” Crawford pointed out she now has three kidneys and that removing the diseased kidney carries its own risks. While her diseased kidney remains, it was disconnected from the renal system when the new kidney was transplanted.

Busher’s insurance covered nothing for this voluntary surgical procedure, but Crawford’s covered not only her $250,000 cost but the cost for Busher’s surgery as well. Busher’s test costs, to determine her compatibility as a donor for Crawford, were paid by the Kidney Acquisition Cost Center, which is Medicare-funded.

Friend Myla Davis, local physician’s assistant, noted how important it is to have support for those who give and for those who receive. “Consider registering to donate,” she suggested.

Crawford’s and Busher’s operations were performed at the Loma Linda University Medical Center. For information about kidney transplants and donations, see or Google kidney transplant surgery.